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ArticlePublication 2024Extended Cost-Effectiveness Analysis of Interventions to Improve Uptake of Diabetes Services in South Africa
This study examines the potential impact of a conditional cash transfer (CCT) program on diabetes …
This study examines the potential impact of a conditional cash transfer (CCT) program on diabetes diagnosis and treatment service utilization in South Africa (SA) using extended cost-effectiveness analysis (ECEA). Applying a Markov model over a 45-year period, the analysis compares costs, health benefits, and financial risk protection (FRP) attributes of different CCT strategies, drawing from SA-specific data. Three scenarios were simulated: covering diagnosis services only, treatment services only, and both diagnosis and treatment services. Cost-effectiveness,…
Sub-Saharan Africa | Health Outcomes | Mathematical Models | Cost-Effectiveness Analysis | Chronic Disease/Risk | Policy/Regulation | Health/Medicine -
ArticlePublication 2023Effects of Public Financing of Essential Maternal and Child Health Interventions Across Wealth Quintiles in Nigeria: An Extended Cost-Effectiveness Analysis
This study evaluates the potential health and financial risk protection benefits of public financing for …
This study evaluates the potential health and financial risk protection benefits of public financing for maternal, newborn, and child health (MNCH) interventions in Nigeria, focusing on different wealth quintiles. Employing extended cost-effectiveness analysis, the research assesses the impact of a policy ensuring zero out-of-pocket costs for 18 essential MNCH services. Three scenarios were modeled: status quo, uniform scale-up, and pro-poor scale-up. Findings suggest that a 5% increase in coverage for all quintiles could prevent significant…
Sub-Saharan Africa | Health Outcomes | Mathematical Models | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Policy/Regulation | Health/Medicine -
ArticlePublication 2022Child Health Inequity through Case Management of Under-Five Malaria in Nigeria: An ECEA
This study assesses the potential impact of subsidies covering the direct and indirect costs of …
This study assesses the potential impact of subsidies covering the direct and indirect costs of under-five malaria case management in Nigeria, utilizing an extended cost-effectiveness analysis (ECEA) and a decision tree model. Findings reveal that fully subsidizing medical, non-medical, and indirect costs could annually avert over 19,000 under-five deaths, 8,600 cases of catastrophic health expenditure (CHE), and US$187 million in out-of-pocket (OOP) spending. Per US$1 million invested, this translates to a significant reduction in under-five…
Sub-Saharan Africa | Health Outcomes | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Policy/Regulation | Health/Medicine -
ArticlePublication 2022Potential Distributional Health & Financial Benefits of Increased Tobacco Taxes in Ethiopia: Findings from a Modeling Study
This study evaluates the potential impacts of Ethiopia's tobacco tax increase in 2020, which raised …
This study evaluates the potential impacts of Ethiopia's tobacco tax increase in 2020, which raised cigarette prices by approximately 67%. Employing parameters such as price elasticity of demand and smoking prevalence, the analysis utilizes existing literature and secondary data to model the effects of the reform on various outcomes, focusing on life years, tax revenues, cigarette expenditures, and catastrophic health expenditures (CHE). Concentrating solely on male smokers due to low female smoking rates, the results…
Sub-Saharan Africa | Health Outcomes | Mathematical Models | Cost-Effectiveness Analysis | Policy/Regulation | Health/Medicine -
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…
Sub-Saharan Africa | Priority Setting/Ethics | Microsimulation | Infectious Diseases -
ArticlePublication 2020Health Gains & Financial Risk Protection Afforded by Public Financing of Selected Malaria Interventions in Ethiopia: An ECEA
This article, published in the Malaria Journal, aims to estimate the expected health and financial …
This article, published in the Malaria Journal, aims to estimate the expected health and financial risk protection (FRP) benefits of universal public financing of key malaria interventions in Ethiopia. An extended cost-effectiveness analysis (ECEA) is used to estimate the potential health and FRP benefits of publicly financing a 10% increase in artemisinin-based combination therapy (ACT), long-lasting insecticide-treated bed nets (LLIN), indoor residual spraying (IRS), and a hypothetical malaria vaccine. The results indicate that ACT, LLIN,…
Sub-Saharan Africa | Priority Setting/Ethics | Cost-Effectiveness Analysis | Infectious Diseases | Social Determinants | Health Systems | Health/Medicine -
ArticlePublication 2019Health and Financial Benefits of Averting Malaria in Zambia: An ECEA
This study used the extended cost-effectiveness analysis (ECEA) to examine impact of the hypothetical rollout …
This study used the extended cost-effectiveness analysis (ECEA) to examine impact of the hypothetical rollout of the malaria vaccine RTS,S/AS01 in Zambia on the health benefits of children under five, and financial benefits on their households. The authors assumed a three-dose vaccination schedule (over 6-9 months), and vaccine cost of US$5 per dose. To assess vaccine impact, for each income quintile, they computed the number of under-five malaria deaths prevented, the household out-of-pocket (OOP) malaria-related…
