Supporting the revision of the health benefits package in Uganda: a constrained optimisation approach

Abstract

This study demonstrates how the linear constrained optimization approach can be used to design a health benefits package (HBP) which maximises the net disability adjusted life years (DALYs) averted given the health system constraints faced by a country, and how the approach can help assess the marginal value of relaxing health system constraints. In the analysis performed for Uganda, 58 interventions were included in the HBP in the base scenario, resulting in a total of 49.9 million net DALYs averted. When task shifting of pharmacists’ and nutrition officers’ tasks to nurses is allowed, 68 interventions were included in the HBP resulting in a total of 53.8 million net DALYs averted (a 7.8% increase). Further, investing only $39 towards hiring additional nutrition officers’ time could avert one net DALY; this increased to $55, $56, and $123 for nurses, pharmacists and doctors respectively, and $971 for expanding the consumable budget.

A Healthcare Service Delivery and Epidemiological Model for Investigating Resource Allocation for Health: TheThanzi La OnseModel

“…The systematic integration of the available data for interventions, means that results that relate to different diseases or interventions are comparable, in contrast to results culled from literature that vary in terms of perspective, counterfactual and outcome measurement. 36 Although the approach demands lots of data, these demands have been met in Malawi, and, we believe, will be met in other countries too. Furthermore, using data to inform decision-making in this way provides a key incentive for improving data systems.…”