Impact evaluations in global health have been conducted with increasingly sophisticated experimental and quasi-experimental designs to ensure internal validity of effectiveness estimates. However, evidence on effectiveness alone cannot reliably inform decisions over the allocation of limited resources.

Health economic evaluation provides a suitable framework for ‘value-for-money’ assessments. In this paper, we will explore to what degree economic evaluations have been conducted alongside published health impact evaluations. We will assess the quality of these, using criteria from an economic evaluation reference case developed for use in low and middle income countries. Using the International Initiative for Impact Evaluations (3ie) and the Ovid MEDLINE databases for the literature review, we have initially identified 70 studies which combined impact and economic evaluations; most of them (56) with experimental designs. When measured against the quality assessment criteria, our initial findings have revealed great variation in study quality. Many studies did not fulfill the basic requirements for economic evaluation such as stating the perspective of the budget holder, using generic health measures that can be compared across diseases, or suitably reflecting uncertainty.

A paper setting out our findings and conclusions is scheduled for publication in 2019.