Resources Repository
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ArticlePublication 2023Simulation-Based Estimates and Projections of Global, Regional and Country-Level Maternal Mortality by Cause, 1990-2050
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given …
While progress has been made globally to reduce maternal deaths, measurement remains a challenge given the many causes and frequent underreporting of maternal deaths. The authors developed a structural microsimulation model of Global Maternal Health (GMatH) for 200 countries and territories using demographic, epidemiologic, clinical and health system data synthesized from the medical literature, Civil Registration Vital Statistics systems and Demographic and Health Survey data. The model was calibrated to empirical data from 1990 to…
Global | Health Systems | Health Outcomes | Evidence Synthesis | Microsimulation | Calibration/Validation | Maternal/Reproductive Health | Clinical Care | Health/Medicine -
ArticlePublication 2008Cost-Effectiveness of Rapid Point-of-Care Prenatal Syphilis Screening in Sub-Saharan Africa
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among …
This paper investigates the cost-effectiveness of using rapid point-of-care tests for prenatal syphilis screening among pregnant women in sub-Saharan Africa, a region with syphilis prevalence rates as high as 17%, and where traditional multi-test screening methods have been challenging to implement. Focusing on newly available rapid point-of-care screening tests, strategies differed by the initial test [rapid plasma reagin (RPR), immunochromographic strip (ICS)], need for confirmation with Treponema pallidum hemagglutination assay, and number of visits required.…
Sub-Saharan Africa | Infectious Diseases | Costing Methods | Test Performance | Mathematical Models | Cost-Effectiveness Analysis | Technology Assessment | Maternal/Reproductive Health | Clinical Care | Health/Medicine -
ArticlePublication 2023Single-Arm Trial Design Estimates Efficacy
Studies to confirm the efficacy of a single HPV vaccine dose, of vaccine durability, and …
Studies to confirm the efficacy of a single HPV vaccine dose, of vaccine durability, and of vaccination modifications are needed, but randomized controlled trials are costly and face logistical and ethical challenges. In this study, the authors demonstrate proof-of-principle that a single-arm design yields valid estimates with similar precision to a randomized controlled trial.
Global | Infectious Diseases | Health Outcomes | Maternal/Reproductive Health | Policy/Regulation | Health/Medicine -
ArticlePublication 2023Out-of-Pocket Expenditures & Financial Risks Associated with Treatment of Vaccine-Preventable Diseases in Ethiopia
This study investigates out-of-pocket (OOP) expenditures and associated catastrophic health expenditures (CHEs) for vaccine-preventable diseases …
This study investigates out-of-pocket (OOP) expenditures and associated catastrophic health expenditures (CHEs) for vaccine-preventable diseases (VPDs) in Ethiopia. Through a cross-sectional costing analysis, data on OOP direct medical and nonmedical expenditures were collected from 995 households in 54 health facilities nationwide. The study focuses on VPDs in children under 5 years for pneumonia, diarrhea, measles, and pertussis, and in children under 15 years for meningitis. Mean OOP expenditures per disease episode ranged from $5·6 to…
Sub-Saharan Africa | Child/Nutrition | Costing Methods | Mathematical Models | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health/Medicine -
ArticlePublication 2023Estimated Travel Time & Staffing Constraints to Accessing the Ethiopian Healthcare System: Two-Step Floating Catchment Area Analysis
This study investigates disparities in health care access across different income levels and geographic locations …
This study investigates disparities in health care access across different income levels and geographic locations in Ethiopia. Employing a two-step floating catchment area method, the research estimates variations in spatial access to health care and staffing levels at facilities. Average travel time from population centers is calculated and adjusted with provider-to-population ratios. Spearman's rank tests are applied to test hypotheses about the roles of travel time versus staffing in access variations. Results reveal regional disparities,…
Sub-Saharan Africa | Health Systems | Health/Medicine -
ArticlePublication 2023Cost-Effectiveness of Novel TB Vaccines: A Modeling Study
A modeling study assessed future costs, cost-savings, and cost-effectiveness of introducing novel tuberculosis (TB) vaccines …
A modeling study assessed future costs, cost-savings, and cost-effectiveness of introducing novel tuberculosis (TB) vaccines in 105 low- and middle-income countries (LMICs) for a range of product characteristics and delivery strategies, compared to a ‘no-new-vaccine’ counterfactual. Vaccine scenarios considered two vaccine product profiles (one targeted at infants, one at adolescents/adults), both assumed to prevent progression to active TB. Vaccine introduction was estimated to require substantial near-term resources, offset by future cost-savings from averted TB burden.…
Global | Infectious Diseases | Mathematical Models | Cost-Effectiveness Analysis | Economics/Finance | Health/Medicine -
ArticlePublication 2022Modeling the Relative Risk of Incidence and Mortality of Select Vaccine-Preventable Diseases
Immunization is one of the most effective public health interventions, saving millions of lives every …
Immunization is one of the most effective public health interventions, saving millions of lives every year. Ethiopia has seen gradual improvements in immunization coverage and access to child health care services; however, inequalities in child mortality across wealth quintiles and regions remain persistent. This paper models the relative distributional incidence and mortality of four vaccine-preventable diseases (VPDs) (rotavirus diarrhea, human papillomavirus, measles, and pneumonia) by wealth quintile and geographic region in Ethiopia. The authors approach…
Sub-Saharan Africa | Infectious Diseases | Priority Setting/Ethics | Evidence Synthesis | Social Determinants | Health/Medicine -
ArticlePublication 2022Conceptualizing Monetary Benchmarks for Health Investments toward Poverty Reduction
Public spending can improve population well-being, for example, by averting or reducing poverty. This article …
Public spending can improve population well-being, for example, by averting or reducing poverty. This article aims to conceptualize monetary benchmarks for health sector investments oriented towards poverty alleviation in low- and lower-middle-income countries. Priority setting in low- and lower-middle-income countries could be informed by health-sector PRBs (poverty reduction benchmarks), in addition to burden of disease and cost-effectiveness considerations. The computed PRBs, expressed in dollars per poverty case averted, can possibly be viewed in a manner…
Global | Health Systems | Priority Setting/Ethics | Evidence Synthesis | Social Determinants | Economics/Finance | Health/Medicine -
ArticlePublication 2022Economic Evaluations of Health System Strengthening Activities
Health system strengthening (HSS) activities should accompany disease-targeting interventions in low/middle-income countries (LMICs). Economic evaluations …
Health system strengthening (HSS) activities should accompany disease-targeting interventions in low/middle-income countries (LMICs). Economic evaluations provide information on how these types of investment might best be balanced but can be challenging. This paper conducted a systematic review to evaluate how researchers address these economic evaluation challenges. The authors searches produced 1978 studies, out of which they included 36. Most studies used data from prospective trials and calculated cost-effectiveness directly from these trial inputs, rather than…
Global | Health Systems | Cost-Effectiveness Analysis | Policy/Regulation | Economics/Finance | Health/Medicine