Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March 2009 COST EFFECTIVENESS ANALYSIS OF.

Slides:

Advertisements

Similar presentations

Burkina Faso Five-Year Evaluation of the Global Fund (GF5YE): Study Area 3 – Health Impact Sharing experiences in linking M&E to research linking M&E to.

Advertisements

Skilled Attendant at Delivery MICS3 Data Analysis and Report Writing.

Fee exemption policies for maternal health services A Review of 11 African countries Benin, Burkina Faso, Burundi, Ghana, Mali, Morocco, Niger, Nigeria,

Skilled Birth Attendant and Skilled Birth Attendance

TELEMEDICINE/TELE-HEALTH TO ENHANCE THE PROVISION OF BURN CARE SERVICES ACROSS THE NORTHERN BURN CARE NETWORK INTRODUCTION Jayne Andrew - Northern Burn.

FIRST REFERRAL UNIT.

A REPRODUCTIVE HEALTH COMMODITY SECURITY STRATEGY FOR THE WEST AFRICA SUBREGION 2007 – 2011 Dr. Kabba Joiner, WAHO 2006 Fall Meeting of the Reproductive.

Assessing technical efficiency of HIV prevention interventions in three sub-Saharan countries S Bautista-Arredondo, SG Sosa-Rubí, D Contreras-Loya, M Opuni,

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March 2009 Patent medicines vendors a resource.

Neonatal Mortality in Ghana Keeps MDG 4 at the Crossroads.

Evaluating the benefit of training Non-Physician Clinicians for Maternal and Newborn Care Mselenge Mdegela MD, Mmed(Obs/Gyn) Centre for Maternal and Newborn.

Task shifting & HRH Crisis: field experience and current thinking within MSF Mit Philips, Médecins Sans Frontières, Brussels. WHO satelite conference,

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March 2009 Equitable Financing of Primary.

23 May 2015 Delivering safer motherhood – sharing the evidence Vincent De Brouwere Institute of Tropical Medicine, Antwerp On behalf of all Immpact teams.

AIDS 2014, Melbourne, Australia July 25th, 2014

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March 2009 The Economic costs associated.

Improving health workforce performance in Ghana, Tanzania and Uganda Kaspar Wyss Swiss Tropical and Public Health Institute.

Skilled attendant at birth mDG 5, target 5A, Indicator 5.2

STRENGTHENING HEALTH SYSTEMS Anne Mills DCPP Editor London School of Hygiene and Tropical Medicine.

Preliminary findings of a routine PMTCT Option B+ programme in a rural district in Malawi Rebecca M. Coulborn 1, Laura Triviño Duran 1, Carol Metcalf 2,

International Health Policy Program -Thailand Cost-utility of dental implant placement to support lower complete denture in Thailand Warisa Panichkriangkrai.

CENTRE FOR HEALTH ECONOMICS AND DEVELOPEMNT ESTIMATING ECONOMIC AND FISCAL IMPACT OF HEALTH AND NON HEALTH EXPENDITURE FROM THE NATIONAL HEALTH BILL Kenneth.

Improving the quality of medical and surgical care 1 Subarachnoid Haemorrhage.

Report to the Select Committee on Social Services on Vacancies in the Public Health Sector Cape Town 6 th March 2012.

1 Econoqualimetrics Edward Broughton, PhD., MPH Senior Economic Analyst, USAID Health Care Improvement Project, EnCompass,

The Lancet Commission on Global Surgery 2 nd Meeting Freetown, Sierra Leone Commission Research & Projects.

The Global Crisis Global shortage of nurses & other health professionals Migration of nurses & doctors to developed countries Impact on delivery of care.

Presented by: Jennifer Bryce Institute for International Programs Johns Hopkins Bloomberg School of Public Health Mortality and Coverage: Where are we.

AUDIT OF MATERNAL DEATHS USING LONGITUDINAL DATA – CASE OF RUFIJI HDSS By Illah Evance.

Washington D.C., USA, July 2012www.aids2012.org Estimating the Costs and Impacts of HIV/AIDS Programs for Botswana Examples of the ART Program and.

W ORKFORCE P OLICY C OLLABORATIVE State Office of Rural Health Programs & Services Provider recruitment Hospital and clinic services Emergency preparedness.

Knowing what you get for what you pay An introduction to cost effectiveness FETP India.

Challenges, Bottlenecks and Solutions to Scaling-up Newborn Care in Cameroun AU Maternal, Child and Newborn Conference 1-3 August, 2013 Johannesburg, South.

