Resources Repository
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ArticlePublication 2017Household Expenditures on Pneumonia and Diarrhoea Treatment
This article, published in BMJ Global Health, quantifies household out-of-pocket (OOP) expenditure for treatment of …
This article, published in BMJ Global Health, quantifies household out-of-pocket (OOP) expenditure for treatment of childhood pneumonia and diarrhoea and estimates its impact on poverty for different socioeconomic groups in Ethiopia. The study finds that wealthier and urban households have higher OOP payments, but poorer and rural households are more likely to be impoverished due to medical payments. The present circumstances call for revisiting the existing health financing strategy for high-priority services that place a…
Costing Methods | Sub-Saharan Africa | Infectious Diseases | Child/Nutrition | Health Systems | Health/Medicine -
ArticlePublication 2016Funding Gap for Immunization Across 94 Low- and Middle-Income Countries
This analysis estimates immunization program costs, potentially available financing, and resulting funding gap for 94 …
This analysis estimates immunization program costs, potentially available financing, and resulting funding gap for 94 low- and middle-income countries over the five-year period of 2016–2020. Vaccine financing by country governments, GAVI, and other development sources was forecasted for vaccine, supply chain, and service delivery based on an analysis of comprehensive multi-year plans together with a series of scenarios. The authors found that that delivery of full vaccination programs across the 94 countries would result in a total…
Costing Methods | Sub-Saharan Africa | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Health Systems | Global Governance | Economics/Finance | Health/Medicine | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2016Country-Level Cost-Effectiveness Thresholds
This article estimates the cost-effectiveness thresholds (CETs) for health interventions in several low and middle-income …
This article estimates the cost-effectiveness thresholds (CETs) for health interventions in several low and middle-income countries (LMICs), based on opportunity costs. When there are constraints on a health care system’s budget or ability to increase expenditures, additional costs imposed by interventions have an “opportunity cost” in terms of the health foregone because other interventions cannot be provided. The authors argue that cost-effectiveness thresholds should reflect health opportunity cost and aim to calculate these in four…
Sub-Saharan Africa | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Economics/Finance | Health/Medicine | Middle East & North Africa | Latin America & Caribbean | Europe | Asia & Pacific -
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 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 | Sub-Saharan Africa | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Health/Medicine -
ReportPublication 2016Above Service Delivery Activities: Cost, Impact, and Efficiency
Costs incurred by health programs for activities conducted above the front-line facility or community setting …
Costs incurred by health programs for activities conducted above the front-line facility or community setting constitute a substantial share of health program spending. Despite the important of these activities in the delivery of major health services, and despite the vast sums spent above the point of service delivery, far less is known about their costs compared with costs at the point of service delivery. This report provides a landscape analysis of these service delivery activities and technical efficiency…
Costing Methods | Sub-Saharan Africa | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine | Latin America & Caribbean | Asia & Pacific -
ReviewPublication 2016Using Economic Evidence to Set Healthcare Priorities in LMIC
Policy makers in low-income and lower-middle-income countries (LMICs) are increasingly looking to develop ‘evidence-based’ frameworks …
Policy makers in low-income and lower-middle-income countries (LMICs) are increasingly looking to develop ‘evidence-based’ frameworks for identifying priority health interventions. This paper synthesizes and appraises the literature on methodological frameworks – which incorporate economic evaluation evidence – for the purpose of setting healthcare priorities in LMICs. A systematic search of Embase, MEDLINE, Econlit and PubMed identified 3968 articles with a further 21 articles identified through manual searching. A total of 36 papers were eligible for inclusion.…
Sub-Saharan Africa | Priority Setting/Ethics | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Technology Assessment | Health Systems | Policy/Regulation | Economics/Finance | Government/Law | Health/Medicine | Middle East & North Africa | Latin America & Caribbean | 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;…
Sub-Saharan Africa | Priority Setting/Ethics | Cost-Effectiveness Analysis | 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…
Sub-Saharan Africa | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Economics/Finance | Health/Medicine