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…
Infectious Diseases | Costing Methods | Evidence Synthesis | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Global -
ArticlePublication 2021Toward Universal Health Coverage Post-COVID-19
During the COVID-19 pandemic and beyond, advancement toward universal health coverage will become more difficult …
During the COVID-19 pandemic and beyond, advancement toward universal health coverage will become more difficult for many countries, demonstrating that locally led priority setting is urgently needed to provide health services with appropriate financial protection to all. Resources are limited and no national constituency can provide an unlimited number of services to their whole population in a sustainable manner, so rationing and setting priorities for the selection of interventions to be included in a defined…
Policy/Regulation | Priority Setting/Ethics | Global -
ArticlePublication 2021Distributional Accounting Impact Model of Tobacco Taxation
As with other ‘sin taxes’, tobacco taxes are generally regarded as a highly cost-effective mechanism …
As with other ‘sin taxes’, tobacco taxes are generally regarded as a highly cost-effective mechanism to reduce consumption while also considered to be regressive. This dichotomy undermines efforts to fully implement tobacco taxes at levels recommended by the WHO due to concerns of fairness. This article demonstrates when there are circumstances in which the impacts of additional tobacco taxes are not regressive, using a standard income-share accounting definition of tax burden. The authors apply mathematical…
Policy/Regulation | Mathematical Models -
ArticlePublication 2021Health Gains and Financial Protection from HPV Vaccination
High out-of-pocket medical expenses for cervical cancer can lead to catastrophic health expenditures and medical …
High out-of-pocket medical expenses for cervical cancer can lead to catastrophic health expenditures and medical impoverishment in many low-resource settings. This article uses a static cohort model that captures the main features of HPV vaccines and population demographics to project health and economic outcomes associated with routine HPV vaccination in Ethiopia. The findings show that, assuming 100% vaccine efficacy against HPV-16/18 and 50% vaccination coverage, routine HPV vaccination could avert up to 970 000 cases…
Infectious Diseases | Priority Setting/Ethics | Microsimulation | Sub-Saharan Africa -
ArticlePublication 2020Distributional Impact of Supplementary Immunization Activities: Measles
Although evidence shows that inequalities in under-5 mortality in low- and middle-income countries are decreasing, …
Although evidence shows that inequalities in under-5 mortality in low- and middle-income countries are decreasing, disparities persist and highlight the need to prioritize inequality reduction and equity in decision-making at the global and national levels. This article studied the differential coverage impact of routine delivery versus supplementary immunization activities (e.g., campaigns) for the delivery of measles vaccine in defining and comparing an equity impact number across the two distinct vaccine delivery modes. The analysis can…
Infectious Diseases | Priority Setting/Ethics | Global -
ArticlePublication 2020Integrating Non-Communicable Disease and HIV Treatment in Uganda
Despite growing enthusiasm for integrating treatment of non-communicable diseases into human immunodeficiency virus (HIV) care …
Despite growing enthusiasm for integrating treatment of non-communicable diseases into human immunodeficiency virus (HIV) care and treatment services in sub-Saharan Africa, there is little evidence on the potential health and financial consequences of such integration. This article aims to study the cost-effectiveness of basic non-communicable disease-HIV integration in a Ugandan setting. The article presents an epidemiologic-cost model to analyze, from the provider perspective, the cost-effectiveness of integrating hypertension, diabetes mellitus and high cholesterol screening and…
Infectious Diseases | Cost-Effectiveness Analysis | Sub-Saharan Africa -
ArticlePublication 2022Spatial-Mechanistic Model to Estimate Sub-National Tuberculosis Burden in Brazilian Municipalities
Reliable subnational estimates of TB incidence are needed to focus disease control resources in areas …
Reliable subnational estimates of TB incidence are needed to focus disease control resources in areas of highest need. This study developed an approach for generating small area estimates of TB incidence, and the fraction of individuals missed by routine case detection, based on available notification and mortality data. The approach is demonstrated by estimating TB outcomes for 5568 municipalities in Brazil, revealing substantial subnational differences in disease burden and other metrics useful for designing high-impact…
Infectious Diseases | Health Outcomes | Mathematical Models | Health/Medicine | Latin America & Caribbean -
ArticlePublication 2022Re-Evaluating the Health Impact and Cost-Effectiveness of Tuberculosis Prevention for Modern ART Cohorts
TB preventive therapy (TPT) is widely accepted to be cost-effective for reducing TB incidence in …
TB preventive therapy (TPT) is widely accepted to be cost-effective for reducing TB incidence in HIV-infected individuals receiving antiretroviral therapy (ART). However, as individuals initiate ART earlier in the course of disease, TB incidence is lower, and it is unclear how ART cost-effectiveness has changed. This study assessed the cost-effectiveness of TPT in contemporary ART cohorts. The authors developed a microsimulation model of TB and HIV and parameterised it using data from a large HIV…
Infectious Diseases | Microsimulation | Cost-Effectiveness Analysis | Health/Medicine | Global | Sub-Saharan Africa -
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,…
Infectious Diseases | Mathematical Models | Microsimulation | Calibration/Validation | Decision Analysis | Cost-Effectiveness Analysis | Global