Tanzania established a Health Technology Assessment Committee in recognition of the increasing role of Health Technology Assessment (HTA) to achieve universal health coverage. The committee has the mandate to develop recommendations on the reimbursement of technologies for decision-makers. It is widely recognized that there are challenges to the technical capacity and human resource availability of HTA, including that of decision-making committees. Committee members need to combine scientific and social judgments vis-a-vis the technology under evaluation. This paper reports on a self-administered survey among committee members to assess their capacity for the tasks at hand. A survey was developed and sent to all members of the HTA committee in Tanzania. Responses were analyzed, and key themes explored. Out of 20 committee members, 15 members completed the survey (response rate 75%). Committee members were primarily government employees who were qualified and well-experienced in clinical medicine. However, they were less qualified and experienced in HTA and expressed low confidence in this subject matter. The results indicate the type of evidence an advisory committee can reasonably be expected to understand and handle. It can also guide future capacity-strengthening activities and programmes, and serve as a baseline for measuring the impact of these programmes.
{"title":"Health Technology Assessment in Tanzania: Capacity and Experience of HTA Committee Members","authors":"Gavin Surgey, A. Mori, R. Baltussen","doi":"10.52872/001c.33116","DOIUrl":"https://doi.org/10.52872/001c.33116","url":null,"abstract":"Tanzania established a Health Technology Assessment Committee in recognition of the increasing role of Health Technology Assessment (HTA) to achieve universal health coverage. The committee has the mandate to develop recommendations on the reimbursement of technologies for decision-makers. It is widely recognized that there are challenges to the technical capacity and human resource availability of HTA, including that of decision-making committees. Committee members need to combine scientific and social judgments vis-a-vis the technology under evaluation. This paper reports on a self-administered survey among committee members to assess their capacity for the tasks at hand. A survey was developed and sent to all members of the HTA committee in Tanzania. Responses were analyzed, and key themes explored. Out of 20 committee members, 15 members completed the survey (response rate 75%). Committee members were primarily government employees who were qualified and well-experienced in clinical medicine. However, they were less qualified and experienced in HTA and expressed low confidence in this subject matter. The results indicate the type of evidence an advisory committee can reasonably be expected to understand and handle. It can also guide future capacity-strengthening activities and programmes, and serve as a baseline for measuring the impact of these programmes.","PeriodicalId":73758,"journal":{"name":"Journal of global health economics and policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48526396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The politics of COVID-19 vaccine equity among refugee populations in Lebanon","authors":"Rasha Kaloti, F. Fouad","doi":"10.52872/001c.32637","DOIUrl":"https://doi.org/10.52872/001c.32637","url":null,"abstract":"","PeriodicalId":73758,"journal":{"name":"Journal of global health economics and policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42233033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"COVID-19 Vaccine donations: Blessings and curses for Africa","authors":"B. Kubheka, Tshowa Kabala","doi":"10.52872/001c.30735","DOIUrl":"https://doi.org/10.52872/001c.30735","url":null,"abstract":"","PeriodicalId":73758,"journal":{"name":"Journal of global health economics and policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46613596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01Epub Date: 2022-08-28DOI: 10.52872/001c.37787
Maggie Nyirenda-Nyang'wa, Gerald Manthalu, Matthias Arnold, Dominic Nkhoma, Mina C Hosseinipour, Maganizo Chagomerana, Precious Chibwe, Kevin Mortimer, Neil Kennedy, Derek Fairley, Victor Mwapasa, Chisomo Msefula, Henry C Mwandumba, Jobiba Chinkhumba, Nigel Klein, Dagmar Alber, Angela Obasi
Background: Timely diagnosis of HIV in infants and children is an urgent priority. In Malawi, 40,000 infants annually are HIV exposed. However, gold standard polymerase-chain-reaction (PCR) based testing requires centralised laboratories, causing turn-around times (TAT) of 2 to 3 months and significant loss to follow-up. If feasible and acceptable, minimising diagnostic delays through HIV Point-of-care-testing (POCT) may be cost-effective. We assessed whether POCT Cepheid Xpert HIV-1 Qual assay whole blood (XpertHIV) was more cost-effective than PCR.
