Coût global de la survie de l'enfant: Estimations à partir de la validation au niveau du pays

Translated title of the contribution: Global cost of child survival: Estimates from country-level validation

Liselore van Ekdom, Karin Stenberg, Robert W. Scherpbier, Louis Niessen

Research output: Contribution to journalArticle

Abstract

Objective To cross-validate the global cost of scaling up child survival interventions to achieve the fourth Millennium Development Goal (MDG4) as estimated by the World Health Organization (WHO) in 2007 by using the latest country-provided data and new assumptions. Methods After the main cost categories for each country were identified, validation questionnaires were sent to 32 countries with high child mortality. Publicly available estimates for disease incidence, intervention coverage, prices and resources for individual-level and programme-level activities were validated against local data. Nine updates to the 2007 WHO model were generated using revised assumptions. Finally, estimates were extrapolated to 75 countries and combined with cost estimates for immunization and malaria programmes and for programmes for the prevention of mother-to-child transmission of the human immunodeficiency virus (HIV). Findings Twenty-six countries responded. Adjustments were largest for system- and programme-level data and smallest for patient data. Country-level validation caused a 53% increase in original cost estimates (i.e. 9 billion 2004 United States dollars [US$]) for 26 countries owing to revised system and programme assumptions, especially surrounding community health worker costs. The additional effect of updated population figures was small; updated epidemiologic figures increased costs by US$ 4 billion (+15%). New unit prices in the 26 countries that provided data increased estimates by US$ 4.3 billion (+16%). Extrapolation to 75 countries increased the original price estimate by US$ 33 billion (+80%) for 2010-2015. Conclusion Country-level validation had a significant effect on the cost estimate. Price adaptations and programme-related assumptions contributed substantially. An additional 74 billion US$ 2005 (representing a 12% increase in total health expenditure) would be needed between 2010 and 2015. Given resource constraints, countries will need to prioritize health activities within their national resource envelope.

Original languageFrench
Pages (from-to)267-277
Number of pages11
JournalBulletin of the World Health Organization
Volume89
Issue number4
DOIs
StatePublished - Apr 2011

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Costs and Cost Analysis
Survival
Social Adjustment
Immunization Programs
Child Mortality
Health Expenditures
Health Care Costs
Malaria
Mothers
HIV
Incidence
Health
Population

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Coût global de la survie de l'enfant : Estimations à partir de la validation au niveau du pays. / van Ekdom, Liselore; Stenberg, Karin; Scherpbier, Robert W.; Niessen, Louis.

In: Bulletin of the World Health Organization, Vol. 89, No. 4, 04.2011, p. 267-277.

Research output: Contribution to journalArticle

van Ekdom, Liselore ; Stenberg, Karin ; Scherpbier, Robert W. ; Niessen, Louis. / Coût global de la survie de l'enfant : Estimations à partir de la validation au niveau du pays. In: Bulletin of the World Health Organization. 2011 ; Vol. 89, No. 4. pp. 267-277.
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abstract = "Objective To cross-validate the global cost of scaling up child survival interventions to achieve the fourth Millennium Development Goal (MDG4) as estimated by the World Health Organization (WHO) in 2007 by using the latest country-provided data and new assumptions. Methods After the main cost categories for each country were identified, validation questionnaires were sent to 32 countries with high child mortality. Publicly available estimates for disease incidence, intervention coverage, prices and resources for individual-level and programme-level activities were validated against local data. Nine updates to the 2007 WHO model were generated using revised assumptions. Finally, estimates were extrapolated to 75 countries and combined with cost estimates for immunization and malaria programmes and for programmes for the prevention of mother-to-child transmission of the human immunodeficiency virus (HIV). Findings Twenty-six countries responded. Adjustments were largest for system- and programme-level data and smallest for patient data. Country-level validation caused a 53{\%} increase in original cost estimates (i.e. 9 billion 2004 United States dollars [US$]) for 26 countries owing to revised system and programme assumptions, especially surrounding community health worker costs. The additional effect of updated population figures was small; updated epidemiologic figures increased costs by US$ 4 billion (+15{\%}). New unit prices in the 26 countries that provided data increased estimates by US$ 4.3 billion (+16{\%}). Extrapolation to 75 countries increased the original price estimate by US$ 33 billion (+80{\%}) for 2010-2015. Conclusion Country-level validation had a significant effect on the cost estimate. Price adaptations and programme-related assumptions contributed substantially. An additional 74 billion US$ 2005 (representing a 12{\%} increase in total health expenditure) would be needed between 2010 and 2015. Given resource constraints, countries will need to prioritize health activities within their national resource envelope.",
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