A Cost-Effectiveness Analysis of a Pediatric Operating Room in Uganda

Abstract

The construction of a pediatric operating room in Uganda is a cost-effective and worthwhile investment, endorsing future decisions to enhance pediatric surgical capacity in the resource-limited settings of Sub-Saharan Africa.

Global paediatric surgery: meeting an unmet need—the response of the British Association of Paediatric Surgeons

“…The scale and complexity of the factors contributing to the deficit in paediatric surgical care in LMIC is so vast that any one action—however beneficial—will only produce marginal change in shifting the burden of surgical care in children, albeit in the right direction. Studies itemising the return on investment in provision of facilities have shown impressive efficiency [6] but statistical analysis is redundant in this field of medicine because of a lack of contextual reference points and proxies need to suffice instead. Surrogates such as retention and growth of the workforce and initiatives which attempt to register the characteristics and volume of surgical disease [7] in LMIC will bring some definition against which change and impact can be measured in the future.…”

Access to pediatric surgery delivered by general surgeons and anesthesia providers in Uganda: Results from 2 rural regional hospitals

“…40 Using the methodology described in the Disease Control Priorities 3, our group previously calculated the value of statistical life in Uganda to be 827.32 USD with an income elasticity of 1.5. 41 The economic benefit of pediatric surgery at Soroti and Lacor was calculated by multiplying the DALYs averted/year by the value of statistical life in Uganda.…”

“…Previously conducted CEA on pediatric surgical interventions have demonstrated that they are highly cost-effective with regard to a country's GDP as well as the $240 threshold applied by the World Bank. 41,56 Our group previously estimated that the prevision of a pediatric operating room in Uganda had an incremental cost-effectiveness ratio of 6.39 USD per disabilityadjusted life-year averted or 397 USD per life saved. 41 Additionally, a systematic review of CEA in pediatric surgical interventions demonstrated that pediatric surgical interventions had similar cost-effectiveness ratios as standard pediatric vaccinations and bed nets for malaria prevention and were more cost-effective then multidrug antiretroviral therapy for HIV treatment.…”

“…41,56 Our group previously estimated that the prevision of a pediatric operating room in Uganda had an incremental cost-effectiveness ratio of 6.39 USD per disabilityadjusted life-year averted or 397 USD per life saved. 41 Additionally, a systematic review of CEA in pediatric surgical interventions demonstrated that pediatric surgical interventions had similar cost-effectiveness ratios as standard pediatric vaccinations and bed nets for malaria prevention and were more cost-effective then multidrug antiretroviral therapy for HIV treatment. 56 These data support increasing general pediatric surgical capacity in regional referral hospitals, which can have a major impact on the burden of surgical disease in children living in Uganda.…”

Investing in all of Our Children: Global Pediatric Surgery for the Twenty‐First Century

“…Advances in national datasets, informatics, and training programs [9] have improved workforce and research gaps in surgical care for children. Several policy leaders and donor groups, such as Kids OR, have made investment in surgical infrastructure for children a global health priority [10].…”