Resources Repository
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ArticlePublication 2014'Big Push' To Reduce Maternal Mortality in Uganda and Zambia
In the past decade, “big push” global health initiatives financed by international donors have aimed …
In the past decade, “big push” global health initiatives financed by international donors have aimed to rapidly reach ambitious health targets in low-income countries. The health system impacts of these efforts are infrequently assessed. Saving Mothers, Giving Life is a global public-private partnership that aims to reduce maternal mortality dramatically in one year in eight districts from Uganda and Zambia. The authors evaluate the first six to twelve months of the program’s implementation, its ownership…
Sub-Saharan Africa | Health Systems | Health Outcomes | Government/Law | Health/Medicine -
ArticlePublication 2014Rise and Fall of HIV in High-Prevalence Countries: A Challenge for Mathematical Modeling
Several countries with generalized, high-prevalence HIV epidemics, mostly in sub-Saharan Africa, have experienced rapid declines …
Several countries with generalized, high-prevalence HIV epidemics, mostly in sub-Saharan Africa, have experienced rapid declines in transmission. These HIV epidemics, often with rapid onsets, have generally been attributed to a combination of factors related to high-risk sexual behavior. The subsequent declines in these countries began prior to widespread therapy or implementation of any other major biomedical prevention. This change has been construed as evidence of behavior change, often on the basis of mathematical models, but…
Sub-Saharan Africa | Infectious Diseases | Health Outcomes | Mathematical Models | Health/Medicine -
ArticlePublication 2013Validation and Calibration of a Simulation Model of Pediatric HIV Infection
The authors developed a microsimulation model of pediatric HIV disease progression using the Cost-Effectiveness of …
The authors developed a microsimulation model of pediatric HIV disease progression using the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) model framework. This CEPAC-Pediatric model was then validated by varying CD4 data and comparing the corresponding model-generated survival curves to empirical survival curves obtained from the International Epidemiologic Database to Evaluate AIDS (IeDEA). The model was calibrated to other African countries by systematically varying immunologic and HIV mortality-related input parameters. In the calibration analyses, the model-generated…
Sub-Saharan Africa | Infectious Diseases | Microsimulation | Calibration/Validation | Child/Nutrition | Health/Medicine -
ArticlePublication 2013Estimated Mortality Impact of Vaccinations 2011–2020 in 73 GAVI Alliance Countries
From August to December 2011, a multidisciplinary group with expertise in mathematical modeling was constituted …
From August to December 2011, a multidisciplinary group with expertise in mathematical modeling was constituted by the GAVI Alliance and the Bill & Melinda Gates Foundation to estimate the impact of vaccination in 73 countries supported by the GAVI Alliance. The number of deaths averted in persons projected to be vaccinated during 2011–2020 was estimated for ten antigens: hepatitis B, yellow fever, Haemophilus influenzae type B (Hib), Streptococcus pneumoniae, rotavirus, Neisseria meningitidis serogroup A, Japanese…
Sub-Saharan Africa | Infectious Diseases | Health Outcomes | Mathematical Models | State-Transition | Dynamic Transmission | Microsimulation | Global Governance | Economics/Finance | Health/Medicine | Science/Technology | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2013Public Finance of Rotavirus Vaccination in India and Ethiopia: Extended CEA
This study uses extended cost-effectiveness analysis (ECEA) to evaluate a hypothetical publicly financed program for …
This study uses extended cost-effectiveness analysis (ECEA) to evaluate a hypothetical publicly financed program for rotavirus vaccination in India and Ethiopia. The authors measured program impact on: (1) averted rotavirus deaths; (2) reduction in household expenditures; (3) financial risk protection; and (4) distributional consequences across the country’s wealth strata. In India and Ethiopia, the program was predicted to decrease rotavirus deaths substantially, and effectively provide financial risk protection among the poor, while also reducing household…
Sub-Saharan Africa | Infectious Diseases | Priority Setting/Ethics | Health Outcomes | Cost-Effectiveness Analysis | Child/Nutrition | Social Determinants | Culture/Society | Economics/Finance | Health/Medicine | Asia & Pacific -
ArticlePublication 2011Health and Economic Impact of HPV 16/18 Vaccination and Cervical Cancer Screening in Eastern Africa
In this article the authors use epidemiologic data from Kenya, Mozambique, Tanzania, Uganda, and Zimbabwe …
In this article the authors use epidemiologic data from Kenya, Mozambique, Tanzania, Uganda, and Zimbabwe to develop models of HPV-related infection and disease. For each country, they assessed HPV vaccination of girls before age 12 followed by screening with HPV DNA testing once, twice, or three times per lifetime (at ages 35, 40, 45). For women over age 30, they assessed only screening (with HPV DNA testing up to three times per lifetime or VIA…
Sub-Saharan Africa | Infectious Diseases | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Economics/Finance | Health/Medicine | Science/Technology -
ArticlePublication 2010Health and Economic Impact of Rotavirus Vaccination in GAVI-Eligible Countries
Rotavirus infection is responsible for about 500,000 deaths annually, and the disease burden is disproportionately …
Rotavirus infection is responsible for about 500,000 deaths annually, and the disease burden is disproportionately borne by children in low-income countries. Motivated by the global recommendation by the WHO that all countries include infant rotavirus vaccination in their national immunization programs, the objective of this analysis was to provide information on the expected health, economic and financial consequences of rotavirus vaccines in the 72 GAVI support-eligible countries. The authors synthesized population-level data from various sources (primarily from…
Sub-Saharan Africa | Infectious Diseases | Health Outcomes | Mathematical Models | State-Transition | Cost-Effectiveness Analysis | Child/Nutrition | Economics/Finance | Health/Medicine | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2010Cost-Effectiveness of Alternative Pregnancy Termination Strategies in Nigeria and Ghana
To explore the policy implications of increasing access to safe abortion in Nigeria and Ghana, …
To explore the policy implications of increasing access to safe abortion in Nigeria and Ghana, the authors developed a computer-based decision analytic model which simulates induced abortion and its potential complications in a cohort of women. The model was used to compare the costs and benefits of unsafe abortion and three first-trimester abortion modalities: hospital-based dilatation and curettage, hospital- and clinic-based manual vacuum aspiration (MVA), and medical abortion using misoprostol (MA). The results showed that…
Sub-Saharan Africa | Maternal/Reproductive Health | State-Transition | Cost-Effectiveness Analysis | Culture/Society | Economics/Finance | Health/Medicine