58 results found
COSMIC CONSORTIUM, 2019, Community-based malaria screening and treatment for pregnant women receiving standard intermittent preventive treatment with sulfadoxine-pyrimethamine: a multicentre (The Gambia, Burkina Faso and Benin) cluster randomised controlled trial, Clinical Infectious Diseases, Vol: 68, Pages: 586-596, ISSN: 1058-4838
BackgroundWe investigated whether adding community scheduled malaria screening and treatment (CSST) with artemether-lumefantrine by community health workers (CHWs) to standard intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) would improve maternal and infant health.MethodsIn this 2-arm cluster-randomized, controlled trial, villages in Burkina Faso, The Gambia, and Benin were randomized to receive CSST plus IPTp-SP or IPTp-SP alone. CHWs in the intervention arm performed monthly CSST during pregnancy. At each contact, filter paper and blood slides were collected, and at delivery, a placental biopsy was collected. Primary and secondary endpoints were the prevalence of placental malaria, maternal anemia, maternal peripheral infection, low birth weight, antenatal clinic (ANC) attendance, and IPTp-SP coverage.ResultsMalaria infection was detected at least once for 3.8% women in The Gambia, 16.9% in Benin, and 31.6% in Burkina Faso. There was no difference between study arms in terms of placenta malaria after adjusting for birth season, parity, and IPTp-SP doses (adjusted odds ratio, 1.06 [95% confidence interval, .78–1.44]; P = .72). No difference between the study arms was found for peripheral maternal infection, anemia, and adverse pregnancy outcomes. ANC attendance was significantly higher in the intervention arm in Burkina Faso but not in The Gambia and Benin. Increasing number of IPTp-SP doses was associated with a significantly lower risk of placenta malaria, anemia at delivery, and low birth weight.ConclusionsAdding CSST to existing IPTp-SP strategies did not reduce malaria in pregnancy. Increasing the number of IPTp-SP doses given during pregnancy is a priority.Clinical Trials RegistrationNCT01941264; ISRCTN37259296.
Ginsburg O, Rositch AF, Conteh L, et al., 2018, Breast cancer disparities among women in low- and middle-income countries, Current Breast Cancer Reports, Vol: 10, Pages: 179-186, ISSN: 1943-4588
Purpose of ReviewThe burden of breast cancer in low-income and middle-income countries transitioning to higher levels of human development is a public health crisis, set to increase dramatically in the coming decades. This paper provides an overview of the burden in human and economic terms, a summary of the costs, and cost-effective analyses for breast cancer interventions and suggests a way forward through research to better inform national, regional, and global policies for breast cancer control.Recent FindingsInequitable access to effective health services for breast cancer is striking between and within countries, where much of the costs are shouldered through out-of-pocket expenditures. A variety of factors can influence opportunities for women with breast symptoms to seek care and to access effective and affordable early detection and treatment services.SummaryResearch into disparities and solutions to overcome these, including an evidence-informed investment case for breast cancer control, can help to garner the necessary political will and sustained commitments to ensure adequate and sustainable resources are available to reduce disparities in breast cancer survival.
Tanner M, Whittaker M, Abdallah OK, et al., 2017, malERA: An updated research agenda for health systems and policy research in malaria elimination and eradication, PLoS Medicine, Vol: 14, ISSN: 1549-1277
Health systems underpin disease elimination and eradication programmes. In an eliminationand eradication context, innovative research approaches are needed across health systemsto assess readiness for programme reorientation, mitigate any decreases in effectivenessof interventions (‘effectiveness decay’), and respond to dynamic and changing needs. Themalaria eradication research agenda (malERA) Refresh consultative process for the Panelon Health Systems and Policy Research identifies opportunities to build health systems evidenceand the tools needed to eliminate malaria from different zones, countries, and regionsand to eradicate it globally. The research questions are organised as a portfolio that globalhealth practitioners, researchers, and funders can identify with and support. This supportsthe promotion of an actionable and more cohesive approach to building the evidence basefor scaled-up implementation of findings. Gaps and opportunities discussed in the paperinclude delivery strategies to meet the changing dynamics of needs of individuals, environments,and malaria programme successes; mechanisms and approaches to best supportaccelerated policy and financial responsiveness at national and global level to ensure timelyresponse to evidence and needs, including in crisis situations; and systems’ readiness toolsand decision-support systems.
