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;…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Education/Labor | Economics/Finance | Policy/Regulation | Health Systems | Government/Law | Health/Medicine | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
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…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Outcomes | Education/Labor | Economics/Finance | Health Systems | Costing Methods | Mathematical Models | Maternal/Reproductive Health | Social Determinants | Health/Medicine | Sub-Saharan Africa | Asia & Pacific -
ArticlePublication 2015Universal Public Finance of Tuberculosis Treatment in India: An Extended CEA
This paper evaluates the consequences of universal public finance (UPF) for tuberculosis treatment in India …
This paper evaluates the consequences of universal public finance (UPF) for tuberculosis treatment in India using extended cost-effectiveness analysis (ECEA). The authors evaluated the impact of UPF on health gains, financial consequences, and catastrophic health expenditures, and concluded that the health gains and insurance value of UPF would accrue mostly to the poor. However, reductions in out-of-pocket expenditures were found to be more uniformly distributed across income quintiles. A variant on the base case suggests…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Outcomes | Economics/Finance | Policy/Regulation | Health Systems | Costing Methods | Infectious Diseases | Social Determinants | Clinical Care | Health/Medicine | Asia & Pacific -
ArticlePublication 2015Extended Cost-Effectiveness Analysis of Treatment and Prevention of Diarrhoea in Ethiopia
This article, published in BMJ Open, aims to illustrate the size and distribution of benefits …
This article, published in BMJ Open, aims to illustrate the size and distribution of benefits due to the treatment and prevention of diarrhoea (i.e., rotavirus vaccination) in Ethiopia. The authors use an economic model to examine the impacts of universal public finance (UPF) of diarrhoeal treatment alone, as opposed to diarrhoeal treatment along with rotavirus vaccination using extended cost-effectiveness analysis (ECEA). The study finds that diarrhoeal treatment paired with rotavirus vaccination is more cost effective…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Outcomes | Climate/Environment | Economics/Finance | Health Systems | Costing Methods | Infectious Diseases | Child/Nutrition | Social Determinants | Environmental Health | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2017Household Energy Interventions in Haryana, India: An Extended CEA
In this paper, the authors examine the use of solid fuels as a primary energy …
In this paper, the authors examine the use of solid fuels as a primary energy source for cooking in India, which contributes to high rates of infant and child mortality as well as other diseases caused by household air pollution (HAP). To achieve the widespread adoption of one of three interventions – a mud chimney stove, a blower stove, and LPG use—the government needs to offer subsidies to households using solid fuels. While the reduction…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Climate/Environment | Economics/Finance | Policy/Regulation | Chronic Disease/Risk | Social Determinants | Environmental Health | Energy/Engineering | Science/Technology | Asia & Pacific -
ArticlePublication 2016Accounting for Technical, Ethical, and Political Factors in Priority Setting
This article investigates two cases of priority setting to explore how, in addition to technical …
This article investigates two cases of priority setting to explore how, in addition to technical considerations, ethical and political factors shape the allocation of health resources. First, they discuss how Thai authorities adjudicated a coverage decision for HLA-B*1502 screening, which meets the national cost-effectiveness threshold for only some of the conditions it can detect. Second, they consider England’s Cancer Drugs Fund to investigate the interplay of technical decision making and political reality. The findings suggest four concluding…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Climate/Environment | Policy/Regulation | Health Systems | Chronic Disease/Risk | Government/Law | Health/Medicine | Science/Technology | Global | Europe -
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…
Priority Setting/Ethics | Cost-Effectiveness Analysis | Economics/Finance | Policy/Regulation | Health Systems | Costing Methods | Chronic Disease/Risk | Food/Agriculture | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2013Health Benefits and Cost-Effectiveness of Strategies to Reduce Maternal Mortality in Afghanistan
This article, published in Health Policy and Planning, disaggregates data on pregnancies in Afghanistan to …
This article, published in Health Policy and Planning, disaggregates data on pregnancies in Afghanistan to evaluate health outcomes and cost-effectiveness of interventions related to childbirth. These interventions include antenatal care, family planning, skilled birth attendance, access to transport, referral facilities, and quality of overall care. Outcomes include pregnancy-related complications, maternal deaths, maternal mortality ratios, costs and cost-effectiveness ratios. The authors report that increasing family planning would be the most effective individual intervention. The model suggests…
Cost-Effectiveness Analysis | Health Outcomes | Economics/Finance | Policy/Regulation | Health Systems | State-Transition | Maternal/Reproductive Health | Health/Medicine | Asia & Pacific -
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 Outcomes | Economics/Finance | Policy/Regulation | Health Systems | State-Transition | Maternal/Reproductive Health | Health/Medicine | Sub-Saharan Africa