Methods: From July-August 2018, 700 PCR Abbott tests using dried blood spots (DBS) were performed on 680 participants who enrolled on the feasibility, acceptability and performance of the XpertHIV study. Newly identified HIV-positive We conducted a cost-minimisation and cost-effectiveness analysis of XpertHIV against PCR, as the standard of care. A random sample of 200 caregivers from the 680 participants had semi-structured interviews to explore costs from a societal perspective of XpertHIV at Mulanje District Hospital, Malawi. Analysis used TAT as the primary outcome measure. Results were extrapolated from the study period (29 days) to a year (240 working days). Sensitivity analyses characterised individual and joint parameter uncertainty and estimated patient cost per test.
Results: During the study period, XpertHIV was cost-minimising at $42.34 per test compared to $66.66 for PCR. Over a year, XpertHIV remained cost-minimising at $16.12 compared to PCR at $27.06. From the patient perspective (travel, food, lost productivity), the cost per test of XpertHIV was $2.45. XpertHIV had a mean TAT of 7.10 hours compared to 153.15 hours for PCR. Extrapolates accounting for equipment costs, lab consumables and losses to follow up estimated annual savings of $2,193,538.88 if XpertHIV is used nationally, as opposed to PCR.
Conclusions: This preliminary evidence suggests that adopting POCT XpertHIV will save time, allowing HIV-exposed infants to receive prompt care and may improve outcomes. The Malawi government will pay less due to XpertHIV's cost savings and associated benefits.
{"title":"Costing and cost-effectiveness of Cepheid Xpert HIV -1 Qual Assay using whole blood protocol versus PCR by Abbott Systems in Malawi.","authors":"Maggie Nyirenda-Nyang'wa, Gerald Manthalu, Matthias Arnold, Dominic Nkhoma, Mina C Hosseinipour, Maganizo Chagomerana, Precious Chibwe, Kevin Mortimer, Neil Kennedy, Derek Fairley, Victor Mwapasa, Chisomo Msefula, Henry C Mwandumba, Jobiba Chinkhumba, Nigel Klein, Dagmar Alber, Angela Obasi","doi":"10.52872/001c.37787","DOIUrl":"10.52872/001c.37787","url":null,"abstract":"<p><strong>Background: </strong>Timely diagnosis of HIV in infants and children is an urgent priority. In Malawi, 40,000 infants annually are HIV exposed. However, gold standard polymerase-chain-reaction (PCR) based testing requires centralised laboratories, causing turn-around times (TAT) of 2 to 3 months and significant loss to follow-up. If feasible and acceptable, minimising diagnostic delays through HIV Point-of-care-testing (POCT) may be cost-effective. We assessed whether POCT Cepheid Xpert HIV-1 Qual assay whole blood (XpertHIV) was more cost-effective than PCR.</p><p><strong>Methods: </strong>From July-August 2018, 700 PCR Abbott tests using dried blood spots (DBS) were performed on 680 participants who enrolled on the feasibility, acceptability and performance of the XpertHIV study. Newly identified HIV-positive We conducted a cost-minimisation and cost-effectiveness analysis of XpertHIV against PCR, as the standard of care. A random sample of 200 caregivers from the 680 participants had semi-structured interviews to explore costs from a societal perspective of XpertHIV at Mulanje District Hospital, Malawi. Analysis used TAT as the primary outcome measure. Results were extrapolated from the study period (29 days) to a year (240 working days). Sensitivity analyses characterised individual and joint parameter uncertainty and estimated patient cost per test.</p><p><strong>Results: </strong>During the study period, XpertHIV was cost-minimising at $42.34 per test compared to $66.66 for PCR. Over a year, XpertHIV remained cost-minimising at $16.12 compared to PCR at $27.06. From the patient perspective (travel, food, lost productivity), the cost per test of XpertHIV was $2.45. XpertHIV had a mean TAT of 7.10 hours compared to 153.15 hours for PCR. Extrapolates accounting for equipment costs, lab consumables and losses to follow up estimated annual savings of $2,193,538.88 if XpertHIV is used nationally, as opposed to PCR.