Nayagam S, Sicuri E, Lemoine M, et al., 2017, Economic evaluations of HBV testing and treatment strategies and applicability to low and middle-income countries, BMC Infectious Diseases, Vol: 17, Pages: 107-116, ISSN: 1471-2334
Background: Many people living with chronic HBV infection remain undiagnosed until later stages of disease.Increasing testing and treatment rates form part of the strategy to respond to the WHO goal of eliminating viralhepatitis as a public health threat by 2030. However, achieving these ambitious targets is dependent on findingeffective and cost-effective methods of scale up strategies. The aim of this study was to undertake a narrativereview of the literature on economic evaluations of testing and treatment for HBV infection, to help inform thedevelopment of the 2017 WHO Hepatitis Testing Guidelines.Methods: We undertook a focussed literature review for economic evaluations on testing for HBV accompanied byantiviral treatment. The search was carried out in Pubmed and included only articles published after 2000 and writtenin English. We narratively synthesise the results and discuss the key drivers of cost-effectiveness and their applicabilityto low and middle-income countries (LMICs).Results: Nine published studies were included in this review, only one of which was performed in a low or middleincomesetting in West Africa. Eight studies were performed in high-income settings, seven among high risk groupsand one among the general population. The studies were heterogeneous in many respects including the populationand testing strategy under consideration, model structure and baselines parameters, willingness to pay thresholds andoutcome measures used. However, most studies found HBV testing and treatment to be cost-effective, even at lowHBsAg prevalence levels.Conclusions: Currently economic evaluations of HBV testing and treatment strategies in LMICs is lacking, thereforelimiting the ability to provide formal recommendations on the basis of cost-effectiveness alone. Further implementationresearch is needed in order to help guide national policy planning.
Cucunuba ZM, Sicuri E, Diaz D, et al., 2017, ESTIMATING THE COSTS AND COST-EFFECTIVENESS OF EARLY DIAGNOSIS AND TREATMENT OF CHAGAS DISEASE IN COLOMBIA, 65th Annual Meeting of the American-Society-of-Tropical-Medicine-and-Hygiene (ASTMH), Publisher: AMER SOC TROP MED & HYGIENE, Pages: 364-364, ISSN: 0002-9637
McRobie ES, Matovu F, Nanyiti A, et al., 2017, National responses to global health targets: Exploring policy transfer in the context of the UNAIDS '90-90-90' treatment targets in Ghana and Uganda, Health Policy and Planning, Vol: 33, Pages: 17-33, ISSN: 1460-2237
Global health organizations frequently set disease-specific targets with the goal of eliciting adoption at the national-level; consideration of the influence of target setting on national policies, programme and health budgets is of benefit to those setting targets and those intended to respond. In 2014, the Joint United Nations Programme on HIV/AIDS set ‘ambitious’ treatment targets for country adoption: 90% of HIV-positive persons should know their status; 90% of those on treatment; 90% of those achieving viral suppression. Using case studies from Ghana and Uganda, we explore how the target and its associated policy content have been adopted at the national level. That is whether adoption is in rhetoric only or supported by programme, policy or budgetary changes. We review 23 (14 from Ghana, 9 from Uganda) national policy, operational and strategic documents for the HIV response and assess commitments to ‘90–90–90’. In-person semi-structured interviews were conducted with purposively sampled key informants (17 in Ghana, 20 in Uganda) involved in programme-planning and resource allocation within HIV to gain insight into factors facilitating adoption of 90–90–90. Interviews were transcribed and analysed thematically, inductively and deductively, guided by pre-existing policy theories, including Dolowitz and Marsh’s policy transfer framework to describe features of the transfer and the Global Health Advocacy and Policy Project framework to explain observations. Regardless of notable resource constraints, transfer of the 90–90–90 targets was evident beyond rhetoric with substantial shifts in policy and programme activities. In both countries, there was evidence of attempts to minimize resource constraints by seeking programme efficiencies, prioritization of programme activities and devising domestic financing mechanisms; however, significant resource gaps persist. An effective health network, comprised