Sub-Saharan Africa | Priority Setting/Ethics | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Health Systems | Health/Medicine -
ArticlePublication 2019Impact of Taxing Sugar-Sweetened Beverages in South Africa: An ECEA
In this paper, the authors conducted an extended cost-effectiveness analysis of a newly imposed tax …
In this paper, the authors conducted an extended cost-effectiveness analysis of a newly imposed tax on sugar-sweetened beverages (SSBs) in South Africa. They estimated the averted premature deaths related to type 2 diabetes mellitus (T2DM), financial benefits to households, increased government tax revenues, and healthcare savings for the government, across various income quintiles. The authors found that a 10% SSB tax increase would avert an estimated 8,000 T2DM-related premature deaths over 20 years, with most…
Sub-Saharan Africa | Cost-Effectiveness Analysis | Chronic Disease/Risk | Social Determinants | Policy/Regulation | Health/Medicine -
ArticlePublication 2018Equity Impact Vaccines May Have on Averting Deaths and Medical Impoverishment
In this analysis, authors estimated the number of deaths averted and the number of cases …
In this analysis, authors estimated the number of deaths averted and the number of cases of medical impoverishment averted of ten antigens and their corresponding vaccines across income quintiles for forty-one low- and middle-income countries. The study found that vaccines administered between 2016 and 2030 would prevent 36 million deaths. Vaccines will have the greatest impact on reducing cases of poverty caused by hepatitis B, helping an estimated 14 million people avoid medical impoverishment. An…
Sub-Saharan Africa | Priority Setting/Ethics | Costing Methods | Health Outcomes | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Global Governance | Economics/Finance | Health/Medicine | Science/Technology | Middle East & North Africa | Asia & Pacific -
ArticlePublication 2018Modeling Gains from Investing in Preventive Chemotherapy for NTDs in Madagascar
In this paper, the authors conducted an extended cost-effectiveness analysis (ECEA) to five Neglected Tropical …
In this paper, the authors conducted an extended cost-effectiveness analysis (ECEA) to five Neglected Tropical Disease (NTD) interventions in Madagascar. The five NTDs included schistosomiasis, lymphatic filariasis, and three-soil transmitted helminthiases. The analysis found that preventive chemotherapy for all NTDs resulted $125 per DALY averted with a benefit-cost ratio between 5 and 31. Preventive chemotherapy for schistosomiasis alone was found to prevent over 175,000 infections, avert 2,000 DALYs and for every $100,000 spent, provide an additional…
Sub-Saharan Africa | Cost-Effectiveness Analysis | Infectious Diseases | Social Determinants | Policy/Regulation | Health/Medicine -
ArticlePublication 2017Adolescent Pregnancy Prevention Program in Zambia
This article, published in Trials, outlines a protocol for a cost-benefit analysis (CBA) and an …
This article, published in Trials, outlines a protocol for a cost-benefit analysis (CBA) and an extended cost-effectiveness analysis (ECEA) of a comprehensive adolescent pregnancy prevention program in Zambia. The study will be conducted alongside a cluster-randomized controlled trial, which tests the hypothesis that economic support with or without community dialogue is an effective strategy for reducing adolescent childbearing rates. The ECEA will estimate the costs of the intervention packages per unit health and non-health gain…
Sub-Saharan Africa | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Child/Nutrition | Social Determinants | Health Systems | Health/Medicine -
ArticlePublication 2017Catastrophic Costs Potentially Averted by TB Control in India and South Africa
This study estimated the reduction in tuberculosis-related catastrophic costs with an aggressive expansion of tuberculosis …
This study estimated the reduction in tuberculosis-related catastrophic costs with an aggressive expansion of tuberculosis services in India and South Africa from 2016 to 2035, in line with the End TB Strategy. The authors investigated three intervention scenarios: improved treatment of drug-sensitive tuberculosis; improved treatment of multidrug-resistant tuberculosis; and expansion of access to tuberculosis care through intensified case finding (South Africa only). In India and South Africa, improvements in treatment for drug-sensitive and multidrug-resistant tuberculosis…
Sub-Saharan Africa | Priority Setting/Ethics | Mathematical Models | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine | Asia & Pacific -
ArticlePublication 2016Extended CEA: Diarrhea and Pneumonia in Ethiopia
This chapter examines universal public finance of the prevention and treatment of pneumonia and diarrhea …
This chapter examines universal public finance of the prevention and treatment of pneumonia and diarrhea in Ethiopia, with a focus on children under age five years. This extended cost-effectiveness analysis examines benefits by income quintile so that policy makers can better understand how each package affects different segments of the population and permits the incorporation of financial risk protection in the economic evaluation of health policies - both critical elements of universal health coverage.
