Resources Repository
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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 | Policy/Regulation | Maternal/Reproductive Health | Health Outcomes | Infectious Diseases | Health/Medicine -
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…
Global | Maternal/Reproductive Health | Health Outcomes | Mathematical Models | Microsimulation | Calibration/Validation | Health Systems | Clinical Care | 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…
Global | Maternal/Reproductive Health | Health Outcomes | Evidence Synthesis | Microsimulation | Calibration/Validation | Health Systems | Clinical Care | Health/Medicine -
ArticlePublication 2010Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis
This article, published in PLoS Medicine, conducted a cost-effectiveness analysis of strategies to improve pregnancy …
This article, published in PLoS Medicine, conducted a cost-effectiveness analysis of strategies to improve pregnancy and childbirth safety in India. Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy and pregnancy-associated complications in individual women, and considers delivery location, attendant, and facility level. Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged…
Global | Maternal/Reproductive Health | Evidence Synthesis | Mathematical Models | Microsimulation | Cost-Effectiveness Analysis | Economics/Finance | Health/Medicine | Asia & Pacific -
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 | Policy/Regulation | Cost-Effectiveness Analysis | Health Systems | Economics/Finance | Health/Medicine -
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…
Global | Policy/Regulation | Priority Setting/Ethics -
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).…
Global | Policy/Regulation | Health Outcomes | Infectious Diseases -
ArticlePublication 2022COVID-19 Response: The Need for Economic Evaluation
COVID-19-related policies are fraught with trade-offs. Many of these trade-offs involve dimensions that can be …
COVID-19-related policies are fraught with trade-offs. Many of these trade-offs involve dimensions that can be quantitatively weighed using economic evaluation, such as those between health and cost outcomes. Other types of dimensions, such as those involving equity or autonomy, can be harder to quantify but should be considered in a comprehensive health policy decision-making context nonetheless. The authors of this New England Journal of Medicine Perspectives article outline how methods of economic evaluation and decision…
Global | Policy/Regulation | Priority Setting/Ethics | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Infectious Diseases | Economics/Finance | Health/Medicine | North America -
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…
Global | Maternal/Reproductive Health | Health Outcomes | Mathematical Models | Cost-Effectiveness Analysis | Child/Nutrition | Clinical Care | Sub-Saharan Africa | Asia & Pacific