Economic Evaluation of Interventions to Reduce Road Traffic injuries - A Review of the Literature with Applications to Low and Middie-income Countries

2004 ◽  
Vol 16 (1) ◽  
pp. 23-31 ◽  
Author(s):  
H.R. Waters ◽  
A.A. Hyder ◽  
T.L. Phillips

Road Traffic Injuries (RTIs) kill over one million people worldwide annually. This article takes the perspective of economic costs and benefits to review the impact of available road safety interventions in industrialized countries - and the potential effect of these interventions in low and middle-income countries, where RTIs pose an increasingly large public health problem. A comprehensive review of the literature on cost-benefits and cost-effectiveness studies related to road traffic injuries internationally, with comparisons of costs adjusted for inflation and exchange differentials was conducted. In the United States (US), motor vehicle inspection laws resulted in annual savings of US $1.7 to $2.3 billion. The installation of seatbelts results in net savings of $162 per vehicle; with benefits outweighing costs by a factor ranging from 240 to 1,727. Other cost effective interventions include mandatory seatbelt use, lowering speed limits, motorcycle helmet laws, and traffic calming devices such as speed bumps and road deviations. The dearth of similar economic evaluations of interventions for road traffic injuries in low and middle-income countries represents a serious research gap and hinders the implementation of effective strategies in those countries. Asia Pac J Public Health 2004; 16(1): 23-31.

Author(s):  
Chris Bullen ◽  
Jessica McCormack ◽  
Amanda Calder ◽  
Varsha Parag ◽  
Kannan Subramaniam ◽  
...  

Abstract Background: The global COVID-19 pandemic has disrupted healthcare worldwide. In low- and middle-income countries (LMICs), where people may have limited access to affordable quality care, the COVID-19 pandemic has the potential to have a particularly adverse impact on the health and healthcare of individuals with noncommunicable diseases (NCDs). A World Health Organization survey found that disruption of delivery of healthcare for NCDs was more significant in LMICs than in high-income countries. However, the study did not elicit insights into the day-to-day impacts of COVID-19 on healthcare by front-line healthcare workers (FLHCWs). Aim: To gain insights directly from FLHCWs working in countries with a high NCD burden, and thereby identify opportunities to improve the provision of healthcare during the current pandemic and in future healthcare emergencies. Methods: We recruited selected frontline healthcare workers (general practitioners, pharmacists, and other medical specialists) from nine countries to complete an online survey (n = 1347). Survey questions focused on the impact of COVID-19 pandemic on clinical practice and NCDs; barriers to clinical care during the pandemic; and innovative responses to the many challenges presented by the pandemic. Findings: The majority of FLHCWs responding to our survey reported that their care of patients had been impacted both adversely and positively by the public health measures imposed. Most FLHCs (95%) reported a deterioration in the mental health of their patients. Conclusions: Continuity of care for NCDs as part of pandemic preparedness is needed so that chronic conditions are not exacerbated by public health measures and the direct impacts of the pandemic.


2021 ◽  
Author(s):  
Siân Herbert ◽  
Heather Marquette

This paper reviews emerging evidence of the impact of COVID-19 on governance and conflict, using a “governance and conflict first” approach in contrast to other research and synthesis on COVID-19 in the social sciences that tends to be structured through a public health lens. It largely focuses on evidence on low- and middle-income countries but also includes a number of examples from high-income countries, reflecting the global nature of the crisis. It is organised around four cross-cutting themes that have enabled the identification of emerging bodies of evidence and/or analysis: Power and legitimacy; Effectiveness, capacity, and corruption; Violence, unrest, and conflict; and Resilience, vulnerability, and risk. The paper concludes with three over-arching insights that have emerged from the research: (1) the importance of leadership; (2) resilience and what “fixing the cracks” really means; and (3) why better ways are needed to add up all the “noise” when it comes to COVID-19 and evidence.


2020 ◽  
Author(s):  
William M. Weiss ◽  
Piya Bhumika ◽  
Althea Andrus ◽  
Robert Cohen

Abstract Background Significant levels of funding have been provided to low- and middle-income countries for development assistance for health, with most funds coming through direct bilateral investment led by the United States and the United Kingdom. Direct attribution of impact to large scale programs funded by donors remains elusive due the difficulty of knowing what would have happened without those programs, and the lack of detailed contextual information to support causal interpretation of changes. Methods This study uses the synthetic control analysis method to estimate the impact of one donor’s funding (United States Agency for International Development, USAID) on under-five mortality across several low- and middle-income countries that received above average levels of USAID funding for maternal and child health programs between 2000 and 2016. Results In the study period (2000-16), countries with above average USAID funding had an under-fiver mortality rate lower than the synthetic control by an average of 29 deaths per 1,000 live births (year to year range of 2 – 38). This finding was stable across several sensitivity analyses. Conclusions The synthetic control method is a valuable addition to the range of approaches for quantifying the impact of large-scale health programs in low- and middle-income countries. The findings suggest that adequately funded donor programs (in this case USAID) help countries to reduce child mortality to significantly lower rates than would have occurred without those investments.


2020 ◽  
Author(s):  
William Weiss ◽  
Bhumika Piya ◽  
Andrus Althea ◽  
Robert Cohen

Abstract BackgroundSignificant levels of funding have been provided to low- and middle-income countries for development assistance for health, with most funds coming through direct bilateral investment led by the United States and the United Kingdom. Direct attribution of impact to large scale programs funded by donors remains elusive due the difficulty of knowing what would have happened without those programs, and the lack of detailed contextual information to support causal interpretation of changes. MethodsThis study uses the synthetic control analysis method to estimate the impact of one donor’s funding (United States Agency for International Development, USAID) on under-five mortality across several low- and middle-income countries that received above average levels of USAID funding for maternal and child health programs between 2000 and 2016. ResultsIn the study period (2000-16), countries with above average USAID funding had an under-fiver mortality rate lower than the synthetic control by an average of 29 deaths per 1,000 live births (year to year range of 2 – 38). This finding was stable across several sensitivity analyses. ConclusionsThe synthetic control method is a valuable addition to the range of approaches for quantifying the impact of large-scale health programs in low- and middle-income countries. The findings suggest that adequately funded donor programs (in this case USAID) help countries to reduce child mortality to significantly lower rates than would have occurred without those investments.


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