Health economics: potential applications in HIV/AIDS control in Africa

Kirigia, Joses Muthuri; Sambo, Luís Gomes; Anikpo, Emilienne; Karisa, Eddie; Mwabu, Germano

doi:10.4314/ajhs.v12i1.30794

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…The devastating economic burden of the HIV/AIDS pandemic disease on households and the macro economy has been extensively described by Kirigia, Sambo, Okorosobo, and Mwabu (2002) and by Kirigia, Sambo, Anikpo, Karisa, and Mwabu (2005). With the increasing availability of highly active antiretroviral therapy (HAART) in subSaharan Africa and with the World Health Organization (WHO) goal of universal access to care and support for people living with HIV/AIDS (PLWHA) (WHO, 2007), it is paramount to assess whether countries have the resources needed to achieve a nationwide and sustainable provision of HAART.…”

Section: Introductionmentioning

confidence: 99%

Costing universal access of highly active antiretroviral therapy in Benin

et al. 2008

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The study aimed to estimate costs of provision and access to highly active antiretroviral therapy (HAART) in order to assist in planning and resource allocation regarding scaling up and sustainable access to HAART in Benin. A prospective study was carried out to collect data on costs of provision of care at the Outpatient Treatment Centre (OTC) of the National University hospital in Cotonou, Benin and on costs borne by people living with HIV/AIDS (PLWHA) and their families in accessing care. We used an Excel model, a macro costing approach and WHO guidelines for costing health services. Annual costs were subsequently extrapolated from a societal perspective over a 10-year time horizon. Sensitivity analysis was conducted on major cost categories. The study population was mostly of middle age (median age of 38, IQR 34-42), married (65%), working class (60%) with low literacy (70% primary education level or less). The main drivers of costs of HAART service provision were drugs (73%), biological monitoring (15%) and personnel (8%). Annual costs of provision of HAART and household costs borne by PLWHA and families in seeking care amounted to 1160 USD and 111 USD per PLWHA respectively. These household costs are respectively 40% and 14% of household health and education related costs and may represent catastrophic health expenditures for patients and families. The provision of drugs and biological monitoring, and household costs in accessing care, remain by far the main barriers to ensuring universal access to HAART.

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Section: Introductionmentioning

confidence: 99%

Costing universal access of highly active antiretroviral therapy in Benin

et al. 2008

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“…Examples of pertinent health financing evidence include: costing; economic evaluation of services and interventions; economic viability analysis of health financing mechanisms; allocative and technical efficiency analyses and productivity trend analyses of health facilities; national and sub-national health accounts; and health financing equity analyses [31,32]. …”

Section: Discussionmentioning

confidence: 99%

National health financing policy in Eritrea: a survey of preliminary considerations

Kirigia

Zere²,

Akazili

2012

BMC Int Health Hum Rights

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BackgroundThe 58th World Health Assembly and 56th WHO Regional Committee for Africa adopted resolutions urging Member States to ensure that health financing systems included a method for prepayment to foster financial risk sharing among the population and avoid catastrophic health-care expenditure. The Regional Committee asked countries to strengthen or develop comprehensive health financing policies. This paper presents the findings of a survey conducted among senior staff of selected Eritrean ministries and agencies to elicit views on some of the elements likely to be part of a national health financing policy.MethodsThis is a descriptive study. A questionnaire was prepared and sent to 19 senior staff (Directors) in the Ministry of Health, Labour Department, Civil Service Administration, Eritrean Confederation of Workers, National Insurance Corporation of Eritrea and Ministry of Local Government. The respondents were selected by the Ministry of Health as key informants.ResultsThe key findings were as follows: the response rate was 84.2% (16/19); 37.5% (6/16) and 18.8% said that the vision of Eritrean National Health Financing Policy (NHFP) should include the phrases ‘equitable and accessible quality health services’ and ‘improve efficiency or reduce waste’ respectively; over 68% indicated that NHFP should include securing adequate funding, ensuring efficiency, ensuring equitable financial access, protection from financial catastrophe, and ensuring provider payment mechanisms create positive incentives to service providers; over 80% mentioned community participation, efficiency, transparency, country ownership, equity in access, and evidence-based decision making as core values of NHFP; over 62.5% confirmed that NHFP components should consist of stewardship (oversight), revenue collection, revenue pooling and risk management, resource allocation and purchasing of health services, health economics research, and development of human resources for health; over 68.8% indicated cost-sharing, taxation and social health insurance as preferred revenue collection mechanisms; and 68.75% indicated their preferred provider payment mechanism to be a global (lump sum) budget.ConclusionThis study succeeded in gathering the preliminary views of senior staff of selected Eritrean ministries and agencies regarding the likely elements of the NHFP, i.e. the vision, objectives, components, provider payment mechanisms, and health financing agency and its governance. In addition to stakeholder surveys, it would be helpful to inform the development of the NHFP with other pieces of evidence, including cost-effectiveness analysis of health services and interventions, financial feasibility analysis of financing options, a survey of the political and professional acceptability of financing options, national health accounts, and equity analyses.

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