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Decision rules for allocation of finances to health systems strengthening

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  • Morton, Alec
  • Thomas, Ranjeeta
  • Smith, Peter C.

Abstract

A key dilemma in global health is how to allocate funds between disease-specific “vertical projects” on the one hand and “horizontal programmes” which aim to strengthen the entire health system on the other. While economic evaluation provides a way of approaching the prioritisation of vertical projects, it provides less guidance on how to prioritise between horizontal and vertical spending. We approach this problem by formulating a mathematical program which captures the complementary benefits of funding both vertical projects and horizontal programmes. We show that our solution to this math program has an appealing intuitive structure. We illustrate our model by computationally solving two specialised versions of this problem, with illustrations based on the problem of allocating funding for infectious diseases in sub-Saharan Africa. We conclude by reflecting on how such a model may be developed in the future and used to guide empirical data collection and theory development.

Suggested Citation

  • Morton, Alec & Thomas, Ranjeeta & Smith, Peter C., 2016. "Decision rules for allocation of finances to health systems strengthening," Journal of Health Economics, Elsevier, vol. 49(C), pages 97-108.
    • Handle: RePEc:eee:jhecon:v:49:y:2016:i:c:p:97-108
    DOI: 10.1016/j.jhealeco.2016.06.001
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    References listed on IDEAS

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    Cited by:

    1. Klas Kellerborg & Werner Brouwer & Pieter Baal, 2020. "Costs and benefits of interventions aimed at major infectious disease threats: lessons from the literature," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(9), pages 1329-1350, December.
    2. Özlem Karsu & Alec Morton, 2021. "Trading off health and financial protection benefits with multiobjective optimization," Health Economics, John Wiley & Sons, Ltd., vol. 30(1), pages 55-69, January.
    3. Kirwin, Erin & Meacock, Rachel & Round, Jeff & Sutton, Matt, 2022. "The diagonal approach: A theoretic framework for the economic evaluation of vertical and horizontal interventions in healthcare," Social Science & Medicine, Elsevier, vol. 301(C).
    4. Hauck, K. & Morton, A. & Chalkidou, K. & Chi, Y-Ling & Culyer, A. & Levin, C. & Meacock, R. & Over, M. & Thomas, R. & Vassall, A. & Verguet, S. & Smith, P.C., 2019. "How can we evaluate the cost-effectiveness of health system strengthening? A typology and illustrations," Social Science & Medicine, Elsevier, vol. 220(C), pages 141-149.
    5. James Love-Koh & Susan Griffin & Edward Kataika & Paul Revill & Sibusiso Sibandze & Simon Walker & Jessica Ochalek & Mark Sculpher & Matthias Arnold, 2019. "Economic analysis for health benefits package design," Working Papers 165cherp, Centre for Health Economics, University of York.
    6. Morton, Alec & Arulselvan, Ashwin & Thomas, Ranjeeta, 2018. "Allocation rules for global donors," Journal of Health Economics, Elsevier, vol. 58(C), pages 67-75.
    7. Sakshi Mohan & Simon Walker & Freddie Sengooba & Elizabeth Ekirapa Kiracho & Chrispus Mayora & Aloysius Ssennyonjo & Candia Tom Aliti & Paul Revill, 2023. "Supporting the revision of the health benefits package in Uganda: A constrained optimisation approach," Health Economics, John Wiley & Sons, Ltd., vol. 32(6), pages 1244-1255, June.
    8. Peter Smith, 2020. "Evaluating the Cost-effectiveness of Health System Strengthening: A Platforms Perspective," Seminar Briefing 002245, Office of Health Economics.
    9. van Baal, Pieter & Morton, Alec & Severens, Johan L., 2018. "Health care input constraints and cost effectiveness analysis decision rules," Social Science & Medicine, Elsevier, vol. 200(C), pages 59-64.
    10. Peter S., 2020. "Evaluating the Cost-effectiveness of Health System Strengthening: A Platforms Perspective," Briefings 002245, Office of Health Economics.
    11. Morton, Alec & Arulselvan, Ashwin & Thomas, Ranjeeta, 2018. "Allocation rules for global donors," LSE Research Online Documents on Economics 101210, London School of Economics and Political Science, LSE Library.
    12. Rui Miao & Xiaohao Xiang & Qi Wu & Zhibin Jiang, 2020. "Evaluation method of medical service system based on DEMATEL and the information entropy: A case study of hypertension diagnosis and treatment in China," PLOS ONE, Public Library of Science, vol. 15(12), pages 1-15, December.
    13. Tom L. Drake & Yoel Lubell, 2017. "Malaria and Economic Evaluation Methods: Challenges and Opportunities," Applied Health Economics and Health Policy, Springer, vol. 15(3), pages 291-297, June.

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    More about this item

    Keywords

    Global health; Health systems strengthening; Resource allocation; Cost effectiveness analysis; Economic analysis;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • C6 - Mathematical and Quantitative Methods - - Mathematical Methods; Programming Models; Mathematical and Simulation Modeling
    • C61 - Mathematical and Quantitative Methods - - Mathematical Methods; Programming Models; Mathematical and Simulation Modeling - - - Optimization Techniques; Programming Models; Dynamic Analysis
    • C63 - Mathematical and Quantitative Methods - - Mathematical Methods; Programming Models; Mathematical and Simulation Modeling - - - Computational Techniques

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