scholarly journals Challenges Faced By Decision Makers From Middle Income Countries In Transferring Pharmacoeconomic Data And Analyses From Other Jurisdictions

2014 ◽  
Vol 17 (3) ◽  
pp. A26
Author(s):  
M. Drummond ◽  
F. Augustovski ◽  
Z. Kalo ◽  
B.M. Yang ◽  
A. Pichon-Riviere ◽  
...  
Keyword(s):  
Decision Makers ◽  
Pharmacoeconomic Data ◽  
Middle Income ◽  
Middle Income Countries

scholarly journals COST, CONTEXT, AND DECISIONS IN HEALTH ECONOMICS AND HEALTH TECHNOLOGY ASSESSMENT

2018 ◽  
Vol 34 (5) ◽  
pp. 434-441 ◽  
Author(s):  
Anthony J. Culyer
Keyword(s):  
Health Economics ◽  
Health Technology Assessment ◽  
Decision Maker ◽  
Technology Assessment ◽  
Health Technology ◽  
Decision Makers ◽  
Negative Consequences ◽  
Middle Income ◽  
Middle Income Countries ◽  
Context Dependent

Objectives:This study is an attempt to demystify and clarify the idea of cost in health economics and health technology assessment (HTA).Methods:Its method draws on standard concepts in economics. Cost is a more elusive concept than is commonly thought and can be particularly elusive in multidisciplinary territory like HTA.Results:The article explains that cost is more completely defined as opportunity cost, why cost is necessarily associated with a decision, and that it will always vary according to the context of that decision: whether choice is about inputs or outputs, what the alternatives are, the timing of the consequences of the decision, the nature of the commitment to which a decision maker is committed, who the decision maker is, and the constraints and discretion limiting or liberating the decision maker. Distinctions between short and long runs and between fixed and variable inputs are matters of choice, not technology, and are similarly context-dependent. Harms or negative consequences are, in general, not costs. Whether so-called “clinically unrelated” future costs and benefits should be counted in current decisions again depends on context.Conclusions:The costs of entire health programs are context-dependent, relating to planned rates of activity, volumes, and timings. The implications for the methods of HTA are different in the contexts of low- and middle-income countries compared with high-income countries, and further differ contextually according to the budget constraints (fixed or variable) facing decision makers.

scholarly journals Scaling-Up NCD Interventions in South-East Asia (SUNI-SEA) - the cost evaluation of life-style related NCD interventions

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Koot
Keyword(s):  
Scaling Up ◽  
Decision Makers ◽  
Cost Evaluation ◽  
Health Coverage ◽  
Community Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Gains ◽  
The Cost ◽  
Universal Health

Abstract Vietnam, Myanmar, and Indonesia are trying to create innovative synergies within and between sectors to prevent and treat NCDs. Universal Health Coverage (UHC) is the objective of these countries. The challenge for decision makers in healthcare is to implement programmes and interventions that effectively contain NCDs at the lowest possible cost both in community-based and primary care facilities. The value of implementation and upscaling is assessed by estimating costs, savings and health gains. The presentation focuses on cost-effectiveness evaluation of the entire scaling-up, allowing for comparison within and among countries and generate recommendations for achieving UHC in low- and middle-income countries.

scholarly journals Non-Tuberculous Mycobacteria: Molecular and Physiological Bases of Virulence and Adaptation to Ecological Niches

2020 ◽  
Vol 8 (9) ◽  
pp. 1380
Author(s):  
André C. Pereira ◽  
Beatriz Ramos ◽  
Ana C. Reis ◽  
Mónica V. Cunha
Keyword(s):  
Developed Countries ◽  
Decision Makers ◽  
Public Health Issue ◽  
Individual Species ◽  
Ecological Niches ◽  
Research Gaps ◽  
Middle Income ◽  
Middle Income Countries ◽  
Species Specific ◽  
Total Environment

Non-tuberculous mycobacteria (NTM) are paradigmatic colonizers of the total environment, circulating at the interfaces of the atmosphere, lithosphere, hydrosphere, biosphere, and anthroposphere. Their striking adaptive ecology on the interconnection of multiple spheres results from the combination of several biological features related to their exclusive hydrophobic and lipid-rich impermeable cell wall, transcriptional regulation signatures, biofilm phenotype, and symbiosis with protozoa. This unique blend of traits is reviewed in this work, with highlights to the prodigious plasticity and persistence hallmarks of NTM in a wide diversity of environments, from extreme natural milieus to microniches in the human body. Knowledge on the taxonomy, evolution, and functional diversity of NTM is updated, as well as the molecular and physiological bases for environmental adaptation, tolerance to xenobiotics, and infection biology in the human and non-human host. The complex interplay between individual, species-specific and ecological niche traits contributing to NTM resilience across ecosystems are also explored. This work hinges current understandings of NTM, approaching their biology and heterogeneity from several angles and reinforcing the complexity of these microorganisms often associated with a multiplicity of diseases, including pulmonary, soft-tissue, or milliary. In addition to emphasizing the cornerstones of knowledge involving these bacteria, we identify research gaps that need to be addressed, stressing out the need for decision-makers to recognize NTM infection as a public health issue that has to be tackled, especially when considering an increasingly susceptible elderly and immunocompromised population in developed countries, as well as in low- or middle-income countries, where NTM infections are still highly misdiagnosed and neglected.

scholarly journals 40 years after Alma-Ata, is building new hospitals in low-income and lower-middle-income countries beneficial?

