scholarly journals Accounting for country- and time-specific values in the economic evaluation of health-related projects relevant to low- and middle-income countries

2021 ◽  
Author(s):  
James Lomas ◽  
Karl Claxton ◽  
Jessica Ochalek
Keyword(s):  
Economic Evaluation ◽  
Marginal Cost ◽  
Healthcare Sector ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Related ◽  
Evaluation Parameters ◽  
Over Time ◽  
Value Of Health ◽  
Low And Middle Income

Abstract Economic evaluation of health-related projects requires principles and methods to address the various trade-offs that need to be made between costs and benefits, across sectors and social objectives, and over time. Existing guidelines for economic evaluation in low- and middle-income countries embed implicit assumptions about expected changes in the marginal cost per unit of health produced by the healthcare sector, the consumption value of health and the appropriate discount rates for health and consumption. Separating these evaluation parameters out requires estimates for each country over time, which have hitherto been unavailable. We present a conceptual economic evaluation framework that aims to clarify the distinct roles of these different evaluation parameters in evaluating a health-related project. Estimates for each are obtained for each country and in each time period, based on available empirical evidence. Where existing estimates are not available, for future values of the marginal cost per unit of health produced by the healthcare sector, new estimates are obtained following a practical method for obtaining projected values. The framework is applied to a simple, hypothetical, illustrative example, and the results from our preferred approach are compared against those obtained from other approaches informed by the assumptions implicit within existing guidelines. This exposes the consequences of applying such assumptions, which are not supported by available evidence, in terms of potentially sub-optimal decisions. In general, we find that applying existing guidelines as done in conventional practice likely underestimates the value of health-related projects on account of not allowing for expected growth in the marginal cost per unit of health produced by the healthcare sector.

scholarly journals Examining the use of economic evaluations in health-related humanitarian programmes in low- and middle-income countries: a systematic review

2019 ◽  
Vol 35 (2) ◽  
pp. 210-218 ◽  
Author(s):  
Lizna A Makhani ◽  
Valerie Moran ◽  
Zia Sadique ◽  
Neha S Singh ◽  
Paul Revill ◽  
...  
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
Bibliographic Databases ◽  
Economic Evaluations ◽  
Middle Income ◽  
System Perspective ◽  
Middle Income Countries ◽  
Humanitarian Crises ◽  
Health Related ◽  
Low And Middle Income

Abstract The costly nature of health sector responses to humanitarian crises and resource constraints means that there is a need to identify methods for priority setting and long-term planning. One method is economic evaluation. The aim of this systematic review is to examine the use of economic evaluations in health-related humanitarian programmes in low- and middle-income countries. This review used peer-reviewed literature published between January 1980 and June 2018 extracted from four main electronic bibliographic databases. The eligibility criteria were full economic evaluations (which compare the costs and outcomes of at least two interventions and provide information on efficiency) of health-related services in humanitarian crises in low- and middle-countries. The quality of eligible studies is appraised using the modified 36-question Drummond checklist. From a total of 8127 total studies, 11 full economic evaluations were identified. All economic evaluations were cost-effectiveness analyses. Three of the 11 studies used a provider perspective, 2 studies used a healthcare system perspective, 3 studies used a societal perspective and 3 studies did not specify the perspective used. The lower quality studies failed to provide 7information on the unit of costs and did not justify the time horizon of costs and discount rates, or conduct a sensitivity analysis. There was limited geographic range of the studies, with 9 of the 11 studies conducted in Africa. Recommendations include greater use of economic evaluation methods and data to enhance the microeconomic understanding of health interventions in humanitarian settings to support greater efficiency and transparency and to strengthen capacity by recruiting economists and providing training in economic methods to humanitarian agencies.

scholarly journals A scoping review of health-related stigma outcomes for high-burden diseases in low- and middle-income countries

BMC Medicine ◽  
2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Jeremy C. Kane ◽  
Melissa A. Elafros ◽  
Sarah M. Murray ◽  
Ellen M. H. Mitchell ◽  
Jura L. Augustinavicius ◽  
...  
Keyword(s):  
Scoping Review ◽  
Middle Income ◽  
High Burden ◽  
Middle Income Countries ◽  
Related Stigma ◽  
Health Related ◽  
Low And Middle Income

scholarly journals Materno-fetal and neonatal outcomes associated with caesarean section delivery in private and public hospitals in low- and middle-income countries: a systematic review