Cucunuba Perez ZM, Nouvellet P, Conteh L, et al., 2017, Modelling historical changes in the force-of-infection of Chagas disease to inform control and elimination programmes: application in Colombia, BMJ Global Health, Vol: 2, ISSN: 2059-7908
Background WHO's 2020 milestones for Chagas disease include having all endemic Latin American countries certified with no intradomiciliary Trypanosoma cruzi transmission, and infected patients under care. Evaluating the variation in historical exposure to infection is crucial for assessing progress and for understanding the priorities to achieve these milestones.Methods Focusing on Colombia, all the available age-structured serological surveys (undertaken between 1995 and 2014) were searched and compiled. A total of 109 serosurveys were found, comprising 83 742 individuals from rural (indigenous and non-indigenous) and urban settings in 14 (out of 32) administrative units (departments). Estimates of the force-of-infection (FoI) were obtained by fitting and comparing three catalytic models using Bayesian methods to reconstruct temporal and spatial patterns over the course of three decades (between 1984 and 2014).Results Significant downward changes in the FoI were identified over the course of the three decades, and in some specific locations the predicted current seroprevalence in children aged 0–5 years is <1%. However, pronounced heterogeneity exists within departments, especially between indigenous, rural and urban settings, with the former exhibiting the highest FoI (up to 66 new infections/1000 people susceptible/year). The FoI in most of the indigenous settings remain unchanged during the three decades investigated. Current prevalence in adults in these 15 departments varies between 10% and 90% depending on the dynamics of historical exposure.Conclusions Assessing progress towards the control of Chagas disease requires quantifying the impact of historical exposure on current age-specific prevalence at subnational level. In Colombia, despite the evident progress, there is a marked heterogeneity indicating that in some areas the vector control interventions have not been effective, hindering the possibility of achieving interruption by 2020. A su
Pitt C, Ndiaye M, Conteh L, et al., 2017, Large-scale delivery of seasonal malaria chemoprevention to children under 10 in Senegal: an economic analysis., Health Policy and Planning, Vol: 32, Pages: 1256-1266, ISSN: 1460-2237
Seasonal Malaria Chemoprevention (SMC) is recommended for children under 5 in the Sahel and sub-Sahel. The burden in older children may justify extending the age range, as has been done effectively in Senegal. We examine costs of door-to-door SMC delivery to children up to 10 years by community health workers (CHWs). We analysed incremental financial and economic costs at district level and below from a health service perspective. We examined project accounts and prospectively collected data from 405 CHWs, 46 health posts, and 4 district headquarters by introducing questionnaires in advance and completing them after each monthly implementation round. Affordability was explored by comparing financial costs of SMC to relevant existing health expenditure levels. Costs were disaggregated by administration month and by health service level. We used linear regression models to identify factors associated with cost variation between health posts. The financial cost to administer SMC to 180 000 children over one malaria season, reaching ∼93% of children with all three intended courses of SMC was $234 549 (constant 2010 USD) or $0.50 per monthly course administered. Excluding research-participation incentives, the financial cost was $0.32 per resident (all ages) in the catchment area, which is 1.2% of Senegal's general government expenditure on health per capita. Economic costs were 18.7% higher than financial costs at $278 922 or $0.59 per course administered and varied widely between health posts, from $0.38 to $2.74 per course administered. Substantial economies of scale across health posts were found, with the smallest health posts incurring highest average costs per monthly course administered. SMC for children up to 10 is likely to be affordable, particularly where it averts substantial curative care costs. Estimates of likely costs and cost-effectiveness of SMC in other contexts must account for variation in average costs across deliver