2019 ◽  
Vol 3 (Suppl 3) ◽  
pp. e001293 ◽  
Author(s):  
Fanny Chabrol ◽  
Lucien Albert ◽  
Valéry Ridde
Keyword(s):  
Low Income ◽  
Environmental Sustainability ◽  
Public Hospitals ◽  
Decision Makers ◽  
Middle Income ◽  
Middle Income Countries ◽  
Geographical Inequalities ◽  
Urban Rural ◽  
Hospital Construction

Public hospitals in low-income and lower-middle-income countries face acute material and financial constraints, and there is a trend towards building new hospitals to contend with growing population health needs. Three cases of new hospital construction are used to explore issues in relation to their funding, maintenance and sustainability. While hospitals are recognised as a key component of healthcare systems, their role, organisation, funding and other aspects have been largely neglected in health policies and debates since the Alma Ata Declaration. Building new hospitals is politically more attractive for both national decision-makers and donors because they symbolise progress, better services and nation-building. To avoid the ‘white elephant’ syndrome, the deepening of within-country socioeconomic and geographical inequalities (especially urban–rural), and the exacerbation of hospital-centrism, there is an urgent need to investigate in greater depth how these hospitals are integrated into health systems and to discuss their long-term economic, social and environmental sustainability.

scholarly journals Impact of community-based girl groups

2021 ◽  
Author(s):  
Miriam Temin ◽  
Craig Heck
Keyword(s):  
Evidence Base ◽  
Decision Makers ◽  
Gender Attitudes ◽  
Attitudes And Beliefs ◽  
Community Members ◽  
Community Based ◽  
Middle Income ◽  
Program Impact ◽  
Middle Income Countries ◽  
And Gender

Programs increasingly use community-based girl groups (CBGGs) to address risks and empower adolescent girls, but evidence on their impact is not always accessible to decision makers. A closer look at 30 CBGG programs in low- and middle-income countries found that CBGGs had the greatest reported success in improving health and gender attitudes and beliefs, while their effect on health behavior and status is mixed. Program implementers should consider CBGGs as a way to facilitate girls’ empowerment, with complementary measures to engage community members and to promote enabling environments for greater program impact. Increased interest and investment in CBGGs should be supported by greater investment in further research to bolster the evidence base.

scholarly journals Challenges to Operationalizing Sustainable Diets: Perspectives From Kenya and Vietnam

2021 ◽  
Vol 5 ◽  
Author(s):  
Lesli Hoey ◽  
Colin K. Khoury ◽  
Jamleck Osiemo ◽  
Anna Shires ◽  
Brenda Binge ◽  
...  
Keyword(s):  
Food Systems ◽  
Change Agents ◽  
Project Managers ◽  
Decision Makers ◽  
National Guidelines ◽  
Institutional Barriers ◽  
Middle Income ◽  
Sustainable Diets ◽  
Middle Income Countries ◽  
Sector Data

Despite the urgent need for comprehensive food systems strategies, the challenge lies in defining feasible, evidence-based intervention points. Too little is known about issues food systems decision-makers and other change agents are running up against, particularly in low- and middle-income countries where food systems are the most vulnerable to a growing number of intertwined crises. We look at this question through the lens of sustainable diets, a growing area of research and a concept that is the basis of over 30 sets of national guidelines that aim to simultaneously address health, economic and environmental dimensions of food systems. Based on 114 interviews carried out in Kenya and Vietnam, we examine the extent to which food systems researchers, business and project managers and policy actors are attempting to intervene in food systems in ways that mirror the concept of sustainable diets. We also consider how they are managing two key ingredients that are critical to systems-change—interdisciplinary data and cross-sector collaboration. Most stakeholders we interviewed were carrying out systems-based projects, oriented—even if not explicitly—around many of the sustainable diets domains: agriculture, livelihoods, food security/access/nutrition and/or environment. The majority faced formidable challenges with both data and collaborations, however, showing why it can be so difficult to move from normative ideals like “sustainable diets” to practical realities, regardless of the context. To support more comprehensive food systems policies and interventions, our findings suggest the need for strategies that can improve the collection and accessibility of actionable, cross-sector data, and mechanisms to overcome institutional barriers that limit collaboration.