</p><p><strong>Conclusions: </strong>This preliminary evidence suggests that adopting POCT XpertHIV will save time, allowing HIV-exposed infants to receive prompt care and may improve outcomes. The Malawi government will pay less due to XpertHIV's cost savings and associated benefits.</p>","PeriodicalId":73758,"journal":{"name":"Journal of global health economics and policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501532/pdf/nihms-1866209.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10306666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"FDA approval of Pfizer-BioNTech: Evaluating the significance of mRNA vaccine approval","authors":"Syed Abdullah Monawwer, Raahim Naeem","doi":"10.52872/001c.30733","DOIUrl":"https://doi.org/10.52872/001c.30733","url":null,"abstract":"","PeriodicalId":73758,"journal":{"name":"Journal of global health economics and policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42532267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vaccine hesitancy and its determinants – a way forward?","authors":"J. Michel, T. Sauter, Marcel Tanner","doi":"10.52872/001c.30018","DOIUrl":"https://doi.org/10.52872/001c.30018","url":null,"abstract":"","PeriodicalId":73758,"journal":{"name":"Journal of global health economics and policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41691969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rakesh Sharma, P. Jelly, Vishwas As, L. Chadha, V. Saxena, Latika Mohan
{"title":"A comparative study of attitudes towards COVID-19 vaccination in the rural and urban population of Uttarakhand, India","authors":"Rakesh Sharma, P. Jelly, Vishwas As, L. Chadha, V. Saxena, Latika Mohan","doi":"10.52872/001c.29948","DOIUrl":"https://doi.org/10.52872/001c.29948","url":null,"abstract":"","PeriodicalId":73758,"journal":{"name":"Journal of global health economics and policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47081386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Implementing policies and programmes to reduce the impact of globalisation on oral health in Pacific Island Countries and Territories","authors":"N. Pili, V. Nosa, Leroy Tatui","doi":"10.52872/001c.29655","DOIUrl":"https://doi.org/10.52872/001c.29655","url":null,"abstract":"","PeriodicalId":73758,"journal":{"name":"Journal of global health economics and policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44487796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Meshbahur Rahman, A. Noman, A. Islam, Nasreen Farhana
Bangladesh striving against double burden: Dengue outbreak surges amid COVID-19 pandemic Mohammad Meshbahur Rahman 1 , Abdullah Al Noman 2 , ANM Shamsul Islam 3 , Nasreen Farhana 4 1 Department of Basic Science, World University of Bangladesh, Dhaka-1230, Bangladesh; Biomedical Research Foundation, Dhaka-1230, Bangladesh, 2 Bioscience Academy Bangladesh, Bangladesh, 3 Department of Public Health & Hospital Administration, National Institute of Preventive & Social Medicine (NIPSOM), Mohakhali, Dhaka-1212, Bangladesh, 4 Department of Microbiology and Mycology, National Institute of Preventive & Social Medicine (NIPSOM), Mohakhali, Dhaka-1212, Bangladesh
孟加拉国努力应对双重负担:COVID-19大流行期间登革热疫情激增Mohammad Meshbahur Rahman 1, Abdullah Al Noman 2, ANM Shamsul Islam 3, Nasreen Farhana 4 1孟加拉国世界大学基础科学系，孟加拉国达卡1230;生物医学研究基金会，达卡1230，孟加拉国;2孟加拉国生物科学院，孟加拉国;3公共卫生和医院管理系，国家预防和社会医学研究所(NIPSOM)，达卡1212，孟加拉国;4微生物学和真菌学，国家预防和社会医学研究所(NIPSOM)，达卡1212，孟加拉国