Cundale K, Thomas R, Malaya JK, et al., 2017, A health intervention or a kitchen appliance? Household costs and benefits of a cleaner burning biomass-fuelled cookstove in Malawi, SOCIAL SCIENCE & MEDICINE, Vol: 183, Pages: 1-10, ISSN: 0277-9536
Pneumonia is the leading cause of mortality for children under five years in sub-Saharan Africa. Household air pollution has been found to increase risk of pneumonia, especially due to exposure from dirty burning biomass fuels. It has been suggested that advanced stoves, which burn fuel more efficiently and reduce smoke emissions, may help to reduce household air pollution in poor, rural settings.This qualitative study aims to provide an insight into the household costs and perceived benefits from use of the stove in Malawi. It was conducted alongside The Cooking and Pneumonia Study (CAPS), the largest village cluster-level randomised controlled trial of an advanced combustion cookstove intervention to prevent pneumonia in children under five to date. In 2015, using 100 semi-structured interviews this study assessed household time use and perceptions of the stove from both control and intervention participants taking part in the CAPS trial in Chilumba. Household direct and indirect costs associated with the intervention were calculated.Users overwhelming liked using the stove. The main reported benefits were reduced cooking times and reduced fuel consumption. In most interviews, the health benefits were not initially identified as advantages of the stove, although when prompted, respondents stated that reduced smoke emissions contributed to a reduction in respiratory symptoms. The cost of the stove was much higher than most respondents said they would be willing to pay.The stoves were not primarily seen as health products. Perceptions of limited impact on health was subsequently supported by the CAPS trial data which showed no significant effect on pneumonia. While the findings are encouraging from the perspective of acceptability, without innovative financing mechanisms, general uptake and sustained use of the stove may not be possible in this setting. The findings also raise the question of whether the stoves should be marketed and championed as ‘health inte
Hone T, Lee JT, Majeed A, et al., 2017, Does charging different user fees for primary and secondary care affect first-contacts with primary healthcare? A systematic review., Health Policy and Planning, Vol: 32, Pages: 723-731, ISSN: 1460-2237
Policy-makers are increasingly considering charging users different fees between primary and secondary care (differential user charges) to encourage utilisation of primary health care in health systems with limited gate keeping. A systematic review was conducted to evaluate the impact of introducing differential user charges on service utilisation. We reviewed studies published in MEDLINE, EMBASE, the Cochrane library, EconLIT, HMIC, and WHO library databases from January 1990 until June 2015. We extracted data from the studies meeting defined eligibility criteria and assessed study quality using an established checklist. We synthesized evidence narratively. Eight studies from six countries met our eligibility criteria. The overall study quality was low, with diversity in populations, interventions, settings, and methods. Five studies examined the introduction of or increase in user charges for secondary care, with four showing decreased secondary care utilisation, and three showing increased primary care utilisation. One study identified an increase in primary care utilisation after primary care user charges were reduced. The introduction of a non-referral charge in secondary care was associated with lower primary care utilisation in one study. One study compared user charges across insurance plans, associating higher charges in secondary care with higher utilisation in both primary and secondary care. Overall, the impact of introducing differential user-charges on primary care utilisation remains uncertain. Further research is required to understand their impact as a demand side intervention, including implications for health system costs and on utilisation among low-income patients.