Sub-Saharan Africa | Priority Setting/Ethics | Health Outcomes | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Social Determinants | Health Systems | Economics/Finance | Health/Medicine -
ArticlePublication 2016Health Gains & Financial Protection from Ethiopian Mental Health Strategy: An ECEA
Using the extended cost-effectiveness analysis (ECEA), this paper evaluates the impacts of fully publicly financed …
Using the extended cost-effectiveness analysis (ECEA), this paper evaluates the impacts of fully publicly financed care for depression, bipolar disorder, schizophrenia and epilepsy as part of the mental and neurological package (MN) of the National Mental Health Strategy in Ethiopia. The following outcomes were estimated disaggregated across wealth quintiles: (1) healthy-life-years (HALYs) gained; (2) household out-of-pocket (OOP) expenditures averted (3) expected financial risk protection (FRP); and (4) productivity impact. The MN package is expected to…
Sub-Saharan Africa | Costing Methods | Health Outcomes | Cost-Effectiveness Analysis | Mental Health | Economics/Finance | Health/Medicine -
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…
Sub-Saharan Africa | Priority Setting/Ethics | Costing Methods | Health Outcomes | Mathematical Models | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Social Determinants | Health Systems | Economics/Finance | Education/Labor | Health/Medicine | 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 -
ArticlePublication 2015Extended Cost-Effectiveness Analysis of Treatment and Prevention of Diarrhoea in Ethiopia
This article, published in BMJ Open, aims to illustrate the size and distribution of benefits …
This article, published in BMJ Open, aims to illustrate the size and distribution of benefits due to the treatment and prevention of diarrhoea (i.e., rotavirus vaccination) in Ethiopia. The authors use an economic model to examine the impacts of universal public finance (UPF) of diarrhoeal treatment alone, as opposed to diarrhoeal treatment along with rotavirus vaccination using extended cost-effectiveness analysis (ECEA). The study finds that diarrhoeal treatment paired with rotavirus vaccination is more cost effective…
Sub-Saharan Africa | Priority Setting/Ethics | Costing Methods | Health Outcomes | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Social Determinants | Environmental Health | Health Systems | Climate/Environment | Economics/Finance | Health/Medicine -
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.
Sub-Saharan Africa | Priority Setting/Ethics | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Social Determinants | Health Systems | Global Governance | Economics/Finance | 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…
Sub-Saharan Africa | Priority Setting/Ethics | Mathematical Models | Cost-Effectiveness Analysis | Infectious Diseases | Maternal/Reproductive Health | Child/Nutrition | Chronic Disease/Risk | Health Systems | Policy/Regulation | Health/Medicine -
ArticlePublication 2015Pneumococcal Vaccination and Pneumonia Treatment in Ethiopia: Results from Extended CEA
This article, published in PLOS ONE, conducts an extended cost-effectiveness analysis (ECEA) of two fully …
This article, published in PLOS ONE, conducts an extended cost-effectiveness analysis (ECEA) of two fully publicly financed interventions in Ethiopia: pneumococcal vaccination for newborns and pneumonia treatment for under-five children. The authors apply ECEA methods and estimate the program impact on: (1) government program costs; (2) pneumonia and pneumococcal deaths averted; (3) household expenses related to pneumonia/pneumococcal disease treatment averted; (4) prevention of household medical impoverishment; and (5) distributional consequences across the wealth strata of…
Sub-Saharan Africa | Priority Setting/Ethics | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Social Determinants | Health Systems | Economics/Finance | Health/Medicine -
ArticlePublication 2015Salt Reduction Policy in South Africa: Extended Cost-Effectiveness Analysis
This paper is an extended cost-effectiveness analysis to model the potential health and economic impacts of …
This paper is an extended cost-effectiveness analysis to model the potential health and economic impacts of a salt reduction policy in South Africa. The authors used surveys and epidemiologic studies to estimate reductions in CVD resulting from lower salt intake. They calculated the average out-of-pocket (OOP) cost of CVD care and estimated the reduction in OOP expenditures and government subsidies due to the policy. They also estimated the costs of policy implementation and financial risk protection (FRP) benefits. The…
Sub-Saharan Africa | Priority Setting/Ethics | Costing Methods | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Policy/Regulation | Economics/Finance | Food/Agriculture | Health/Medicine -
ArticlePublication 2013Public Finance of Rotavirus Vaccination in India and Ethiopia: Extended CEA
This study uses extended cost-effectiveness analysis (ECEA) to evaluate a hypothetical publicly financed program for …
This study uses extended cost-effectiveness analysis (ECEA) to evaluate a hypothetical publicly financed program for rotavirus vaccination in India and Ethiopia. The authors measured program impact on: (1) averted rotavirus deaths; (2) reduction in household expenditures; (3) financial risk protection; and (4) distributional consequences across the country’s wealth strata. In India and Ethiopia, the program was predicted to decrease rotavirus deaths substantially, and effectively provide financial risk protection among the poor, while also reducing household…
Sub-Saharan Africa | Priority Setting/Ethics | Health Outcomes | Cost-Effectiveness Analysis | Infectious Diseases | Child/Nutrition | Social Determinants | Culture/Society | Economics/Finance | Health/Medicine | Asia & Pacific
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