scholarly journals Cost-effectiveness of neonatal surgery for congenital anomalies in low-income and middle-income countries: a systematic review protocol

2020 ◽  
Vol 4 (1) ◽  
pp. e000755
Author(s):  
Na Eun Kim ◽  
Dominique Vervoot ◽  
Ahmad Hammouri ◽  
Cristiana Riboni ◽  
Hosni Salem ◽  
...  

IntroductionCongenital anomalies are the fifth leading cause of death in children under 5 years old globally (591 000 deaths reported in 2016). Over 95% of deaths occur in low-income and middle-income countries (LMICs). It is estimated that two-thirds of the congenital anomaly health burden could be averted through surgical intervention and that such interventions can be cost-effective. This systematic review aims to evaluate current evidence regarding the cost-effectiveness of neonatal surgery for congenital anomalies in LMICs.Methods and analysisA systematic literature review will be conducted in PubMed, MEDLINE, Embase, Cochrane Library, Scielo, Google Scholar, African Journals OnLine and Regional WHO’s African Index Medicus databases for articles on the cost-effectiveness of neonatal surgery for congenital anomalies in LMICs. The following search strings will be used: (1) congenital anomalies; (2) LMICs; and (3) cost-effectiveness of surgical interventions. Articles will be uploaded to Covidence software, duplicates removed and the remaining articles screened by two independent reviewers. Cost information for interventions or procedures will be extracted by country and condition. Outcome measurements by reported unit and cost-effectiveness ratios will be extracted. Methodological quality of each article will be assessed using the Drummond checklist for economic evaluations. The Agency for Healthcare Research and Quality’s Effective Health Care Program guidance will be followed to assess the grade of the studies.Ethics and disseminationNo ethical approval is required for conducting the systematic review. There will be no direct collection of data from individuals. The finalised article will be published in a scientific journal for dissemination. The protocol has been registered with PROSPERO (International Prospective Register of Systematic Reviews).ConclusionCongenital anomalies form a large component of the global health burden that is amenable to surgical intervention. This study will systematically review the current literature on the cost-effectiveness of neonatal surgery for congenital anomalies in LMICs.PROSPERO registration numberCRD42020172971.

2019 ◽  
Vol 20 (6) ◽  
pp. 266-273
Author(s):  
Pushpa Udayangani Gamalathge ◽  
Sanjeewa Kularatna ◽  
Hannah E Carter ◽  
Sameera Senanayake ◽  
Nicholous Graves

Background: Hospital-acquired infections (HAI) contribute to prolonged hospital stays and account for a substantial economic burden to healthcare systems. Middle-income countries (MICs) experience a greater burden of HAI than developed countries. Evidence on the cost-effectiveness of interventions to reduce HAI is required to inform decision-making in these settings. Aim: To synthesise the evidence on cost-effectiveness as related to HAI interventions in MICs and to assess the quality of this evidence. Methods: A systematic review of published literature on the cost-effectiveness of interventions to reduce the incidence of HAI in MICs between 2000 and 2018 was conducted. Results: Six studies met the pre-determined inclusion criteria. The studies were from three countries: Thailand; India; and Vietnam. The evidence suggests that interventions to reduce HAI are cost-effective and, in most cases, cost-saving to healthcare systems. The quality of the reporting varied across studies. Conclusions: The implementation of HAI prevention interventions appears to be a high value use of resources in MICs. There is a need for further cost-effectiveness analyses in a wider range of MICs in order to confirm these findings. Improved standardisation and quality of reporting is required.


2020 ◽  
Vol 5 (9) ◽  
pp. e002213
Author(s):  
Deliana Kostova ◽  
Garrison Spencer ◽  
Andrew E Moran ◽  
Laura K Cobb ◽  
Muhammad Jami Husain ◽  
...  

Hypertension in low-income and middle-income countries (LMICs) is largely undiagnosed and uncontrolled, representing an untapped opportunity for public health improvement. Implementation of hypertension control strategies in low-resource settings depends in large part on cost considerations. However, evidence on the cost-effectiveness of hypertension interventions in LMICs is varied across geographical, clinical and evaluation contexts. We conducted a comprehensive search for published economic evaluations of hypertension treatment programmes in LMICs. The search identified 71 articles assessing a wide range of hypertension intervention designs and cost components, of which 42 studies across 15 countries reported estimates of cost-effectiveness. Although comparability of results was limited due to heterogeneity in the interventions assessed, populations studied, costs and study quality score, most interventions that reported cost per averted disability-adjusted life-year (DALY) were cost-effective, with costs per averted DALY not exceeding national income thresholds. Programme elements that may reduce cost-effectiveness included screening for hypertension at younger ages, addressing prehypertension, or treating patients at lower cardiovascular disease risk. Cost-effectiveness analysis could provide the evidence base to guide the initiation and development of hypertension programmes.