{"title":"Bangladesh striving against double burden: Dengue outbreak surges amid COVID-19 pandemic","authors":"Mohammad Meshbahur Rahman, A. Noman, A. Islam, Nasreen Farhana","doi":"10.52872/001c.29657","DOIUrl":"https://doi.org/10.52872/001c.29657","url":null,"abstract":"Bangladesh striving against double burden: Dengue outbreak surges amid COVID-19 pandemic Mohammad Meshbahur Rahman 1 , Abdullah Al Noman 2 , ANM Shamsul Islam 3 , Nasreen Farhana 4 1 Department of Basic Science, World University of Bangladesh, Dhaka-1230, Bangladesh; Biomedical Research Foundation, Dhaka-1230, Bangladesh, 2 Bioscience Academy Bangladesh, Bangladesh, 3 Department of Public Health & Hospital Administration, National Institute of Preventive & Social Medicine (NIPSOM), Mohakhali, Dhaka-1212, Bangladesh, 4 Department of Microbiology and Mycology, National Institute of Preventive & Social Medicine (NIPSOM), Mohakhali, Dhaka-1212, Bangladesh","PeriodicalId":73758,"journal":{"name":"Journal of global health economics and policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45899975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anisa Nazir, Ramya Kancherla, B. Huo, Brintha Sivajohan, Shaishav Datta, A. Brar
The COVID-19 pandemic created an unprecedented burden on health systems, including surgical services, which have been indirectly affected by the growing number of cases due to cancellation of operations, delayed screening and a lack of adequate resources such as PPE and ventilators. In addition to logistical challenges, the pandemic also raised imminent clinical questions that required immediate answers. Global collaborations have been vital to identifying challenges by pooling data and collecting evidence to provide critical information to guide clinical and surgical care. Research partnerships have been the driving force behind global surgery research; however, since the pandemic, there has been an increased need for equitable collaboration and innovation between high-income and low-income research institutions to continue making steady progress towards providing access to safe, affordable surgical care. This article explores academic research partnerships formed during the pandemic and identifies challenges and opportunities presented to researchers and institutions. Finally, this paper recommends that further collaborations be made between HIC and LMICs to ensure policies that global surgery ensures that key stakeholders are at the centre of research. Such policies need to focus on the access to education and mentorship, micro-grants for researchers, and publication opportunities. The COVID-19 pandemic created an unprecedented
{"title":"Global surgery research collaborations during the COVID-19 pandemic","authors":"Anisa Nazir, Ramya Kancherla, B. Huo, Brintha Sivajohan, Shaishav Datta, A. Brar","doi":"10.52872/001c.29066","DOIUrl":"https://doi.org/10.52872/001c.29066","url":null,"abstract":"The COVID-19 pandemic created an unprecedented burden on health systems, including surgical services, which have been indirectly affected by the growing number of cases due to cancellation of operations, delayed screening and a lack of adequate resources such as PPE and ventilators. In addition to logistical challenges, the pandemic also raised imminent clinical questions that required immediate answers. Global collaborations have been vital to identifying challenges by pooling data and collecting evidence to provide critical information to guide clinical and surgical care. Research partnerships have been the driving force behind global surgery research; however, since the pandemic, there has been an increased need for equitable collaboration and innovation between high-income and low-income research institutions to continue making steady progress towards providing access to safe, affordable surgical care. This article explores academic research partnerships formed during the pandemic and identifies challenges and opportunities presented to researchers and institutions. Finally, this paper recommends that further collaborations be made between HIC and LMICs to ensure policies that global surgery ensures that key stakeholders are at the centre of research. Such policies need to focus on the access to education and mentorship, micro-grants for researchers, and publication opportunities. The COVID-19 pandemic created an unprecedented","PeriodicalId":73758,"journal":{"name":"Journal of global health economics and policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45837258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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