Cucunubá ZM, Manne-Goehler JM, Diaz D, et al., 2017, How universal is coverage and access to diagnosis and treatment for Chagas disease in Colombia? A health systems analysis, Social science & medicine, Vol: 175, Pages: 187-198, ISSN: 0037-7856
Limited access to Chagas disease diagnosis and treatment is a major obstacle to reaching the 2020 World Health Organization milestones of delivering care to all infected and illpatients. Colombia has been identified as a health system in transition, reporting one of the highest levels of health insurance coverage in Latin America. We explore if and how this high level of coverage extends to those with Chagas disease, a traditionally marginalised population. Using a mixed methods approach, we calculate coverage for screening, diagnosis and treatment of Chagas. We then identify supply-side constraints both quantitatively and qualitatively. A review of official registries of tests and treatments for Chagas disease delivered between 2008 and 2014 is compared to estimates of infected people. Using the Flagship Framework, we explore barriers limiting access to care. Screening coverage is estimated at 1.2% of the population at risk. Aetiological treatment with either benznidazol or nifurtimox covered 0.3–0.4% of the infected population. Barriers to accessing screening, diagnosis and treatment are identified for each of the Flagship Framework’s five dimensions of interest: financing, payment, regulation, organisation and persuasion. The main challenges identified were: a lack of clarity in terms of financial responsibilities in a segmented health system, claims of limited resources for undertaking activities particularly in primary care, non-inclusion of confirmatory test(s) in the basic package of diagnosis and care, poor logistics in the distribution and supply chain of medicines, and lack of awareness of medical personnel. Very low screening coverage emerges as a key obstacle hindering access to care for Chagas disease. Findings suggest serious shortcomings in this health system for Chagas disease, despite the success of universal health insurance scale-up in Colombia. Whether these shortcomings exist in relation to other neglected tropical diseases need
Nayagam S, Conteh L, Sicuri E, et al., 2016, Community-based screening and treatment for chronic hepatitis B in sub-Saharan Africa - Authors' reply., Lancet Global Health, Vol: 5, Pages: e35-e35, ISSN: 2214-109X
Mulligan J, Conteh L, 2016, Global priorities for research and the relative importance of different research outcomes: an international Delphi survey of malaria research experts, Malaria Journal, Vol: 15, ISSN: 1475-2875
Background: As global research investment increases, attention inevitably turns to assessing and measuring the outcomes and impact from research programmes. Research can have many different outcomes such as producing advances in scientific knowledge, building research capacity and, ultimately, health and broader societal benefits. The aim of this study was to test the use of a Delphi methodology as a way of gathering views from malaria research experts on research priorities and eliciting relative valuations of the different types of health research impact.Methods: An international Delphi survey of 60 malaria research experts was used to understand views on research outcomes and priorities within malaria and across global health more widely.Results: The study demonstrated the application of the Delphi technique to eliciting views on malaria specific research priorities, wider global health research priorities and the values assigned to different types of research impact. In terms of the most important past research successes, the development of new anti-malarial drugs and insecticide-treated bed nets were rated as the most important. When asked about research priorities for future fund-ing, respondents ranked tackling emerging drug and insecticide resistance the highest. With respect to research impact, the panel valued research that focuses on health and health sector benefits and informing policy and product development. Contributions to scientific knowledge, although highly valued, came lower down the ranking, sug-gesting that efforts to move research discoveries to health products and services are valued more highly than pure advances in scientific knowledge.Conclusions: Although the Delphi technique has been used to elicit views on research questions in global health this was the first time it has been used to assess how a group of research experts value or rank different types of research impact. The results suggest it is feasible to inject the views of a
Nayagam S, Conteh L, Sicuri E, 2016, Cost-effectiveness of community-based screening and treatment for chronic hepatitis B in The Gambia: an economic modelling analysis (vol 4, pg e568, 2016), LANCET GLOBAL HEALTH, Vol: 4, Pages: E794-E794, ISSN: 2214-109X
Ginsburg O, Bray F, Coleman MP, et al., 2016, The global burden of women's cancers: a grand challenge in global health, Lancet, Vol: 389, Pages: 847-860, ISSN: 1474-547X
Every year, more than 2 million women worldwide are diagnosed with breast or cervical cancer, yet where a woman lives, her socioeconomic status, and agency largely determines whether she will develop one of these cancers and will ultimately survive. In regions with scarce resources, fragile or fragmented health systems, cancer contributes to the cycle of poverty. Proven and cost-effective interventions are available for both these common cancers, yet for so many women access to these is beyond reach. These inequities highlight the urgent need in low-income and middle-income countries for sustainable investments in the entire continuum of cancer control, from prevention to palliative care, and in the development of high-quality population-based cancer registries. In this first paper of the Series on health, equity, and women's cancers, we describe the burden of breast and cervical cancer, with an emphasis on global and regional trends in incidence, mortality, and survival, and the consequences, especially in socioeconomically disadvantaged women in different settings.