2019 ◽  
Vol 3 (1) ◽  
pp. e000538 ◽  
Author(s):  
Stephanie Michele Goley ◽  
Sidonie Sakula-Barry ◽  
Ann Kelly ◽  
Naomi Wright

IntroductionCongenital anomalies are the fifth leading cause of mortality in children under 5 years globally. The greatest burden is faced by those in developing countries, where over 95% of deaths occur. Many of these deaths may have been preventable through antenatal diagnosis and early intervention. This study aims to conduct a systematic review that investigates the use of antenatal ultrasound to diagnose congenital anomalies and improve the health outcomes of infants in low-income and middle-income countries (LMICs).Methods and analysisA systematic literature review will be conducted using three search strings: (1) structural congenital anomalies, (2) LMICs and (3) antenatal diagnosis. Four electronic databases will be searched: MEDLINE, Embase, PubMed and the Cochrane Library. Title, abstract and full-text screening will be undertaken in duplicate by two reviewers independently using Covidence. Consensus will be sought from the wider authorship for discrepancies. Data extraction will be undertaken by the principal investigator. The primary analysis will focus on the availability and effectiveness of antenatal ultrasound for structural congenital anomalies. Secondary outcomes will include neonatal morbidity and mortality, termination rates and referral rates for further antenatal care. Descriptive statistics and a narrative synthesis will be included in the final report. The methodological quality of the included studies will be evaluated using the Cochrane-approved Risk of Bias for Non-Randomised Studies of Intervention and Risk of Bias in Randomised Trials V.2.0 tools.Ethics and disseminationEthical approval is not required for conducting the systematic review as there will be no direct collection of data from individuals. The results will be submitted for publication in a scientific journal and presented internationally.ConclusionThis is the first study, to our knowledge, to systematically review current literature on the use of antenatal ultrasound for the detection of congenital anomalies in LMICs. This is vital to define current practice, highlight global disparities and evaluate effects on health outcomes for infants in low-resource settings.PROSPERO registration numberCRD42019105620.


2019 ◽  
Vol 6 (4) ◽  
Author(s):  
Sabbir Haider ◽  
Usa Chaikledkaew ◽  
Montarat Thavorncharoensap ◽  
Sitaporn Youngkong ◽  
Md Ashadul Islam ◽  
...  

2021 ◽  
Author(s):  
Nonjabulo Gwala ◽  
Thembelihle Patricia Dlungwane ◽  
Sphamandla Nkambule ◽  
Tivani Mashamba-Thompson

Abstract BackgroundIn recent years, the shift from traditional face-to-face teaching methods to eLearning methods has shown to improve professional training, particularly for the health workers in achieving necessary specialised worker training. However, there is a insufficient evidence on the costs and cost-effectiveness of designing and deploying eLearning interventions for healthcare workers in low- and middle-income countries.MethodsThe study protocol was developed and reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The Cochrane Handbook for Systematic Reviews of Interventions will be used to guide the conduct of the proposed systematic review and meta-analysis. Systematic literature searches will be conducted using the EBSCOhost platform ( Academic Search Complete, ERIC, health source: nursing/academic edition, MEDLINE with Full Text, OpenDissertations), Google Scholar, and the following databases: Web of Science, PubMed and ProQuest databases, evaluating the cost and cost-effectiveness of e-learning interventions for healthcare workers in low- and middle-income countries. The searches will be open to peer-reviewed articles published in all languages and no restriction in publication year. We will further evaluate the cost-effectiveness by determining heterogeneity in the content, if feasible we will do a meta-analysis using Meta- Easy Excel software tools. We will use OR and 95% CIs as measures of effect for dichotomous outcomes. As for continuous outcomes, we will use standardised mean differences and 95% CIs. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach will be used to assess the certainty of the evidence across outcomes. PRISMA-P will be used to report the findings of this systematic review and meta-analysis.DiscussionThis systematic review target to deliver complete evidence of cost and the cost-effectiveness of eLearning interventions for healthcare worker training. The study will be disseminated through the publication of the manuscript and policy brief in an appropriate journal and shared with the relevant stakeholders through conference presentations, discussions and seminars.Protocol registrationPROSPERO ID: 271180


2020 ◽  
Vol 10 ◽  
pp. S90-S94
Author(s):  
Euridxe Barbosa ◽  
Brito Gulela ◽  
Maria A. Taimo ◽  
Dino M. Lopes ◽  
O. Agatha Offorjebe ◽  
...  

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