scholarly journals Cost Effectiveness of Environmental Lead Risk Mitigation in Low- and Middle-Income Countries

GeoHealth ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. 87-101 ◽  
Author(s):  
Bret Ericson ◽  
Jack Caravanos ◽  
Conrado Depratt ◽  
Cynthia Santos ◽  
Mishelle Gomez Cabral ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Risk Mitigation ◽  
Middle Income ◽  
Environmental Lead ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Are low and middle-income countries prioritising high-value healthcare interventions?

2020 ◽  
Vol 5 (2) ◽  
pp. e001850
Author(s):  
Ashley A Leech ◽  
David D Kim ◽  
Joshua T Cohen ◽  
Peter J Neumann
Keyword(s):  
Cost Effectiveness ◽  
Cost Saving ◽  
National Health ◽  
Sub Saharan Africa ◽  
Health Plans ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Priority ◽  
Sub Saharan ◽  
Low And Middle Income

IntroductionSince resources are finite, investing in services that produce the highest health gain ‘return on investment’ is critical. We assessed the extent to which low and middle-income countries (LMIC) have included cost-saving interventions in their national strategic health plans.MethodsWe used the Tufts Medical Center Global Health Cost-Effectiveness Analysis Registry, an open-source database of English-language cost-per-disability-adjusted life year (DALY) studies, to identify analyses published in the last 10 years (2008–2017) of cost-saving health interventions in LMICs. To assess whether countries prioritised cost-saving interventions within their latest national health strategic plans, we identified 10 countries, all in sub-Saharan Africa, with the highest measures on the global burden of disease scale and reviewed their national health priority plans.ResultsWe identified 392 studies (63%) targeting LMICs that reported 3315 cost-per-DALY ratios, of which 207 ratios (6%) represented interventions reported to be cost saving. Over half (53%) of these targeted sub-Saharan Africa. For the 10 countries we investigated in sub-Saharan Africa, 58% (79/137) of cost-saving interventions correspond with priorities identified in country plans. Alignment ranged from 95% (21/22 prioritised cost-saving ratios) in South Africa to 17% (2/12 prioritised cost-saving ratios) in Cameroon. Human papillomavirus vaccination was a noted priority in 70% (7/10) of national health prioritisation plans, while 40% (4/10) of countries explicitly included prenatal serological screening for syphilis. HIV prevention and treatment were stated priorities in most country health plans, whereas 40% (2/5) of countries principally outlined efforts for lymphatic filariasis. From our sample of 45 unique interventions, 36% of interventions (16/45) included costs associated directly with the implementation of the intervention.ConclusionOur findings indicate substantial variation across country and disease area in incorporating economic evidence into national health priority plans in a sample of sub-Saharan African countries. To make health economic data more salient, the authors of cost-effectiveness analyses must do more to reflect implementation costs and other factors that could limit healthcare delivery.

Cost-effectiveness of Surgery in Low- and Middle-income Countries: A Systematic Review

2013 ◽  
Vol 38 (1) ◽  
pp. 252-263 ◽  
Author(s):  
Caris E. Grimes ◽  
Jaymie Ang Henry ◽  
Jane Maraka ◽  
Nyengo C. Mkandawire ◽  
Michael Cotton
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Systematic review of the costs and effectiveness of interventions to increase infant vaccination coverage in low- and middle-income countries

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cristina Munk ◽  
Allison Portnoy ◽  
Christian Suharlim ◽  
Emma Clarke-Deelder ◽  
Logan Brenzel ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Scale Up ◽  
Immunization Coverage ◽  
Health Systems Strengthening ◽  
Cash Transfer ◽  
Immunization Programs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Objective Evidence ◽  
Low And Middle Income

Abstract Background In recent years, several large studies have assessed the costs of national infant immunization programs, and the results of these studies are used to support planning and budgeting in low- and middle-income countries. However, few studies have addressed the costs and cost-effectiveness of interventions to improve immunization coverage, despite this being a major focus of policy attention. Without this information, countries and international stakeholders have little objective evidence on the efficiency of competing interventions for improving coverage. Methods We conducted a systematic literature review on the costs and cost-effectiveness of interventions to improve immunization coverage in low- and middle-income countries, including both published and unpublished reports. We evaluated the quality of included studies and extracted data on costs and incremental coverage. Where possible, we calculated incremental cost-effectiveness ratios (ICERs) to describe the efficiency of each intervention in increasing coverage. Results A total of 14 out of 41 full text articles reviewed met criteria for inclusion in the final review. Interventions for increasing immunization coverage included demand generation, modified delivery approaches, cash transfer programs, health systems strengthening, and novel technology usage. We observed substantial heterogeneity in costing methods and incompleteness of cost and coverage reporting. Most studies reported increases in coverage following the interventions, with coverage increasing by an average of 23 percentage points post-intervention across studies. ICERs ranged from $0.66 to $161.95 per child vaccinated in 2017 USD. We did not conduct a meta-analysis given the small number of estimates and variety of interventions included. Conclusions There is little quantitative evidence on the costs and cost-effectiveness of interventions for improving immunization coverage, despite this being a major objective for national immunization programs. Efforts to improve the level of costing evidence—such as by integrating cost analysis within implementation studies and trials of immunization scale up—could allow programs to better allocate resources for coverage improvement. Greater adoption of standardized cost reporting methods would also enable the synthesis and use of cost data.

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