scholarly journals The anthropocosmos model

2003 ◽  
Vol 70 (422/423) ◽  
pp. 391
Author(s):  
Athens Center Of Ekistics
Keyword(s):  
Low Income ◽  
Large Scale ◽  
Decision Makers ◽  
Human Settlements ◽  
Full Spectrum ◽  
Middle Income ◽  
Theoretical Concepts ◽  
Middle Income Countries ◽  
Wide Range ◽  
Complex Phenomena

The authors of the papers in all three double issues of volume 70 of Ekistics, coming from the broad fields of Geography, History and a wide range of social sciences in general, refer to Society. They focus on Anthropos - Jean Gottmann - and his life-long contribution, through concrete theoretical concepts, to the understanding of the nature and dynamics of urbanization, as well as the structure, function and evolution of Human Settlements Systems. They interpret these principles and emphasize their validity in large-scale Human Settlements - from Metropolis through Megalopolis to Eperopolis - mainly in high- and middle-income countries (less in low-income ones). They demonstrate the relevance of Gottmann's concepts in explaining current global complex phenomena of a social, political and cultural nature. They also identify a set of urgent desirable priority themes for further research, ranging from the clarification of epistemological issues among disciplines to defining ways for expanding the relevance of these principles to the full spectrum of Human Settlements, and bringing them to an explicitly operational level for use by decision makers.

scholarly journals The United Nations Office on Drugs and Crime’s Efforts to Strengthen a Culture of Prevention in Low- and Middle-Income Countries

2020 ◽  
Vol 22 (1) ◽  
pp. 18-28 ◽  
Author(s):  
Hanna Heikkilä ◽  
Wadih Maalouf ◽  
Giovanna Campello
Keyword(s):  
United Nations ◽  
Capacity Building ◽  
Decision Makers ◽  
Evidence Based ◽  
Prevention Programming ◽  
Middle Income ◽  
Middle Income Countries ◽  
The United Nations ◽  
Culture Of Prevention ◽  
Low And Middle Income

AbstractThis article discusses how decision-makers can be supported to strengthen a culture of prevention. This article presents an example of the United Nations Office on Drugs and Crime’s (UNODC) work to engage with decision-makers to create readiness, demand, and capacity for evidence-based prevention programming among them, particularly in low- and middle-income countries. First, we utilized two of the UNODC’s data sources to describe the context where the UNODC’s prevention efforts take place. Analysis of the first dataset on prevention activities implemented globally revealed a gap in translating evidence into practice on a global scale. The second dataset consisted of UNODC policy documents mandating and guiding global action to address substance use. The analysis showed that at the level of political frameworks, prevention is gradually gaining more attention but is still frequently left in the shadow of health- and law enforcement-related issues. In addition, these guiding documents did not reflect fully the current scientific understanding of what constitutes an effective prevention response. Against this background, the feasibility of the UNODC’s efforts to bridge the science–practice gap in the field of prevention was discussed by presenting the results from the UNODC’s regional capacity-building seminars focused on the role of monitoring and evaluation in prevention programming. The results showed potential of this capacity building to affect the attitudes and knowledge of targeted decision-makers. Such efforts to increase decision-makers’ readiness and ultimately their endorsement, adoption, and ongoing support of evidence-based preventive interventions should be continued and intensified.

scholarly journals What next after GDP-based cost-effectiveness thresholds?

2020 ◽  
Vol 4 ◽  
pp. 176
Author(s):  
Y-Ling Chi ◽  
Mark Blecher ◽  
Kalipso Chalkidou ◽  
Anthony Culyer ◽  
Karl Claxton ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Decision Rules ◽  
Cost Effective ◽  
Evidence Base ◽  
Decision Makers ◽  
Health Coverage ◽  
Middle Income ◽  
Policy Makers ◽  
Middle Income Countries ◽  
The World

Public payers around the world are increasingly using cost-effectiveness thresholds (CETs) to assess the value-for-money of an intervention and make coverage decisions. However, there is still much confusion about the meaning and uses of the CET, how it should be calculated, and what constitutes an adequate evidence base for its formulation. One widely referenced and used threshold in the last decade has been the 1-3 GDP per capita, which is often attributed to the Commission on Macroeconomics and  WHO guidelines on Choosing Interventions that are Cost Effective (WHO-CHOICE). For many reasons, however, this threshold has been widely criticised; which has led experts across the world, including the WHO, to discourage its use. This has left a vacuum for policy-makers and technical staff at a time when countries are wanting to move towards Universal Health Coverage. This article seeks to address this gap by offering five practical options for decision-makers in low- and middle-income countries that can be used instead of the 1-3 GDP rule, to combine existing evidence with fair decision-rules or develop locally relevant CETs. It builds on existing literature as well as an engagement with a group of experts and decision-makers working in low, middle and high income countries.

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