Cost-effectiveness and return on investment of protecting health workers in low- and middle-income countries during the COVID-19 pandemic

Risko, Nicholas; Werner, Kalin; Offorjebe, Ogechukwu Agatha; Vecino-Ortiz, Andrés I.; Wallis, Lee; Razzak, Junaid Abdul

doi:10.1371/journal.pone.0240503

Cited by 39 publications

(75 citation statements)

References 10 publications

(13 reference statements)

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“…At high disease prevalence, universal PPE is the best strategy to protect HCW. 13 Risko et al 22 (139) (LMIC) HCWs Inadequate PPE: absence of one or more of the PPE elements Full PPE on the basis of the WHO best practice guidelines (EFST): gloves, gown, face shield and masks for all encounters involving a suspected case and enhanced precautions for aerosol generating procedures SIR (ESFT)—(S) susceptible, (I) infected, and (R) recovered ICER: cost/HCW death averted; ICER = cost/HCW case averted (no WTP reported) Cost-effectiveness; ROI analysis 30-week period Societal perspective Immediate investment in the wide-scale production and distribution of PPE for LMICs yields a significant benefit in lives saved and ROI. The authors also conclude that this public health strategy is required to prevent massive depletion of the healthcare workforce.…”

Section: Resultsmentioning

confidence: 99%

Cost-Effectiveness of COVID-19 Policy Measures: A Systematic Review

et al. 2021

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Objectives The coronavirus disease 2019 pandemic has had a major impact on our society, with drastic policy restrictions being implemented to contain the spread of the severe acute respiratory syndrome coronavirus 2. This study aimed to provide an overview of the available evidence on the cost-effectiveness of various coronavirus disease 2019 policy measures. Methods A systematic literature search was conducted in PubMed, Embase, and Web of Science. Health economic evaluations considering both costs and outcomes were included. Their quality was comprehensively assessed using the Consensus Health Economic Criteria checklist. Next, the quality of the epidemiological models was evaluated. Results A total of 3688 articles were identified (March 2021), of which 23 were included. The studies were heterogeneous with regard to methodological quality, contextual factors, strategies’ content, adopted perspective, applied models, and outcomes used. Overall, testing/screening, social distancing, personal protective equipment, quarantine/isolation, and hygienic measures were found to be cost-effective. Furthermore, the most optimal choice and combination of strategies depended on the reproduction number and context. With a rising reproduction number, extending the testing strategy and early implementation of combined multiple restriction measures are most efficient. Conclusions The quality assessment highlighted numerous flaws and limitations in the study approaches; hence, their results should be interpreted with caution because the specific context (country, target group, etc) is a key driver for cost-effectiveness. Finally, including a societal perspective in future evaluations is key because this pandemic has an indirect impact on the onset and treatment of other conditions and on our global economy.

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Section: Resultsmentioning

confidence: 99%

Cost-Effectiveness of COVID-19 Policy Measures: A Systematic Review

et al. 2021

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“…However, during the COVID-19 outbreak, frequent stock out and inadequate supply of PPEs have been a major challenge for healthcare workers [ 32 ] and health systems performance worldwide [ 33 ]. Ensuring the continuous availability of PPEs for healthcare workers managing COVID-19 patients is essential for maintaining healthcare workers infection rates below 10% and mortality below 1% [ 34 ]. Additionally, wide-scale procurement and distribution of PPEs for low-and-middle-income countries is cost-effective and yields a large downstream return on investment [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…Ensuring the continuous availability of PPEs for healthcare workers managing COVID-19 patients is essential for maintaining healthcare workers infection rates below 10% and mortality below 1% [ 34 ]. Additionally, wide-scale procurement and distribution of PPEs for low-and-middle-income countries is cost-effective and yields a large downstream return on investment [ 34 ]. In this study, insufficiency of PPEs was associated with lower odds of compliance with PPEs usage.…”

Section: Discussionmentioning

confidence: 99%

Infection prevention and control compliance among exposed healthcare workers in COVID-19 treatment centers in Ghana: A descriptive cross-sectional study

