Midterm review of national health plans: an example from the United Republic of Tanzania

IntroductionSince resources are finite, investing in services that produce the highest health gain ‘return on investment’ is critical. We assessed the extent to which low and middle-income countries (LMIC) have included cost-saving interventions in their national strategic health plans.MethodsWe used the Tufts Medical Center Global Health Cost-Effectiveness Analysis Registry, an open-source database of English-language cost-per-disability-adjusted life year (DALY) studies, to identify analyses published in the last 10 years (2008–2017) of cost-saving health interventions in LMICs. To assess whether countries prioritised cost-saving interventions within their latest national health strategic plans, we identified 10 countries, all in sub-Saharan Africa, with the highest measures on the global burden of disease scale and reviewed their national health priority plans.ResultsWe identified 392 studies (63%) targeting LMICs that reported 3315 cost-per-DALY ratios, of which 207 ratios (6%) represented interventions reported to be cost saving. Over half (53%) of these targeted sub-Saharan Africa. For the 10 countries we investigated in sub-Saharan Africa, 58% (79/137) of cost-saving interventions correspond with priorities identified in country plans. Alignment ranged from 95% (21/22 prioritised cost-saving ratios) in South Africa to 17% (2/12 prioritised cost-saving ratios) in Cameroon. Human papillomavirus vaccination was a noted priority in 70% (7/10) of national health prioritisation plans, while 40% (4/10) of countries explicitly included prenatal serological screening for syphilis. HIV prevention and treatment were stated priorities in most country health plans, whereas 40% (2/5) of countries principally outlined efforts for lymphatic filariasis. From our sample of 45 unique interventions, 36% of interventions (16/45) included costs associated directly with the implementation of the intervention.ConclusionOur findings indicate substantial variation across country and disease area in incorporating economic evidence into national health priority plans in a sample of sub-Saharan African countries. To make health economic data more salient, the authors of cost-effectiveness analyses must do more to reflect implementation costs and other factors that could limit healthcare delivery.

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Nganyi and Others v. United Republic of Tanzania 176 ILR 58

International Law Reports ◽

10.1017/cbo9781108551625.002 ◽

2018 ◽

pp. 58-99

Keyword(s):

United Republic ◽

United Republic Of Tanzania

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An 8-year Pattern of Orofacial Sarcoma from the National Referral Hospital in United Republic of Tanzania

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1290 ◽

2016 ◽

Vol 7 (4) ◽

pp. 207-212 ◽

Cited By ~ 1

Keyword(s):

Head And Neck ◽

Demographic Data ◽

Neck Region ◽

Referral Hospital ◽

Histopathological Diagnosis ◽

Primary Tumors ◽

Female Ratio ◽

United Republic ◽

United Republic Of Tanzania ◽

National Referral Hospital

ABSTRACT Aim: This study aimed at evaluating the pattern of head and neck sarcomas among patients treated at Muhimbili National Hospital, Tanzania. Background Sarcomas of the head and neck are very rare, representing only 1% of all primary tumors arising within the head and neck region and accounting for 4 to 10% of all sarcomas, with more than 50 distinct existing histologic subtypes. Materials and methods It was a retrospective study whereby histological results of the lesions arising from oral and maxillofacial region between 2008 and 2016 were analyzed. Patient's demographic data, histopathological diagnosis, and the type of sarcoma were recorded. The lesions were broadly grouped as soft and hard tissue sarcomas (HTSs). Data analysis was done using Statistical Package for the Social Sciences version 19 computer program. Results Sarcomas accounted for 7% of all lesions occurring in orofacial region. Male to female ratio was 1:1.4. The age ranged from 3 to 81 years, mean age being 33 ± 16 years. The most affected age groups were of 30 to 39 followed by 20 to 29 years. Approximately half of the patients were aged below 30 years and three quarters below 40 years. Kaposi's sarcoma (KS) and rhabdomyosarcoma were the most common soft tissue sarcoma (STS), while osteosarcoma and chondrosarcoma were the commonest HTS. Conclusion The analysis demonstrated that the head and neck sarcomas are a very rare group of neoplasm, with approximately 20 cases per year. The STSs are more common than the HTSs, while KS is the most common, followed by osteosarcoma and rhabdomyosarcoma. Generally, patients less than 40 years of age are the mostly affected, with a slightly higher female predominance. Clinical significance By contributing to the identification of the incidence of sarcomas at a tertiary hospital in Tanzania, this study promotes scientific understanding of pattern of occurrence and underscores the necessity of early detection of sarcomas, since the affected are young individuals. How to cite this article Moshy JR, Owibingire SS, Sohal KS. An 8-year Pattern of Orofacial Sarcoma from the National Referral Hospital in United Republic of Tanzania. Int J Head Neck Surg 2016;7(4):207-212.

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