Resources Repository
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ArticlePublication 2016Departures from Cost-Effectiveness Recommendations: Health System Constraints
Cost-effectiveness analysis assumes a single constraint, in the form of the budget constraint, whereas in reality …
Cost-effectiveness analysis assumes a single constraint, in the form of the budget constraint, whereas in reality decision makers may be faced with numerous other constraints. The objective of this article is to develop a typology of constraints that may act as barriers to implementation of cost-effectiveness recommendations. Six categories of constraints are considered: the design of the health system; costs of implementing change; system interactions between interventions; uncertainty in estimates of costs and benefits; weak governance;…
Cost-Effectiveness Analysis | Health/Medicine | Education/Labor | Sub-Saharan Africa | Policy/Regulation | Health Systems | Priority Setting/Ethics | Economics/Finance | Government/Law | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2015Salt Reduction Policy in South Africa: Extended Cost-Effectiveness Analysis
This paper is an extended cost-effectiveness analysis to model the potential health and economic impacts of …
This paper is an extended cost-effectiveness analysis to model the potential health and economic impacts of a salt reduction policy in South Africa. The authors used surveys and epidemiologic studies to estimate reductions in CVD resulting from lower salt intake. They calculated the average out-of-pocket (OOP) cost of CVD care and estimated the reduction in OOP expenditures and government subsidies due to the policy. They also estimated the costs of policy implementation and financial risk protection (FRP) benefits. The…
Cost-Effectiveness Analysis | Food/Agriculture | Health/Medicine | Sub-Saharan Africa | Policy/Regulation | Health Systems | Priority Setting/Ethics | Costing Methods | Chronic Disease/Risk | Economics/Finance -
ArticlePublication 2019Country Contextualization of Cost-Effectiveness Studies
This article, published in BMJ Global Health, provides experiences of country contextualization of WHO-CHOICE methods …
This article, published in BMJ Global Health, provides experiences of country contextualization of WHO-CHOICE methods and models to a country level. Results from three contextualized cost-effectiveness analyses (CEAs) are presented, and the authors discuss how this evidence can inform priority setting in Ethiopia. This method of contextualized CEAs requires inclusion of national analysts and use of country-specific inputs for either costs, epidemiology, demography, baseline coverage or effects. Rank ordering of interventions by incremental cost-effectiveness ratios…
Cost-Effectiveness Analysis | Health/Medicine | Sub-Saharan Africa | Policy/Regulation | Health Systems | Clinical Care -
ArticlePublication 2017Designing an Optimal HIV Programme for South Africa
This 2017 study compares the traditional and a novel method of comparing cost-effectiveness interventions in …
This 2017 study compares the traditional and a novel method of comparing cost-effectiveness interventions in the context of HIV in South Africa, using a modeling approach. The authors argue that the assumptions of a) independence of interventions, and b) linear scale-up effects do not hold because South Africa has a large domestically funded HIV program with highly saturated coverage levels. The authors therefore aim to better allocate resources for HIV interventions in South Africa when…
Operations Research | Cost-Effectiveness Analysis | Health/Medicine | Sub-Saharan Africa | Health Systems | Priority Setting/Ethics | Mathematical Models | Infectious Diseases | Economics/Finance -
ArticlePublication 2016Maternal-Related Deaths and Impoverishment among Adolescent Girls in India and Niger
This article, published in BMJ Open, examined the distribution of maternal deaths and impoverishment among …
This article, published in BMJ Open, examined the distribution of maternal deaths and impoverishment among adolescent girls across socioeconomic groups in Niger and India, which have the largest fertility rate, and number of maternal deaths, respectively. Results showed that in Niger and India, the poorer adolescents had a larger number of maternal deaths compared to the richer. Impoverishment occurred mostly among the richer adolescents in Niger and among the poorer adolescents in India. Increasing educational…
Cost-Effectiveness Analysis | Health/Medicine | Education/Labor | Sub-Saharan Africa | Health Systems | Priority Setting/Ethics | Costing Methods | Health Outcomes | Mathematical Models | Maternal/Reproductive Health | Social Determinants | Economics/Finance | Asia & Pacific -
ArticlePublication 2015Health Gains & Financial Risk Protection by Public Financing in Ethiopia: An ECEA
This article, published in the Lancet Global Health, aims to evaluate the health and financial …
This article, published in the Lancet Global Health, aims to evaluate the health and financial risk protection benefits of selected interventions that could be publicly financed by the government of Ethiopia. The authors used an extended cost-effectiveness analysis (ECEA) to assess the health gains (deaths averted) and financial risk protection afforded (cases of poverty averted) by a bundle of nine interventions that the Government of Ethiopia aims to make universally available. This approach incorporates financial…
Cost-Effectiveness Analysis | Health/Medicine | Sub-Saharan Africa | Policy/Regulation | Health Systems | Priority Setting/Ethics | Mathematical Models | Infectious Diseases | Maternal/Reproductive Health | Child/Nutrition | Chronic Disease/Risk -
ArticlePublication 2012Health and Economic Outcomes of Interventions to Reduce Pregnancy-Related Mortality in Nigeria
This paper examines the cost-effectiveness and impact of individual and integrated packages of interventions aimed …
This paper examines the cost-effectiveness and impact of individual and integrated packages of interventions aimed to reduce maternal mortality in Nigeria, a country with extremely high maternal mortality rates. Using a previously validated model adapted to the Nigerian context, the study finds that an increase of access to family planning is the most effective individual strategy, which not only reduces pregnancy-related mortality but also proves to be economically efficient. However, relying solely on family planning…
Cost-Effectiveness Analysis | Health/Medicine | Sub-Saharan Africa | Policy/Regulation | Health Systems | Health Outcomes | State-Transition | Maternal/Reproductive Health | Economics/Finance -
ArticlePublication 2024Extended Cost-Effectiveness Analysis of Interventions to Improve Uptake of Diabetes Services in South Africa
This study examines the potential impact of a conditional cash transfer (CCT) program on diabetes …
This study examines the potential impact of a conditional cash transfer (CCT) program on diabetes diagnosis and treatment service utilization in South Africa (SA) using extended cost-effectiveness analysis (ECEA). Applying a Markov model over a 45-year period, the analysis compares costs, health benefits, and financial risk protection (FRP) attributes of different CCT strategies, drawing from SA-specific data. Three scenarios were simulated: covering diagnosis services only, treatment services only, and both diagnosis and treatment services. Cost-effectiveness,…
Cost-Effectiveness Analysis | Health/Medicine | Sub-Saharan Africa | Policy/Regulation | Health Outcomes | Mathematical Models | Chronic Disease/Risk -
ArticlePublication 2023Effects of Public Financing of Essential Maternal and Child Health Interventions Across Wealth Quintiles in Nigeria: An Extended Cost-Effectiveness Analysis
This study evaluates the potential health and financial risk protection benefits of public financing for …
This study evaluates the potential health and financial risk protection benefits of public financing for maternal, newborn, and child health (MNCH) interventions in Nigeria, focusing on different wealth quintiles. Employing extended cost-effectiveness analysis, the research assesses the impact of a policy ensuring zero out-of-pocket costs for 18 essential MNCH services. Three scenarios were modeled: status quo, uniform scale-up, and pro-poor scale-up. Findings suggest that a 5% increase in coverage for all quintiles could prevent significant…
Cost-Effectiveness Analysis | Health/Medicine | Sub-Saharan Africa | Policy/Regulation | Health Outcomes | Mathematical Models | Maternal/Reproductive Health