Resources Repository
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ArticlePublication 2016Assessing Medical Impoverishment by Cause
This article, published in BMC Medicine, utilizes a cost and epidemiological model to propose an …
This article, published in BMC Medicine, utilizes a cost and epidemiological model to propose an assessment of the burden of medical impoverishment in Ethiopia (i.e., the number of households crossing a poverty line due to out-of-pocket (OOP) direct medical expenses). Among 20 leading causes of mortality, the authors estimate the burden of medical impoverishment to be around 350,000 poverty cases, with the top three causes of medical impoverishment attributed to diarrhea, lower respiratory infections, and…
Costing Methods | Sub-Saharan Africa | Health Systems | Health/Medicine -
ArticlePublication 2016Prevention and Treatment of Cardiovascular Disease
This article, published in Cost Effectiveness and Resource Allocation, aims to assess the cost-effectiveness of …
This article, published in Cost Effectiveness and Resource Allocation, aims to assess the cost-effectiveness of prevention and treatment of ischemic heart disease (IHD) and stroke in an Ethiopian setting. Fifteen single interventions and sixteen intervention packages are assessed from a healthcare provider perspective. The results indicate that the escalating burden of CVD and its risk factors warrants timely action. Selected CVD intervention packages could be scaled up at a modest budget increase, but the level…
Cost-Effectiveness Analysis | Sub-Saharan Africa | Chronic Disease/Risk | Health Systems | Health/Medicine -
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 | Sub-Saharan Africa | Priority Setting/Ethics | Health Systems | Policy/Regulation | Economics/Finance | Education/Labor | Government/Law | Health/Medicine | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2015Expansion of Surgical Access in Rural Ethiopia: Extended Cost-Effectiveness Analysis
This article, published in Health Policy and Planning, utilizes an extended cost effectiveness analysis (ECEA) …
This article, published in Health Policy and Planning, utilizes an extended cost effectiveness analysis (ECEA) to examine how policies to expand access to surgery in rural Ethiopia would impact health, impoverishment, and equity. The study finds that health benefits, financial risk protection, and equity appear to be in tension in the expansion of access to surgical care. Health benefits from each of the examined policies accrue primarily among the poor, but without travel vouchers, many…
Cost-Effectiveness Analysis | Sub-Saharan Africa | Priority Setting/Ethics | Health Systems | Economics/Finance | Health/Medicine -
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 | Sub-Saharan Africa | Priority Setting/Ethics | Mathematical Models | Infectious Diseases | Maternal/Reproductive Health | Child/Nutrition | Chronic Disease/Risk | Health Systems | Policy/Regulation | Health/Medicine -
ArticlePublication 2015Health and Social Protection Effects of Measles Vaccination in Ethiopia: Extended CEA
Using extended cost-effectiveness analysis (ECEA), this paper evaluates the health and economic implications of different …
Using extended cost-effectiveness analysis (ECEA), this paper evaluates the health and economic implications of different vaccine delivery strategies in Ethiopia: (1) routine immunization, (2) routine immunization with financial incentives, and (3) mass campaigns, known as supplemental immunization activities (SIAs), for measles vaccination. At higher costs, SIAs reached higher levels of vaccine coverage. Routine immunization paired with financial incentives was found to increase the demand among poorer households.
Cost-Effectiveness Analysis | Sub-Saharan Africa | Priority Setting/Ethics | Infectious Diseases | Child/Nutrition | Social Determinants | Health Systems | Global Governance | Economics/Finance | Health/Medicine -
ArticlePublication 2014'Big Push' To Reduce Maternal Mortality in Uganda and Zambia
In the past decade, “big push” global health initiatives financed by international donors have aimed …
In the past decade, “big push” global health initiatives financed by international donors have aimed to rapidly reach ambitious health targets in low-income countries. The health system impacts of these efforts are infrequently assessed. Saving Mothers, Giving Life is a global public-private partnership that aims to reduce maternal mortality dramatically in one year in eight districts from Uganda and Zambia. The authors evaluate the first six to twelve months of the program’s implementation, its ownership…
Health Outcomes | Sub-Saharan Africa | Health Systems | Government/Law | Health/Medicine -
ArticlePublication 2014Rise and Fall of HIV in High-Prevalence Countries: A Challenge for Mathematical Modeling
Several countries with generalized, high-prevalence HIV epidemics, mostly in sub-Saharan Africa, have experienced rapid declines …
Several countries with generalized, high-prevalence HIV epidemics, mostly in sub-Saharan Africa, have experienced rapid declines in transmission. These HIV epidemics, often with rapid onsets, have generally been attributed to a combination of factors related to high-risk sexual behavior. The subsequent declines in these countries began prior to widespread therapy or implementation of any other major biomedical prevention. This change has been construed as evidence of behavior change, often on the basis of mathematical models, but…
Health Outcomes | Sub-Saharan Africa | Mathematical Models | Infectious Diseases | Health/Medicine -
ArticlePublication 2010Cost-Effectiveness of Alternative Pregnancy Termination Strategies in Nigeria and Ghana
To explore the policy implications of increasing access to safe abortion in Nigeria and Ghana, …
To explore the policy implications of increasing access to safe abortion in Nigeria and Ghana, the authors developed a computer-based decision analytic model which simulates induced abortion and its potential complications in a cohort of women. The model was used to compare the costs and benefits of unsafe abortion and three first-trimester abortion modalities: hospital-based dilatation and curettage, hospital- and clinic-based manual vacuum aspiration (MVA), and medical abortion using misoprostol (MA). The results showed that…
Cost-Effectiveness Analysis | Sub-Saharan Africa | State-Transition | Maternal/Reproductive Health | Culture/Society | Economics/Finance | Health/Medicine