Ashinyo

Dubik

Duti³

et al. 2021

PLoS ONE

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Compliance with infection prevention and control (IPC) protocols is critical in minimizing the risk of coronavirus disease (COVID-19) infection among healthcare workers. However, data on IPC compliance among healthcare workers in COVID-19 treatment centers are unknown in Ghana. This study aims to assess IPC compliance among healthcare workers in Ghana’s COVID-19 treatment centers. The study was a secondary analysis of data, which was initially collected to determine the level of risk of COVID-19 virus infection among healthcare workers in Ghana. Quantitative data were conveniently collected using the WHO COVID-19 risk assessment tool. We analyzed the data using descriptive statistics and logistic regression analyses. We observed that IPC compliance during healthcare interactions was 88.4% for hand hygiene and 90.6% for Personal Protective Equipment (PPE) usage; IPC compliance while performing aerosol-generating procedures (AGPs), was 97.5% for hand hygiene and 97.5% for PPE usage. For hand hygiene during healthcare interactions, lower compliance was seen among nonclinical staff [OR (odds ratio): 0.43; 95% CI (Confidence interval): 0.21–0.89], and healthcare workers with secondary level qualification (OR: 0.24; 95% CI: 0.08–0.71). Midwives (OR: 0.29; 95% CI: 0.09–0.93) and Pharmacists (OR: 0.15; 95% CI: 0.02–0.92) compliance with hand hygiene was significantly lower than registered nurses. For PPE usage during healthcare interactions, lower compliance was seen among healthcare workers who were separated/divorced/widowed (OR: 0.08; 95% CI: 0.01–0.43), those with secondary level qualifications (OR 0.08; 95% CI 0.01–0.43), non-clinical staff (OR 0.16 95% CI 0.07–0.35), cleaners (OR: 0.16; 95% CI: 0.05–0.52), pharmacists (OR: 0.07; 95% CI: 0.01–0.49) and among healthcare workers who reported of insufficiency of PPEs (OR: 0.33; 95% CI: 0.14–0.77). Generally, healthcare workers’ infection prevention and control compliance were high, but this compliance differs across the different groups of health professionals in the treatment centers. Ensuring an adequate supply of IPC logistics coupled with behavior change interventions and paying particular attention to nonclinical staff is critical in minimizing the risk of COVID-19 transmission in the treatment centers.

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“…Currently, healthcare workers are at risk and are experiencing job-related stress (Ramaci et al, 2020). Healthcare workers are those employees of a healthcare facility who interact closely with patients, such as doctors, nurses, technicians/medics, and ancillary staff (Risko et al, 2020). Health services aim to increase the health level of the society and to protect people from health risks by providing the best health service to those in need (Özdinç, 2019).…”

Section: Attitudes Of Healthcare Workersmentioning

confidence: 99%

Understanding employees’ responses to the COVID‐19 pandemic: The attractiveness of healthcare jobs

Al-Abrrow¹,

Al-Maatoq²,

Alharbi³

et al. 2020

Glob Bus Org Exc

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The purpose of this study was to examine the impact of COVID-19 on the attractiveness of work in the Iraqi health sector by looking at the mediating role of employees' attitudes. A questionnaire survey was used to collect data from 218 health sector employees. The results revealed that there is a significant impact of COVID-19 pandemic on employees' attitudes that influence their decision to quit the health sector and look for jobs in other sectors. As health sector employees are prone to suffer the most in the pandemic, this crisis significantly affected the attractiveness of jobs in the health sector, leading to an increase in employees' negative attitudes and their desire to leave work.

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Cost-effectiveness and return on investment of protecting health workers in low- and middle-income countries during the COVID-19 pandemic

Cited by 39 publications

References 10 publications

Cost-Effectiveness of COVID-19 Policy Measures: A Systematic Review

Cost-Effectiveness of COVID-19 Policy Measures: A Systematic Review

Infection prevention and control compliance among exposed healthcare workers in COVID-19 treatment centers in Ghana: A descriptive cross-sectional study

Understanding employees’ responses to the COVID‐19 pandemic: The attractiveness of healthcare jobs

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