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Our main objective is to support better health resource allocation decisions in low- and middle-income countries, by answering the questions: “what works, for whom and at what cost”?
Our main objective is to support better health resource allocation decisions in low- and middle-income countries, by answering the questions: “what works, for whom and at what cost”?
To achieve this, we have a dual focus: to evaluate both the health impact and value-for-money of population- and system-level health interventions. This evidence will provide a holistic understanding about the most effective, efficient and equitable interventions; providing evidence that can be used by local policy-makers to inform future decisions.
GHE2's work is comprised of two key areas:
1. IMPACT EVALUATION STUDIES
1. IMPACT EVALUATION STUDIES
Randomised experiments are not effective for evaluating large-scale interventions that go beyond patient-level, disease-specific interventions. Therefore, country-specific case studies, focussing on quazi-experimental research, are being conducted by our researchers in Brazil, Indonesia and South Africa to evaluate the impact of specific system-and-population-level interventions:
Team: FIPE/USP (Natalia Ferreira-Batista, Maria Dolorez Diaz, Fernando Antoni Slaibe Postali, Adriano Dutra Teixeira)
Following the inception of the largest community-based health programme in Brazil (the Family Health Programme), we are conducting an assessment of costs and impacts in health outcomes, related specifically to the expansion in coverage of Brazilian primary health.
Analysis will be key in assessing the effectiveness and efficiency of healthcare investments, and will help to inform decisions regarding the allocation of future government budgets.
Team: CHEPS (Afra Dhyaniputri, Budi Hidayat, Taufik Hidayat, Atik Nurwahyuni, Royasia Viki Ramadani)
In 2014, Indonesia introduced a national health insurance program (Jaminan Kesehatan Nasional - JKN) to increase access to healthcare services, protecting people from the catastrophic health payment, and close inequitable use of healthcare services.
Since the JKN’s introduction, no systemic impact evaluation against its objectives has been undertaken. Our study is working to provide the first in-depth assessment of the impact of the JKN.
Team: PRICELESS SA (Ijeoma Edoka, Karen Hofman, Maninie Molatseli, Nicholas Stacey)
South Africa is presently undergoing a re-structuring of the healthcare system with the ultimate goal of achieving universal health coverage through National Health Insurance (NHI).
The ICRMP is one of the primary health care (PHC) reforms that aims to improve both access to and quality of health care services through targeted improvements in PHC administrative process, health service delivery, human resources for health and infrastructure. Our study evaluates the impact of the programme on the performance of PHC facilities.
2. CROSS-CUTTING METHOD STUDIES
2. CROSS-CUTTING METHOD STUDIES
To complement these case studies, four cross-cutting papers are being written by the UK team to explore and address the key methodological challenges of impact evaluation and economic evaluation approaches:
Team: CHE (Simon Walker, Aimee Fox, Mike Drummond, Susan Griffin, Nils Gutacker, Paul Revill, Mark Sculpher)
This paper provides an overview of the challenges of conducting economic evaluations of population and health system level policies and interventions, and considers some of the analytical methods which can be used to overcome these challenges.
Team: CHE/FIPE (James Love-Koh, Andrew Mirelman, Fernando Antoni Slaibe Postali)
This paper provides an overview of equity issues for the economic evaluation of population and health system-level interventions. It highlights relevant issues to consider when conducting an evaluation and illustrates these with a case study of a primary care intervention in Brazil.
Team: CHE (Sumit Mazumdar, Noemi Kreif)
This paper presents a critical review of the key issues in empirical analysis of causal impacts of health system interventions that encourage progress towards universal health coverage (UHC) objectives in LMICs, and discusses the evaluation of National Health Insurance Scheme (JKN) in Indonesia as a case- study to illustrate how some of these questions could be addressed.
Team: CHE (Noemi Kreif, Andrew Mirelman, James Love-Koh)
Impact evaluations, while increasingly rigorous in design, are not enough to determine whether an investment in a particular programme is worthwhile. This paper explores to what degree economic evaluations have been conducted alongside published health impact evaluations, in low-and middle income countries.
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