Does health economics research align with the disease burden in the Middle East and North Africa region? A systematic review of economic evaluation studies on public health interventions

Abstract

Introduction Economic evaluation studies demonstrate the value of money in health interventions and enhance the efficiency of the healthcare system. Therefore, this study reviews published economic evaluation studies of public health interventions from 26 Middle East and North Africa (MENA) countries and examines whether they addressed the region's major health problems. Methods PubMed and Scopus were utilized to search for relevant articles published up to June 26, 2021. The reviewers independently selected studies, extracted data, and assessed the quality of studies using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results The search identified 61 studies. Approximately half (28 studies; 46%) were conducted in Israel and Iran. The main areas of interest for economic evaluation studies were infectious diseases (21 studies; 34%), cancers (13 studies; 21%), and genetic disorders (nine studies; 15%). Five (8%), 39 (64%), 16 (26%), and one (2%) studies were classified as excellent, high, average, and poor quality, respectively. The mean of CHEERS checklist items reported was 80.8% (SD 14%). Reporting the structure and justification of the selected model was missed in 21 studies (37%), while price and conversion rates and the analytical methods were missed in 21 studies (34%). Conclusions The quantity of economic evaluation studies on public health interventions in the MENA region remains low; however, the overall quality is high to excellent. There were obvious geographic gaps across countries regarding the number and quality of studies and gaps within countries concerning disease prioritization. The observed research output, however, did not reflect current and upcoming disease burden and risk factors trends in the MENA region.

Bibliometric and Visualization Analysis of the Ecology of Men’s Sexual and Reproductive Healthcare Research in MENA (1985–2022): Outputs, Trends, Shortcomings and Hotspots

“…Collectively, such identified mismatches support a very recent review of published economic evaluation studies of public health interventions from 26 MENA countries that found that the research output did not reflect current and upcoming disease burden and risk factors trends in the MENA region[ 27 ]. In the face of inevitable pressures from competing for alternative interventions, countries could direct their finite health budgets to meet the priority health needs of their populations to reach fair and efficient outcomes[ 55 ].…”

“…In terms of trends and shortcomings, we noted that the number of publications on men’s SRHC were low, reflecting a generally low trend of research publications on other topics from the Arab world. For instance, a recent review of published economic evaluation studies from MENA observed very low output[ 27 ]; and similarly, pancreatic cancer and breast cancer bibliometric reviews also confirm the low contribution of Arab countries [ 28 , 29 ]. Whilst the precise reasons for such low output could be numerous, some authors proposed that it might reflect the regional instabilities and civil wars in MENA that impede medical research, increase brain drain, lead to isolation of research groups, and reallocate medical research funds towards other domains and to humanitarian relief [ 30 , 31 ].…”

“…Other factors include the amount of R&D funding allocated, the prevailing competitive atmosphere amongst institutes and individuals, and the dominant education system in the country that can significantly impact research productivity, as well as whether residency programmes have integrated research rotations in their curricula, which influences research outcomes [ 17 , 30 , 32 ]. Notwithstanding, a point to be considered is that identified publications might not correctly reflect research efforts on men’s SRHC across MENA, where studies are more likely to be written in local languages for local authorities, limiting their chances of publication, as noted by others[ 27 ].…”

Global, Regional, and National Burdens of Otitis Media From 1990 to 2019: A Population Based Study

“…The incidence of otitis media is high in South Asia, North Africa, and the Middle East, which is explained in part by the low socioeconomic status and poor healthcare services in these regions ( Zakaria et al 2020 ). Although the public health interventions in North Africa and the Middle East have improved, they are still at lower levels than those in other regions ( Nagi et al 2022 ). Nationally, the Republic of Korea had the largest increase in incidence of the disease.…”