Nayagam S, Thursz M, Sicuri E, et al., 2016, Requirements for global elimination of hepatitis B: a modelling study., Lancet Infectious Diseases, Vol: 16, Pages: 1399-1408, ISSN: 1473-3099
BackgroundDespite the existence of effective prevention and treatment interventions, hepatitis B virus (HBV) infection continues to cause nearly 1 million deaths each year. WHO aspires to global control and elimination of HBV infection. We aimed to evaluate the potential impact of public health interventions against HBV, propose targets for reducing incidence and mortality, and identify the key developments required to achieve them.MethodsWe developed a simulation model of the global HBV epidemic, incorporating data on the natural history of HBV, prevalence, mortality, vaccine coverage, treatment dynamics, and demographics. We estimate the impact of current interventions and scaling up of existing interventions for prevention of infection and introducing wide-scale population screening and treatment interventions on the worldwide epidemic.FindingsVaccination of infants and neonates is already driving a large decrease in new infections; vaccination has already prevented 210 million new chronic infections by 2015 and will have averted 1·1 million deaths by 2030. However, without scale-up of existing interventions, our model showed that there will be a cumulative 63 million new cases of chronic infection and 17 million HBV-related deaths between 2015 and 2030 because of ongoing transmission in some regions and poor access to treatment for people already infected. A target of a 90% reduction in new chronic infections and 65% reduction in mortality could be achieved by scaling up the coverage of infant vaccination (to 90% of infants), birth-dose vaccination (to 80% of neonates), use of peripartum antivirals (to 80% of hepatitis B e antigen-positive mothers), and population-wide testing and treatment (to 80% of eligible people). These interventions would avert 7·3 million deaths between 2015 and 2030, including 1·5 million cases of cancer deaths. An elimination threshold for incidence of new chronic infections would be reached by 2090 worldwide. The a
Nayagam S, Conteh L, Sicuri E, et al., 2016, Cost-effectiveness of community-based screening and treatment for chronic hepatitis B in The Gambia: an economic modelling analysis, Lancet Global Health, Vol: 4, Pages: e568-e578, ISSN: 2214-109X
Background: Despite the high burden of hepatitis B virus (HBV)infection in sub-Saharan Africa (SSA), a lack of access to widespreadscreening or treatment leads to most people remaining undiagnosed untillater stages of disease when prognosis is poor and treatment options arelimited. We evaluated the cost-effectiveness of community-based screeningand early treatment with antiviral therapy for HBV in The Gambia.Methods: An economic evaluation comparing adult community-based screeningusing a Hepatitis B surface antigen (HBsAg) rapid test and subsequent HBVantiviral therapy to a status quo scenario, where no treatment isavailable, was performed by combining a decision tree with a Markov statetransition model. This was parameterised with primary screening and costdata from the PROLIFICA study. A health provider perspective was takenand costs and health outcomes were discounted at 3% per annum.Findings: In The Gambia, where the HBsAg prevalence is 8.8% among thoseaged over 30 years old, adult screening and treatment for HBV, has anIncremental Cost-Effectiveness Ratio (ICER) of $540 per DisabilityAdjusted Life Year (DALY) averted, $645 per Life Year (LY) saved and $511per Quality Adjusted Life Year (QALY) gained, compared to status quo.These ICERs are in line with willingness-to-pay levels of one times thecountry's Gross Domestic Product (GDP) per capita ($487) per DALYaverted, whilst remaining robust, over a wide range of epidemiologicaland cost parameters.Interpretation: Adult community-based screening and treatment for HBV inthe Gambia is likely to be a cost-effective intervention with an ICERthat is comparable with those of HIV screening and treatmentinterventions in SSA. Even higher cost-effectiveness, may be achievablewith targeted facility-based screening, price reductions of drug and diagnostics and integration of HBV screening with other public healthinterventions.
