Resources Repository
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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…
Microsimulation | Mathematical Models | Health Outcomes | Calibration/Validation | Maternal/Reproductive Health | Health Systems | Clinical Care | Health/Medicine | Global -
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…
Evidence Synthesis | Microsimulation | Health Outcomes | Calibration/Validation | Maternal/Reproductive Health | Health Systems | Clinical Care | Health/Medicine | Global -
ArticlePublication 2023Achieving the Cancer Moonshot Goal
The Cancer Moonshot seeks to reduce age-standardized cancer mortality rates by at least 50% over …
The Cancer Moonshot seeks to reduce age-standardized cancer mortality rates by at least 50% over the next 25 years. This article estimates trends in U.S. cancer mortality for all cancers and the six leading types and reviews opportunities to prevent, detect, and treat these common cancers.
Mathematical Models | Priority Setting/Ethics | Health Systems | Clinical Care | Health/Medicine | North America -
ArticlePublication 2022Modeling the Relative Risk of Incidence and Mortality of Select Vaccine-Preventable Diseases
Immunization is one of the most effective public health interventions, saving millions of lives every …
Immunization is one of the most effective public health interventions, saving millions of lives every year. Ethiopia has seen gradual improvements in immunization coverage and access to child health care services; however, inequalities in child mortality across wealth quintiles and regions remain persistent. This paper models the relative distributional incidence and mortality of four vaccine-preventable diseases (VPDs) (rotavirus diarrhea, human papillomavirus, measles, and pneumonia) by wealth quintile and geographic region in Ethiopia. The authors approach…
Evidence Synthesis | Priority Setting/Ethics | Infectious Diseases | Social Determinants | Health/Medicine | Sub-Saharan Africa -
ArticlePublication 2022Conceptualizing Monetary Benchmarks for Health Investments toward Poverty Reduction
Public spending can improve population well-being, for example, by averting or reducing poverty. This article …
Public spending can improve population well-being, for example, by averting or reducing poverty. This article aims to conceptualize monetary benchmarks for health sector investments oriented towards poverty alleviation in low- and lower-middle-income countries. Priority setting in low- and lower-middle-income countries could be informed by health-sector PRBs (poverty reduction benchmarks), in addition to burden of disease and cost-effectiveness considerations. The computed PRBs, expressed in dollars per poverty case averted, can possibly be viewed in a manner…
Evidence Synthesis | Priority Setting/Ethics | Social Determinants | Health Systems | Economics/Finance | Health/Medicine | 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…
Microsimulation | Priority Setting/Ethics | 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…
Mathematical Models | Priority Setting/Ethics | Global -
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,…
Microsimulation | Mathematical Models | Calibration/Validation | Decision Analysis | Cost-Effectiveness Analysis | Infectious Diseases | Global -
ArticlePublication 2022Early HPV Natural History Transitions
Microsimulation models used to evaluate the cost-effectiveness of novel cervical cancer screening technologies rely on …
Microsimulation models used to evaluate the cost-effectiveness of novel cervical cancer screening technologies rely on accurate transition risks for human papillomavirus (HPV) infection, persistence (or absence of HPV clearance), progression to precancerous lesions, and invasion. To inform the refinement of such models, we compared the early natural history of HPV types using prospective data from immunocompetent women in the Guanacaste Natural History Study, the ASCUS-LSIL Triage Study, and the Costa Rica HPV Vaccine Trial. We…
Microsimulation | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | North America | Latin America & Caribbean