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ArticlePublication 2019BCA in Low- and Middle-Income Countries: Introduction
This paper introduces the benefit-cost analysis reference case guidance project and the special issue of …
This paper introduces the benefit-cost analysis reference case guidance project and the special issue of the Journal for Benefit-Cost Analysis which contains several associated papers. Investing in global health and development requires making difficult choices about what policies to pursue and what level of resources to devote to different initiatives. Methods of economic evaluation are well established and widely used to quantify and compare the impacts of alternative investments. However, if not well conducted and…
Priority Setting/Ethics | Policy/Regulation | Preferences/Values | Decision Analysis | Benefit-Cost Analysis | Social Determinants | Economics/Finance | Health/Medicine | Global | Critical Thinking/Analysis -
ArticlePublication 2019Valuing Mortality Risk Reductions
This article and the accompanying working paper[1] review the literature and develop recommendations for valuing …
This article and the accompanying working paper[1] review the literature and develop recommendations for valuing mortality risk reductions in benefit-cost analyses that address low- and middle-income countries. Increasing life expectancy is a major goal of many policies implemented around the world. As a result, the value of reducing mortality risks has been extensively studied and several organizations have developed recommendations for estimating these values. However, both the recommendations and the underlying research primarily address high-income…
Priority Setting/Ethics | Policy/Regulation | Preferences/Values | Health Outcomes | Decision Analysis | Benefit-Cost Analysis | Social Determinants | Economics/Finance | Health/Medicine | Global | Critical Thinking/Analysis -
Working PaperPublication 2018Valuing Nonfatal Health Risk Reductions
This paper explores approaches for valuing nonfatal risk reductions associated with policy choices in low- …
This paper explores approaches for valuing nonfatal risk reductions associated with policy choices in low- and middle-income countries. The approach for valuation ideally would be based on estimates of individuals’ willingness to pay for changes in their own risks. However, high quality valuation research is not available for many nonfatal conditions even in high-income settings. Typically, two approaches are used either alone or in combination as rough proxies. The first involves applying an estimate of…
Priority Setting/Ethics | Policy/Regulation | Preferences/Values | Health Outcomes | Decision Analysis | Benefit-Cost Analysis | Social Determinants | Economics/Finance | Health/Medicine | Global | Critical Thinking/Analysis -
ArticlePublication 2019Valuing Changes in Time Use
This paper reviews the literature on the monetary value of time in low- and middle-income …
This paper reviews the literature on the monetary value of time in low- and middle-income countries, focusing on time spent in the informal sector; i.e., for which no compensation is received. Valuing changes in time use is often a critical element of economic analyses of development projects, which may affect the time spent in activities such as collecting water or traveling to health clinics. The authors find support for a commonly-used benchmark of 50% of…
Priority Setting/Ethics | Policy/Regulation | Preferences/Values | Costing Methods | Decision Analysis | Benefit-Cost Analysis | Social Determinants | Economics/Finance | Health/Medicine | Global | Critical Thinking/Analysis -
ArticlePublication 2019Accounting for Timing
This paper offers guidance on the analysis of project impacts over time so that they …
This paper offers guidance on the analysis of project impacts over time so that they can be discounted appropriately in cost-effectiveness or benefit-cost analysis. The quantification and conversion of the time streams of different effects into their equivalent health, health care cost, or consumption effects, avoids embedding multiple arguments in discounting approaches. It helps identify where parameters are likely to differ, what type of evidence is relevant, what is currently known, and how this evidence…
Priority Setting/Ethics | Policy/Regulation | Preferences/Values | Costing Methods | Decision Analysis | Benefit-Cost Analysis | Social Determinants | Economics/Finance | Health/Medicine | Global | Critical Thinking/Analysis -
Working PaperPublication 2018Assessing the Distribution of Impacts
This paper discusses the need to supplement benefit-cost analysis with estimates of how the impacts …
This paper discusses the need to supplement benefit-cost analysis with estimates of how the impacts are distributed across different members of the population, categorized by income level or other attributes. Benefit-cost analysis focuses on estimating aggregate net effects. Decision-makers and other stakeholders also want to know who is harmed, who is helped, and by how much. Responding to these questions requires identifying the characteristics of individuals and impacts of concern, examining how the benefits and…
Priority Setting/Ethics | Policy/Regulation | Preferences/Values | Costing Methods | Decision Analysis | Benefit-Cost Analysis | Social Determinants | Economics/Finance | Health/Medicine | Global | Critical Thinking/Analysis -
ArticlePublication 2019Valuing Protection against Financial Risk
This paper explores the value of the financial risk protection provided by health insurance. While …
This paper explores the value of the financial risk protection provided by health insurance. While the benefits of reducing financial risks have long been recognized, less attention has been paid to how best to measure them. This paper provides a framework for assessing these benefits, focusing on three types of impacts: pooling the risk of unexpected medical expenditures between healthy and sick households, redistributing resources from high to low income recipients, and smoothing consumption over…