Pinder M, Conteh L, Jeffries D, et al., 2016, The RooPfs study to assess whether improved housing provides additional protection against clinical malaria over current best practice in The Gambia: study protocol for a randomized controlled study and ancillary studies, Trials, Vol: 17, ISSN: 1745-6215
BACKGROUND: In malaria-endemic areas, residents of modern houses have less malaria than those living in traditional houses. This study will determine if modern housing provides incremental protection against clinical malaria over the current best practice of long-lasting insecticidal nets (LLINs) and prompt treatment in The Gambia, determine the incremental cost-effectiveness of the interventions, and analyze the housing market in The Gambia. METHODS/DESIGN: A two-armed, household, cluster-randomized, controlled study will be conducted to assess whether improved housing and LLINs combine to provide better protection against clinical malaria in children than LLINs alone in The Gambia. The unit of randomization will be the household, defined as a house and its occupants. A total of 800 households will be enrolled and will receive LLINs, and 400 will receive improved housing before clinical follow-up. One child aged 6 months to 13 years will be enrolled from each household and followed for clinical malaria using active case detection to estimate malaria incidence for two malaria transmission seasons. Episodes of clinical malaria will be the primary endpoint. Study children will be surveyed at the end of each transmission season to estimate the prevalence of Plasmodium falciparum infection, parasite density, and the prevalence of anemia. Exposure to malaria parasites will be assessed using light traps, followed by detection of Anopheles gambiae species and sporozoite infection. Ancillary economic and social science studies will undertake a cost-effectiveness analysis and use qualitative and participatory methods to explore the acceptability of the housing modifications and to design strategies for scaling-up housing interventions. DISCUSSION: The study is the first of its kind to measure the efficacy of housing on reducing clinical malaria, assess the incremental cost-effectiveness of improved housing, and identify mechanisms for scaling up housing interventio
Wiseman V, Mitton C, Doyle-Waters MM, et al., 2016, Using economic evidence to set healthcare priorities in low-income and lower-middle-income countries: a systematic review of methodological frameworks, Health Economics, Vol: 25 Suppl 1, Pages: 140-161, ISSN: 1099-1050
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 synthesises 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. These covered a wide range of health interventions with only two studies including health systems strengthening interventions related to financing, governance and human resources. A little under half of the studies (39%) included multiple criteria for priority setting, most commonly equity, feasibility and disease severity. Most studies (91%) specified a measure of ‘efficiency’ defined as cost per disability-adjusted life year averted. Ranking of health interventions using multi-criteria decision analysis and generalised cost-effectiveness were the most common frameworks for identifying priority health interventions. Approximately a third of studies discussed the affordability of priority interventions. Only one study identified priority areas for the release or redeployment of resources. The paper concludes by highlighting the need for local capacity to conduct evaluations (including economic analysis) and empowerment of local decision-makers to act on this evidence.
