Resources Repository
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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…
Priority Setting/Ethics | Policy/Regulation | Global -
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…
Priority Setting/Ethics | Microsimulation | Infectious Diseases | Sub-Saharan Africa -
ArticlePublication 2021Health Benefit Package Design
Policymakers face difficult choices over which health interventions to publicly finance. This article presents an …
Policymakers face difficult choices over which health interventions to publicly finance. This article presents an approach to health benefits package design that accommodates explicit tradeoffs between improvements in health and provision of financial risk protection. The authors designed a mathematical optimization model to balance gains in health and financial risk protection across candidate interventions when publicly financed. The optimal subset of interventions selected for inclusion was determined with bi-criterion integer programming conditional on a budget…
Priority Setting/Ethics | Mathematical Models | Global -
ArticlePublication 2022Out-of-Pocket Spending and Catastrophic Health Expenditures
Universal health coverage aims to provide access to health services for all without financial hardship. …
Universal health coverage aims to provide access to health services for all without financial hardship. Moving toward universal coverage while ensuring financial risk protection from out-of-pocket health expenditures is a critical objective of the Sustainable Development Goal for Health. In tracking country progress toward universal health coverage, analysts and policymakers usually report on two summary indicators of lack of financial risk protection: the prevalence of catastrophic health expenditures and the prevalence of impoverishing health expenditures.…
Priority Setting/Ethics | Global -
ArticlePublication 2021Incorporating Equity in Infectious Disease Modeling: Measles
Deterministic compartmental models of infectious diseases like measles typically reflect biological heterogeneities in the risk …
Deterministic compartmental models of infectious diseases like measles typically reflect biological heterogeneities in the risk of infection and severity to characterize transmission dynamics. Given the known association of socioeconomic status and increased vulnerability to infection and mortality, it is also critical that such models further incorporate social heterogeneities. This article explores the influence of integrating income-associated differences in parameters of traditional dynamic transmission models. The authors developed a measles “SIR” model, in which the
Priority Setting/Ethics | Dynamic Transmission -
ArticlePublication 2021Economic Value of Changing Mortality Risk
This article develops a framework for quantifying monetary values associated with changes in disease-specific mortality …
This article develops a framework for quantifying monetary values associated with changes in disease-specific mortality risk in low- and middle- income countries to help quantify trade-offs involved in investing in mortality reduction due to one disease versus another. For non-communicable diseases, the absolute monetary value associated with changing mortality risk was highest for cardiovascular diseases in older age groups. Changing the mortality rate from the base-case to the high-performance trajectory was associated with high monetary…
Priority Setting/Ethics | Global -
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…
Priority Setting/Ethics | Infectious Diseases | Global -
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…
Priority Setting/Ethics | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Infectious Diseases | Policy/Regulation | Economics/Finance | Health/Medicine | Global | North America -
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,…
Calibration/Validation | Mathematical Models | Microsimulation | Decision Analysis | Cost-Effectiveness Analysis | Infectious Diseases | Global