Priority Setting/Ethics | Policy/Regulation | Health Systems | Preferences/Values | Decision Analysis | Benefit-Cost Analysis | Cost-Effectiveness Analysis | Social Determinants | Economics/Finance | Health/Medicine | Global | Critical Thinking/Analysis -
Working PaperPublication 2018Assessing Economy-Wide Effects
This paper explores the use of economy-wide models to assess the impact of policies implemented …
This paper explores the use of economy-wide models to assess the impact of policies implemented in low- and middle-income countries. Such models include several distinct approaches, including input-output models, macroeconometric models, hybrid input-output-macroeconometric models, and general equilibrium models. Recent advances allow increasing incorporation of non-market welfare considerations into these tools. This development in turn facilitates a much better understanding of how health and environmental interventions affect metrics of great interest to policy-makers: for example, overall…
Priority Setting/Ethics | Policy/Regulation | Preferences/Values | Costing Methods | Decision Analysis | Benefit-Cost Analysis | Social Determinants | Economics/Finance | Health/Medicine | Global | Critical Thinking/Analysis -
ArticlePublication 2019Improving Nutrition in Haiti
This case study examines the costs and benefits of a package of interventions targeting pregnant …
This case study examines the costs and benefits of a package of interventions targeting pregnant women and children to improve nutrition outcomes in Haiti. These interventions are expected to reduce child stunting, low birthweights, and maternal anemia, as well as deaths to infants and mothers and childhood illnesses. The paper tests the effects of various methodological choices on the valuation of avoided mortality, avoided non-fatal health risks and lifetime productivity, and finds that the benefits…
Priority Setting/Ethics | Policy/Regulation | Preferences/Values | Health Outcomes | Decision Analysis | Benefit-Cost Analysis | Maternal/Reproductive Health | Child/Nutrition | Social Determinants | Economics/Finance | Health/Medicine | Global | Critical Thinking/Analysis -
ArticlePublication 2019Controlling Tuberculosis in South Africa
This case study examines the use of both cost-effectiveness analysis and benefit-cost analysis to address …
This case study examines the use of both cost-effectiveness analysis and benefit-cost analysis to address the likely impacts of competing interventions to improve identification of patients with tuberculosis in South Africa. It considers the impacts of different methodological choices for valuing mortality risk reductions and morbidity risk reductions. The results suggest that all combinations of interventions reduced untreated active disease and are likely to result in substantial gains compared to existing interventions.
Priority Setting/Ethics | Policy/Regulation | Preferences/Values | Health Outcomes | Decision Analysis | Benefit-Cost Analysis | Infectious Diseases | Economics/Finance | Health/Medicine | Global | Critical Thinking/Analysis -
ArticlePublication 2019Reducing Air Pollution in India
This case study examines reducing air pollution in India. Air pollution is a persistent and …
This case study examines reducing air pollution in India. Air pollution is a persistent and well-established public health problem in India, and could worsen significantly over time if additional pollution controls are not implemented. The authors site a model coal-fired electricity generating unit at eight locations and examine the benefits and costs of retrofitting the plant with a scrubber unit that reduces sulfur dioxide emissions. They quantify the mortality benefits associated with the reduction in…
Priority Setting/Ethics | Policy/Regulation | Preferences/Values | Health Outcomes | Decision Analysis | Benefit-Cost Analysis | Environmental Health | Economics/Finance | Health/Medicine | Global | Critical Thinking/Analysis -
ArticlePublication 2019Increasing Education in Lower-Middle-Income Countries
This case study examines the effects of increased education on mortality risks. Historically, benefit-cost analyses …
This case study examines the effects of increased education on mortality risks. Historically, benefit-cost analyses have focused on the effect of education on future wages. However, the available evidence also suggests that education reduces under-five and adult mortality rates. This paper estimates how net benefits, as well as the ratio of benefits to costs, responds to the approach used to value mortality risk reductions. It considers one additional year of schooling in lower-middle-income countries, incremental…
Priority Setting/Ethics | Policy/Regulation | Preferences/Values | Health Outcomes | Decision Analysis | Benefit-Cost Analysis | Social Determinants | Education/Labor | Global | Critical Thinking/Analysis -
Working PaperPublication 2018Improving Environmental Management in Uganda
This case study illustrates the application of a computable general equilibrium model to assess the …
This case study illustrates the application of a computable general equilibrium model to assess the economy-wide costs and benefits of investment in water resources development and environmental management (including coincident health implications) in Uganda. This assessment addresses a series of impact channels which trace raw resources such as arable land, water (as rivers and lakes), wetlands, and forests from their sources, through government and private management, and into the economy. The results are then fed…
Priority Setting/Ethics | Policy/Regulation | Preferences/Values | Costing Methods | Decision Analysis | Benefit-Cost Analysis | Social Determinants | Environmental Health | Economics/Finance | Health/Medicine | Global | Critical Thinking/Analysis
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