Pitt C, Ndiaye M, Conteh L, et al., 2015, DELIVERING SEASONAL MALARIA CHEMOPREVENTION TO CHILDREN UNDER TEN AT SCALE IN CENTRAL SENEGAL: COSTS AND COST DETERMINANTS, Publisher: AMER SOC TROP MED & HYGIENE, Pages: 412-413, ISSN: 0002-9637
Meara JG, Leather AJM, Hagander L, et al., 2015, Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development, LANCET, Vol: 386, Pages: 569-624, ISSN: 0140-6736
Nayagam S, Shimakawa Y, Lemoine M, et al., 2014, FEASIBILITY AND COST ANALYSIS OF COMMUNITY BASED HEPATITIS B SCREENING PROGRAMME IN SUB-SAHARAN AFRICA, 49th Annual International Liver Congress of the European-Association-for-the-Study-of-the-Liver, Publisher: ELSEVIER SCIENCE BV, Pages: S36-S36, ISSN: 0168-8278
Balabanova D, Mills A, Conteh L, et al., 2013, Good Health at Low Cost 25 years on: lessons for the future of health systems strengthening, LANCET, Vol: 381, Pages: 2118-2133, ISSN: 0140-6736
Källander K, Tibenderana JK, Akpogheneta OJ, et al., Mobile Health (mHealth) Approaches and Lessons for Increased Performance and Retention of Community Health Workers in Low- and Middle-Income Countries: A Review, Journal of Medical Internet Research, Vol: 15, Pages: e17-e17
Strachan DL, Källander K, ten Asbroek AHA, et al., 2012, Interventions to Improve Motivation and Retention of Community Health Workers Delivering Integrated Community Case Management (iCCM): Stakeholder Perceptions and Priorities, The American Journal of Tropical Medicine and Hygiene, Vol: 87, Pages: 111-119, ISSN: 0002-9637
Sicuri E, Davy C, Marinelli M, et al., 2012, The economic cost to households of childhood malaria in Papua New Guinea: a focus on intra-country variation, HEALTH POLICY AND PLANNING, Vol: 27, Pages: 339-347, ISSN: 0268-1080
Pitt C, Diawara H, Ouédraogo DJ, et al., 2012, Intermittent preventive treatment of malaria in children: a qualitative study of community perceptions and recommendations in Burkina Faso and Mali., PLoS One, Vol: 7
Intermittent preventive treatment of malaria in children (IPTc) is a highly efficacious method of malaria control where malaria transmission is highly seasonal. However, no studies published to date have examined community perceptions of IPTc.
Howitt P, Darzi A, Yang GZ, et al., 2012, Technologies for global health, The Lancet, Vol: 380, Pages: 507-535
Thompson KM, Rabinovich R, Conteh L, et al., 2011, Group report: Developing an eradication investment case, Disease Eradication in the 21st Century: Implications for Global Health, Pages: 133-148, ISBN: 9780262016735
Eradication initiatives offer important opportunities to provide global as well as intergenerational health benefits. Humankind should aspire to the eradication of diseases; however, the decision to commit to an eradication goal should derive from careful consideration of the evidence base and a thorough discussion of the benefits, risks, and costs of eradication compared to the status quo. This chapter discusses the need to develop an eradication investment case (EIC) as a tool to support the decision-making process involved in launching an eradication initiative. Eradication initiatives, like other major societal investments (e.g., capital and infrastructure investments), require careful and deliberate conception and management. Benefits from eradication may include the public good of intergenerational health and associated productivity gains and/or economic savings. However, like other major projects, eradication initiatives represent resource-intensive efforts with associated opportunity costs. Proponents of future eradication initiatives should develop an investment case prior to launch. Critical elements of an EIC are discussed, and the need to standardize the methodology to the greatest extent possible is identified. Since no single overarching decision-making body currently exists to demand and review EICs, an analytic-deliberative process must be developed. The EIC should support and inform deliberations and decisions made by national health leaders at the World Health Assembly and elsewhere, as they consider a global commitment to an eradication goal. An EIC will also stimulate the development of a financial plan, which will provide details about financing the initiative, as stakeholders evaluate the choice to commit to an eradication goal. The EIC will not, however, include the financial or fundraising plan. Innovation should lead to the creation of additional mechanisms to finance eradication initiatives, perhaps including the use of an " eradicatio
Patouillard E, Conteh L, Webster J, et al., 2011, Coverage, Adherence and Costs of Intermittent Preventive Treatment of Malaria in Children Employing Different Delivery Strategies in Jasikan, Ghana, PLOS ONE, Vol: 6, ISSN: 1932-6203
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