Summary of AfHEA’s key milestones. 2 nd Conference of the African Health Economics and Policy Association (AfHEA) Saly – Senegal, 15 th - 17 th March.

Antiretroviral Treatment (ART) & Human resources Wim Van Damme Department of Public Health ITM, 17 October 2006.

MDG Needs Assessment Training Workshop May 9-12, 2005 Health Module.

Promoting Literacy practices in Disability Programmes through CBR Grace Musoke CBR Africa Network March 12,

IRSS – Centre Muraz : A collaborative research initiative for the promotion of Health in Africa Maxime Koiné DRABO MD, MPH, PhD.

Primary Trauma Care Dr Rob McDougall FANZCA PTCF, Trustee.

Summary of the Key Recommendations. HHAPI-NeSS Improve the Health System for mothers and babies. Improve the knowledge and skills of Health Care Providers.

Bending the curve in reducing newborn mortality: focus on quality and effective coverage of selected newborn interventions Joseph de Graft-Johnson Newborn.

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March 2009 Economic Evaluation of Flying.

THE GEOGRAPHY OF COVERAGE Professor Wendy J Graham Immpact, University of Aberdeen & Dr Sennen Hounton UNFPA, New York Presentation for Countdown Equity.

TRANSFORMING THE EDUCATION AND TRAINING OF CLINICAL PROFESSIONAL: DELIVERING MATERNAL AND CHILD HEALTHCARE IN MALAWI MELANIE HAMI GLADYS MSISKA.

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March 2009 Barriers to Antiretroviral Therapy.

STAYING ALIVE! MAKING MATERNAL HEALTH WORK KENYA MONITORING AND EVALUATION TRAINING Tools and AkvoFlow BY ALEXIA WADIME 30 TH OCTOBER 2013.

Scholarly Writing: Presentation Title “Costs of vaginal delivery and Caesarean section at a tertiary level public hospital in Islamabad, Pakistan Author.

1 Leading initiative: Health Systems Strengthening for Equity: The Potential of Mid-Level Health Providers/Non physicians clinicians Dr. Monique Rakotomalala,

Effective Referral System for the Utilization of Critical Maternal and Newborn Health at Rural Health Centers of Ethiopia APHA 143 rd Annual Conference.

The Cost and Impact of Scaling-up Medical Male Circumcision in Uganda: An Empirical Analysis International AIDS Conference Vienna July 2010 Nazarius Mbona.

Human resources for maternal, newborn and child health: opportunities and constraints in the Countdown priority countries Neeru Gupta Health Workforce.

International SBCC Summit

1 5 th World Conference on Virology, December th 2015, Atlanta,USA Chaste KARANGWA 1, Eugene RUGIRA 1, Placidie MUGWANEZA 1, Helene Badini 3, Fabian.

TOPIC:KNOWLEDGE ABOUT INDIVIDUALIZED BIRTH PLAN AND OBSTETRIC DANGER SIGNS AMONG MEN ATTENDING REPRODUCTIVE AND CHILD HEALTH CLINIC AT BUGURUNI HEALTH.

Andrew Baleyku Imperial Royale Hotel, Kampala 26 June 2013 Session 2: Introduction to the bottleneck analysis tool.

Right to health in Rwanda: role of health workers and their training Dr Alex Hakuzimana East African Consultation on the Right to Health Nairobi, Sept.

The Alberta Health Technologies Decision Process: Post Policy Implementation Review Presenter: Sarah Flynn Authors: Dr. Anderson Chuck, Institute of Health.

Global Maternal and Child Health in Rural Malawi : A Resident-Centerd Evaluation Of A New ACGME-Approved Rotation Christina Miller, MD; Sumedh Mankar,

VMMC Sustainability and Early Infant Male Circumcision Dr. Tin Tin Sint HIV section, UNICEF New York.

Flex EMS Program Review March 15, 2017 Christy Edwards

Testing Efficiency Indicators

MOH collaboration to improve maternal and newborn care in Timor-Leste Health Alliance International APHA Annual Meeting November 5, 2007.

WORKING WITH GOVERNMENT FOR THE PROMOTION OF PATIENT CENTRED BLOOD TRANSFUSION MEDICINE IN KENYA, THE RSBTK EXPERIENCE Mary W. Kariithi IAPO Africa Region.

Towards UK poSt Arthroplasty Follow-up rEcommendations: UK SAFE

Kandeke C, Chibuta C, Banda D

AUDIT of maternal deaths using longitudinal data – case of rufiji hdss

An Advocacy-Research Partnership: A Successful Knowledge-Translation Platform? McAuliffe, E, DePinho, H., Clark, P, Sawyer, A, Shehu, D, Masanja, H, Kamwendo,

Horizon 2020 EarLy dEtection of cerVical cAncer in hard-to-reach populations: development and implementation of a new HPV test combining self-sampling.

