Resources Repository
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ArticlePublication 2016Cost-Effectiveness of Diagnosing HIV Infection During Early Infancy in South Africa
In this study the clinical impact and cost-effectiveness of four different early infant HIV diagnosis …
In this study the clinical impact and cost-effectiveness of four different early infant HIV diagnosis (EID) testing strategies for HIV-exposed infants in South Africa were compared using a microsimulation model. The strategies included (1) no EID (diagnosis only after illness), (2) and (3) testing once (at birth alone or at 6 weeks of age alone), and (4) testing twice (at birth and 6 weeks of age). Findings showed that the testing at birth alone strategy…
Microsimulation | Cost-Effectiveness Analysis | Sub-Saharan Africa | Infectious Diseases | Child/Nutrition | Health/Medicine -
ArticlePublication 2016Quality Improvement for Cardiovascular Disease Care in Low- and Middle-Income Countries: A Systematic Review
The majority of global cardiovascular disease (CVD) burden falls on people living in low- and …
The majority of global cardiovascular disease (CVD) burden falls on people living in low- and middle-income countries (LMICs). As part of the Disease Control Priorities Three (DCP3) Study efforts addressing quality improvement, the authors reviewed and summarized currently available evidence on interventions to improve quality of clinic-based CVD prevention and management in LMICs. Using a narrative review of published comparative clinical trials that evaluated efficacy or effectiveness of clinic-based CVD prevention and management quality improvement…
Evidence Synthesis | Middle East & North Africa | Sub-Saharan Africa | Health Outcomes | Chronic Disease/Risk | Health Systems | Health/Medicine | 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…
Mathematical Models | Cost-Effectiveness Analysis | Sub-Saharan Africa | Priority Setting/Ethics | Costing Methods | Health Outcomes | Maternal/Reproductive Health | Social Determinants | Health Systems | Economics/Finance | Education/Labor | Health/Medicine | Asia & Pacific -
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 | Middle East & North Africa | Sub-Saharan Africa | Priority Setting/Ethics | Health Systems | Policy/Regulation | Economics/Finance | Education/Labor | Government/Law | Health/Medicine | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2015Cost-Effectiveness of First-Line Antiretroviral Therapy for HIV-Infected African Children Less Than 3 Years of Age
This article compares the cost-effectiveness of different strategies of first-line antiretroviral therapy (no ART, first-line nevirapine …
This article compares the cost-effectiveness of different strategies of first-line antiretroviral therapy (no ART, first-line nevirapine with second-line lopinavir/ritonavir, and first-line lopinavir/ritonavir with second-line nevirapine) for HIV-infected children less than 3 years of age in Africa, using the Cost-Effectiveness of Preventing AIDS Complications- Pediatric model and data obtained from the International Maternal, Pediatric, and Adolescent Clinical Trial P1060 trial. Results demonstrated that both ART regimens were very cost-effective compared to no ART. First-line lopinavir/ritonavir led to longer…
Microsimulation | Cost-Effectiveness Analysis | Sub-Saharan Africa | Infectious Diseases | Child/Nutrition | 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…
Mathematical Models | Cost-Effectiveness Analysis | Sub-Saharan Africa | Priority Setting/Ethics | Infectious Diseases | Maternal/Reproductive Health | Child/Nutrition | Chronic Disease/Risk | Health Systems | Policy/Regulation | Health/Medicine -
ArticlePublication 2013Validation and Calibration of a Simulation Model of Pediatric HIV Infection
The authors developed a microsimulation model of pediatric HIV disease progression using the Cost-Effectiveness of …
The authors developed a microsimulation model of pediatric HIV disease progression using the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) model framework. This CEPAC-Pediatric model was then validated by varying CD4 data and comparing the corresponding model-generated survival curves to empirical survival curves obtained from the International Epidemiologic Database to Evaluate AIDS (IeDEA). The model was calibrated to other African countries by systematically varying immunologic and HIV mortality-related input parameters. In the calibration analyses, the model-generated…
Microsimulation | Calibration/Validation | Sub-Saharan Africa | Infectious Diseases | Child/Nutrition | Health/Medicine -
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 | State-Transition | Sub-Saharan Africa | Health Outcomes | Maternal/Reproductive Health | Health Systems | Policy/Regulation | Economics/Finance | 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 | State-Transition | Sub-Saharan Africa | Maternal/Reproductive Health | Culture/Society | Economics/Finance | Health/Medicine