2020 ◽  
Author(s):  
Idrissa Beogo ◽  
Amadou Darboue ◽  
Tiara Marthias ◽  
Sia Drissa ◽  
Tchouaket Nguemeleu Eric ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Public Hospitals ◽  
Neonatal Outcomes ◽  
Healthcare Sector ◽  
Middle Income ◽  
Middle Income Countries ◽  
Caesarean Section Delivery ◽  
Private And Public ◽  
Low And Middle Income

Abstract Background: Advancement in medicine has improved birth assistance. As a result, caesarean section delivery (CSD) has become the most commonly performed surgical procedure. The exponential growth has now skewed toward low- and middle-income countries (LMICs) despite the well-established morbimortality risk and extra costs associated to this procedure. The expansion of private healthcare sector may be playing a significant role. The objective of this review synthesizes knowledge and investigates the difference in materno-fetal and neonatal outcomes of CSD in the perinatal period, between private and public hospitals. Methods: Medline, Embase, Cinhal, Cochrane Database, LILACS, and HINARI were screened for peer-reviewed published studies in English and French, from 1990 to 2019, in human subjects and supplemented by manual searches. The studies included were prospective and retrospective cohort studies, cross-sectional and Delphi studies comparing perinatal outcomes of women whose neonates were delivered by caesarean section and by vaginal delivery in public and private hospitals. In total, the searches yielded 7,762 studies, assessed independently by two assessors. Of these, 26 quantitative studies were included which risk of bias was considered fairly low.Results: Elective or not, CSD is associated with a variety of outcomes, including death for both the mother and the neonate. Low quality of life, postpartum depression, infections, and scars were burdens attributable to CSD in both sectors. CSD is associated with less urinary incontinence compared to vaginal delivery but no difference exists in early skin-to-skin contact or in early breastfeeding introduction. Finally, across continents, Africa leads in terms of adverse consequences.Discussion/Conclusion: Private facilities surpassed public ones in CSD rate but were associated with the least severe materno-neonatal outcomes. Countries like China are succeeding through robust policies interventions formulation to contain the CSD epidemic and the health issues associated thereto.

scholarly journals Feminine Appeals on Cigarette Packs Sold in 14 Countries

2021 ◽  
Vol 66 ◽  
Author(s):  
Lauren Czaplicki ◽  
Kevin Welding ◽  
Joanna E. Cohen ◽  
Katherine Clegg Smith
Keyword(s):  
Substantial Proportion ◽  
Middle Income ◽  
Global Trends ◽  
Plain Packaging ◽  
Middle Income Countries ◽  
Gender Neutral ◽  
Traditional Femininity ◽  
Over Time ◽  
Cigarette Packs ◽  
Low And Middle Income

Objective: Limited research has examined feminine marketing appeals on cigarette packs in low-and middle-income countries (LMICs). We reviewed a systematically collected sample of cigarette packs sold across 14 LMICs in 2013 (Wave 1) and 2015–2017 (Wave 2).Methods: Packs in Wave 1 (n = 3,240) and Wave 2 (n = 2,336) were coded for feminine imagery and descriptors (flowers, fashion, women/girls, color “pink”). We examined trends in feminine appeals over time, including co-occurrence with other pack features (slim or lipstick shape, flavor, reduced harm, and reduced odor claims).Results: The proportion of unique feminine cigarette packs significantly decreased from 8.6% (n = 278) in Wave 1 to 5.9% (n = 137) in Wave 2 (p < 0.001). Among all feminine packs, flower-and fashion-related features were most common; a substantial proportion also used flavor and reduced odor appeals.Conclusion: While there was a notable presence of feminine packs, the decline observed may reflect global trends toward marketing gender-neutral cigarettes to women and a general contempt for using traditional femininity to market products directly to women. Plain packaging standards may reduce the influence of branding on smoking among women.

Sign in / Sign up

Export Citation Format

Share Document