Resources Repository
-
Working PaperPublication 2024Economic Evaluation Primer
Economic evaluation is a powerful tool, encouraging the systematic collection and assessment of the evidence …
Economic evaluation is a powerful tool, encouraging the systematic collection and assessment of the evidence needed to support sound policy decisions. In low- and middle-income countries, where resources are especially scarce and needs are very great, such decisions are exceptionally difficult. In these settings, economic evaluation can be particularly useful in determining how to best improve health and welfare. Typically, cost-effectiveness analysis (CEA) is used to prioritize interventions within the health care sector. This approach…
Costing Methods | Health Outcomes | Global | Policy/Regulation | Priority Setting/Ethics | Benefit-Cost Analysis | Cost-Effectiveness Analysis -
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 | Health Outcomes | Global | Clinical Care | Microsimulation | Calibration/Validation | Maternal/Reproductive Health | Health Systems | Health/Medicine -
Working PaperPublication 2018Valuing Nonfatal Health Risk Reductions
This paper explores approaches for valuing nonfatal risk reductions associated with policy choices in low- …
This paper explores approaches for valuing nonfatal risk reductions associated with policy choices in low- and middle-income countries. The approach for valuation ideally would be based on estimates of individuals’ willingness to pay for changes in their own risks. However, high quality valuation research is not available for many nonfatal conditions even in high-income settings. Typically, two approaches are used either alone or in combination as rough proxies. The first involves applying an estimate of…
Decision Analysis | Health Outcomes | Global | Policy/Regulation | Preferences/Values | Priority Setting/Ethics | Benefit-Cost Analysis | Social Determinants | Economics/Finance | Health/Medicine | Critical Thinking/Analysis -
ArticlePublication 2017Costing of National STI Program Implementation, 2016-2021
In 2016 the World Health Assembly adopted the Global Strategy on Sexually Transmitted Infections (STI) …
In 2016 the World Health Assembly adopted the Global Strategy on Sexually Transmitted Infections (STI) 2016–2021 aiming to reduce curable STIs by 90% by 2030. This analysis costed scaling-up priority interventions to achieve coverage targets. Strategy-targeted declines in Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Trichomonas vaginalis were applied to WHO-estimated regional burdens at 2012 levels. Case management was costed for the curable STIs, symptomatic Herpes Simplex Virus 2 (HSV-2), and non-STI vaginal syndromes, with incrementally expanding diagnoses. Service…
Evidence Synthesis | Costing Methods | Global | Clinical Care | Infectious Diseases | Economics/Finance | 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 | Dynamic Transmission | Global | Policy/Regulation | Risk Analysis | Infectious Diseases | Health Systems | 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…
Health Outcomes | Global | Clinical Care | Mathematical Models | Microsimulation | Calibration/Validation | Maternal/Reproductive Health | Health Systems | 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 2022WHO ACTION-I Trial in Low Resource Countries
This study evaluated the cost-effectiveness of dexamethasone administration in dexamethasone in pregnant women at risk …
This study evaluated the cost-effectiveness of dexamethasone administration in dexamethasone in pregnant women at risk of early preterm birth using data from a multicentre, randomized, placebo-controlled trial in Bangladesh, India, Kenya, Nigeria, and Pakistan. Primary cost data were collected in 28 hospitals across the 5 countries. A decision tree model was used to compare dexamethasone treatment to no intervention from a health-care sector perspective. Administration of dexamethasone averted 38 neonatal deaths per 1000 woman–baby units…
Health Outcomes | Global | Clinical Care | Mathematical Models | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Child/Nutrition | Sub-Saharan Africa | Asia & Pacific