Resources Repository
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ArticlePublication 2022Comparative Health Systems Analysis of Differences in Catastrophic Health Expenditure
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications …
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications for health system performance in the area of financial risk protection, as measured by catastrophic health expenditure (CHE). This article compares non-communicable diseases catastrophic health expenditure to the CHE cases caused by communicable diseases across health systems to examine whether: (1) disease burden and catastrophic health expenditure are linked, (2) Catastrophic health expenditures secondary to NCDs disproportionately affect wealthier households and (3) whether the drivers…
Evidence Synthesis | Costing Methods | Global | Health Systems | Infectious Diseases | Cost-Effectiveness Analysis | Chronic Disease/Risk | Economics/Finance | Health/Medicine -
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…
Evidence Synthesis | Microsimulation | Health Outcomes | Global | Health Systems | Calibration/Validation | Maternal/Reproductive Health | Clinical Care | Health/Medicine -
ArticlePublication 2017Estimating the Fitness Cost and Benefit of Cefixime Resistance in Neisseria Gonorrhoeae
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more …
Gonorrhoea is one of the most common bacterial sexually transmitted infections in England, and more than half of annual infections occur in men who have sex with men (MSM). As the bacterium has developed resistance to each first-line antibiotic in turn, an improved understanding is needed of fitness benefits and costs of antibiotic resistance to inform control policy and planning. The authors developed a stochastic compartmental model representing the natural history and transmission of cefixime-sensitive…
Decision Analysis | Global | Policy/Regulation | Health Systems | Infectious Diseases | Dynamic Transmission | Risk Analysis | Government/Law | Health/Medicine | Science/Technology -
ArticlePublication 2023Simulation-Based Comparative Effectiveness Analysis of Policies to Improve Global Maternal Health Outcomes
The Sustainable Development Goals include a target to reduce the global maternal mortality ratio (MMR) …
The Sustainable Development Goals include a target to reduce the global maternal mortality ratio (MMR) to less than 70 maternal deaths per 100,000 live births by 2030, with no individual country exceeding 140. However, on current trends the goals are unlikely to be met. The authors used an empirically calibrated Global Maternal Health microsimulation model, which simulates individual women in 200 countries and territories to evaluate the impact of different interventions and strategies from 2022…
Microsimulation | Health Outcomes | Global | Health Systems | Mathematical Models | Calibration/Validation | 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.
Health Outcomes | Global | Policy/Regulation | Infectious Diseases | Maternal/Reproductive Health | Health/Medicine -
ArticlePublication 2021COVID-19 Mortality and Self-Imposed Behavior Change/Government Regulations
Countries have adopted different approaches, at different times, to reduce the transmission of COVID-19. Cross-country …
Countries have adopted different approaches, at different times, to reduce the transmission of COVID-19. Cross-country comparison could indicate the relative efficacy of these approaches. This article assesses various nonpharmaceutical interventions, comparing the effects of voluntary behavior change and of changes enforced via official regulations, by examining their impacts on subsequent death rates. Voluntarily reduced mobility, occurring prior to government policies, decreases the percent change in deaths per day by 9.2% (95% confidence interval [CI] 4.5–14.0).…
Health Outcomes | Global | Policy/Regulation | Infectious Diseases -
ArticlePublication 2021New Microsimulation Models to Inform Cervical Cancer Control
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis …
Health decision models consider the lifetime natural history of human papillomavirus (HPV) infection and pathogenesis of cervical cancer, and estimate the long-term impact of preventive interventions. We propose a new health decision modeling framework that de-emphasizes previously used cytologic-colposcopic-histologic diagnoses, which are subjective and lack reproducibility, relying instead on HPV type and duration of infection as the major determinants of model transition probabilities. We posit that new model health states and corollary transitions are universal,…
Microsimulation | Decision Analysis | Global | Infectious Diseases | Mathematical Models | Calibration/Validation | Cost-Effectiveness Analysis -
ArticlePublication 2019Estimating the Total Incidence of Global Childhood Cancer: A Simulation-Based Analysis
This study describes the development of a microsimulation model to simulate childhood cancer incidence for …
This study describes the development of a microsimulation model to simulate childhood cancer incidence for 200 countries/territories, taking into account trends in population growth and urbanicity, geographical variation in cancer incidence, and health system barriers to access and referral that contribute to underdiagnosis. The model was calibrated to publicly available cancer registry data, and the total incidence of childhood cancer (diagnosed and undiagnosed) was estimated for each country in 2015 and projections made to 2030.…
Microsimulation | Health Outcomes | Global | Health Systems | Child/Nutrition | Chronic Disease/Risk -
ArticlePublication 2020Impact of Treatment and Imaging Modalities on 5-Year Net Survival of 11 Cancers in 200 Countries
This analysis describes the development of a microsimulation model of stage-specific cancer survival in 200 …
This analysis describes the development of a microsimulation model of stage-specific cancer survival in 200 countries/territories for 11 cancers (oesophagus, stomach, colon, rectum, anus, liver, pancreas, lung, breast, cervix uteri, and prostate). The paper estimated current 5-year net survival for diagnosed cancers in each country and potential survival gains from increasing the availability of individual treatment and imaging modalities, and more comprehensive packages of scale-up. Global 5-year net survival for all 11 cancers (combined) is…
Microsimulation | Health Outcomes | Global | Health Systems | Priority Setting/Ethics | Calibration/Validation | Chronic Disease/Risk