Health gains and financial risk protection afforded by public financing of selected malaria interventions in Ethiopia: an extended cost-effectiveness analysis

Abstract

Background: Malaria is a public health burden and a major cause for morbidity and mortality in Ethiopia. Malaria also places a substantial financial burden on families and Ethiopia's national economy. Economic evaluations, with evidence on equity and financial risk protection (FRP), are therefore essential to support decision-making for policymakers to identify best buys amongst possible malaria interventions. The aim of this study is to estimate the expected health and FRP benefits of universal public financing of key malaria interventions in Ethiopia. Methods: Using extended cost-effectiveness analysis (ECEA), the potential health and FRP benefits were estimated, and their distributions across socioeconomic groups, of publicly financing a 10% coverage increase in artemisininbased combination therapy (ACT), long-lasting insecticide-treated bed nets (LLIN), indoor residual spraying (IRS), and malaria vaccine (hypothetical). Results: ACT, LLIN, IRS, and vaccine would avert 358, 188, 107 and 38 deaths, respectively, each year at a net government cost of $5.7, 16.5, 32.6, and 5.1 million, respectively. The annual cost of implementing IRS would be two times higher than that of the LLIN interventions, and would be the main driver of the total costs. The averted deaths would be mainly concentrated in the poorest two income quintiles. The four interventions would eliminate about $4,627,800 of private health expenditures, and the poorest income quintiles would see the greatest FRP benefits. ACT and LLINs would have the largest impact on malaria-related deaths averted and FRP benefits. Conclusions: ACT, LLIN, IRS, and vaccine interventions would bring large health and financial benefits to the poorest households in Ethiopia.

Cost-benefit analysis of malaria elimination phase surveillance measures in Fujian Province

“…Literature has shown that implementing more effective malaria surveillance and control methods can result in greater economic benefits (15)(16)(17)(18)(19)(20)(21). Presently, malaria management in Fujian Province is incorporated into overall public health efforts.…”

Cost-benefit analysis of the monitoring measures for the malaria elimination stage in Fujian, China

“…Literature has shown that implementing more effective malaria surveillance and control methods can result in greater economic bene ts (15)(16)(17)(18)(19)(20)(21). Presently, malaria management in Fujian Province is incorporated into overall public health efforts.…”

Monitoring Measures in the Elimination of Malaria in Fujian, China: A Cost-Benefit Analysis

“…Literature has shown that implementing more effective malaria monitoring and control measures can produce economic bene ts [15][16][17][18][19][20][21]. At present, malaria monitoring measures in Fujian Province have been incorporated into overall public health efforts.…”

“…We reviewed the literature on the economic evaluation of malaria [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23], held discussions with the research team, consulted the experts on malaria, and then determined the typical bene t indicators. The economic bene ts included the direct medical and non-medical bene ts of avoiding hospitalization and missed work bene ts of avoiding hospitalization.…”

“…Therefore, it is still necessary to conduct a health economics evaluation of the monitoring measures in Fujian, even though it is in the malaria elimination stage. We reviewed and analyzed the literature on the economics of malaria and found that the differences between the nancial and economic costs were negligible; thus, only economic costs are presented here [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. We calculated costs based on health economics theory and the malaria monitoring measures in this stage.…”