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;…
Cost-Effectiveness Analysis | Health/Medicine | Economics/Finance | Sub-Saharan Africa | Priority Setting/Ethics | Health Systems | Policy/Regulation | Education/Labor | Government/Law | 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 | Health/Medicine | Economics/Finance | Sub-Saharan Africa | Priority Setting/Ethics | Health Systems -
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 | Health/Medicine | Sub-Saharan Africa | Priority Setting/Ethics | Infectious Diseases | Maternal/Reproductive Health | Child/Nutrition | Chronic Disease/Risk | Health Systems | Policy/Regulation -
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 | Health/Medicine | Economics/Finance | Sub-Saharan Africa | Priority Setting/Ethics | Infectious Diseases | Child/Nutrition | Social Determinants | Health Systems | Global Governance -
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…
Mathematical Models | Health Outcomes | Health/Medicine | Sub-Saharan Africa | Infectious Diseases -
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 | Health/Medicine | Economics/Finance | Sub-Saharan Africa | State-Transition | Maternal/Reproductive Health | Culture/Society -
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 | Health/Medicine | Sub-Saharan Africa | Priority Setting/Ethics | Infectious Diseases | Social Determinants -
ArticlePublication 2022Re-Evaluating the Health Impact and Cost-Effectiveness of Tuberculosis Prevention for Modern ART Cohorts
TB preventive therapy (TPT) is widely accepted to be cost-effective for reducing TB incidence in …
TB preventive therapy (TPT) is widely accepted to be cost-effective for reducing TB incidence in HIV-infected individuals receiving antiretroviral therapy (ART). However, as individuals initiate ART earlier in the course of disease, TB incidence is lower, and it is unclear how ART cost-effectiveness has changed. This study assessed the cost-effectiveness of TPT in contemporary ART cohorts. The authors developed a microsimulation model of TB and HIV and parameterised it using data from a large HIV…
Cost-Effectiveness Analysis | Health/Medicine | Sub-Saharan Africa | Microsimulation | Infectious Diseases | Global -
ArticlePublication 2014Step-by-Step Guideline for Disease-Specific Costing Studies in LMIC
Disease-specific costing studies can be used as input into cost-effectiveness analyses and provide important information …
Disease-specific costing studies can be used as input into cost-effectiveness analyses and provide important information for efficient resource allocation. This paper provides a step-by-step guideline for conducting disease-specific costing studies in LMICs where data availability is limited and illustrates how the guideline was applied in a costing study of cardiovascular disease prevention care in rural Nigeria. The step-by-step guideline provides practical recommendations on methods and data requirements for six sequential steps: 1) definition of the study…
Costing Methods | Health/Medicine | Sub-Saharan Africa | Chronic Disease/Risk | Health Systems