The Case of the Catholic Pharmaceutical Service in Ghana

Health Services that Deliver for Newborns Post-Doctoral Researcher

Presentation transcript:

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March 2009 COST EFFECTIVENESS ANALYSIS OF ALTERNATIVE TRAINING STRATEGIES FOR IMPROVING ACCESS TO EMERGENCY OBSTETRIC CARE IN BURKINA FASO Hounton S 1,2, Belemsaga D 3, Newlands D 2, Meda N 3, De Brouwere V 4 1 WHO-MDSC, Burkina Faso, 2 University of Aberdeen, UK 3 Centre MURAZ, Burkina Faso, 4 ITM, Antwerp, Belgium

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March Maternal and newborn mortality very high. How to ensure skilled ? 2. Skilled health human resources (number, coverage, availability, access) 3. Effectiveness and cost- effectiveness of strategies to address shortage ? BACKGROUND

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March OBJECTIVES 1. Effectiveness of surgical teams led by specialists, medical doctors, and clinical officers in providing life saving interventions 2. Value for money 3. Policy recommendation for effective coverage of emergency obstetric care in rural areas

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March 2009 METHODS (1)  Study design: Cost-effectiveness analysis (surgeries: c-sections) - Strategy 1: Team led by a specialist (OBGY, surgeon) - Strategy 2: Team led by a general practitioner - Strategy 3: Team led by a clinical officer Comparability of case-mix and supporting environment  Place and participants - Burkina Faso (6 / 13 regions) - All district hospitals  Study period: Oct – Dec 2007  Perspective: health system  Time horizon: 15 years

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March 2009 METHODS (2)  Effectiveness measures - Maternal and newborn case fatality rates - Post caesarean complications (haemorrhage, infections, loosening of sutures)  Costing methodology aims - Average annual cost of training and deployment of providers - Average annual costs of putting in place a surgical team  Incremental Cost Effectiveness Ratio (ICER)

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March 2009 METHODS (3)  Data sources, data collection - Retrospective case extraction of registries (Jan - Dec 2006) - Reports (MOH, University), interviews of stakeholders on barriers and facilitators of the substitutes strategies  Data analysis - Descriptive statistics, multivariate analysis (case-mix) - Macro costing, annual costs estimates (useful lifespan of items, 3% discount rate, allocation of total costs to caesarean section by appropriate proxies of the volume and time) - Sensitivity analysis on major costs categories

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March 2009 RESULTS (1): CASES PROFILE

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March 2009 RESULTS (2) : OUTCOMES  Case fatality rates of caesarean deliveries by provider, district hospitals, , Burkina Faso  Newborns (/1000 c-sections)  Mothers (/1000 c-sections) ObstetriciansGeneral practitionersClinical officers ObstetriciansGeneral practitionersClinical officers

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March 2009 RESULTS (3) : COSTING ICER of caesarean deliveries by providers’ teams, district hospitals, 2006

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March 2009 RESULTS (4): “ENHANCED STRATEGIES” ICER of caesarean deliveries by providers’ teams, district hospitals, 2006

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March 2009  Comparable skills & practices of c-section (thus life saving interventions) between obstetricians and trained doctors  Results comparable to those in Mozambique, Malawi, Zambia, however higher CFR with clinical officers in our settings  Delegation of surgical tasks from specialists to substitutes: necessary, effective and cost-effective in rural areas  HRH : incentives are primarily about career path, supportive environment, degree (prestige), and monetary incentives  Limitations: comparability of settings, providers, cases DISCUSSIONS

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March 2009  All current options for providing emergency surgeries are viable  Trained doctors: most cost effective option  Potential for improved cost-effectiveness of trained doctors if career paths and incentives provided  In Burkina Faso, given shortage will remain for foreseeable future, delegation of surgical tasks from specialists to middle level health substitutes has proven to be effective, is cost effective in the short and mid runs CONCLUSION

Inaugural Conference of the African Health Economics and Policy Association (AfHEA) Accra - Ghana, 10th - 12th March 2009 ACKNOWLEDGEMENTS  West Africa Health Organization (WAHO) Grant WAHO, N°13 Centre MURAZ, 2005  Ministry of health, Centre MURAZ (Burkina Faso)  Collaborators: Sombie I, Cecile Tamini, Mamadou Barro, Fadima Bocoum, Abdoulaye Traore, Moctar Ouédraogo, Peter Byass