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Economic Evaluation in Ethiopian Healthcare Sector Decision Making: Perception, Practice and Barriers

Author

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  • Elias Asfaw Zegeye

    (University of KwaZulu-Natal)

  • Josue Mbonigaba

    (University of KwaZulu-Natal)

  • Sylvia Blanche Kaye

    (Durban University of Technology)

  • Thomas Wilkinson

    (University of Witwatersrand)

Abstract

Background Globally, economic evaluation (EE) is increasingly being considered as a critical tool for allocating scarce healthcare resources. However, such considerations are less documented in low-income countries, such as in Ethiopia. In particular, to date there has been no assessment conducted to evaluate the perception and practice of and barriers to health EE. Objective This paper assesses the use and perceptions of EE in healthcare decision-making processes in Ethiopia. Methods In-depth interview sessions with decision makers/healthcare managers and program coordinators across six regional health bureaus were conducted. A qualitative analysis approach was conducted on three thematic areas. Results A total of 57 decision makers/healthcare managers were interviewed from all tiers of the health sector in Ethiopia, ranging from the Federal Ministry of Health down to the lower levels of the health facility pyramid. At the high-level healthcare decision-making tier, only 56 % of those interviewed showed a good understanding of EE when explaining in terms of cost and consequences of alternative courses of action and value for money. From the specific program perspective, 50 % of the prevention of mother-to-child transmission of HIV/AIDS program coordinators indicated the relevance of EE to program planning and decision making. These respondents reported a limited application of costing studies on the HIV/AIDS prevention and control program, which were most commonly used during annual planning and budgeting. Conclusion The study uncovered three important barriers to growth of EE in Ethiopia: a lack of awareness, a lack of expertise and skill, and the traditional decision-making culture.

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  • Elias Asfaw Zegeye & Josue Mbonigaba & Sylvia Blanche Kaye & Thomas Wilkinson, 2017. "Economic Evaluation in Ethiopian Healthcare Sector Decision Making: Perception, Practice and Barriers," Applied Health Economics and Health Policy, Springer, vol. 15(1), pages 33-43, February.
    • Handle: RePEc:spr:aphecp:v:15:y:2017:i:1:d:10.1007_s40258-016-0280-z
    DOI: 10.1007/s40258-016-0280-z
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    References listed on IDEAS

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    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    2. Brousselle, Astrid & Lessard, Chantale, 2011. "Economic evaluation to inform health care decision-making: Promise, pitfalls and a proposal for an alternative path," Social Science & Medicine, Elsevier, vol. 72(6), pages 832-839, March.
    3. Gregory Merlo & Katie Page & Julie Ratcliffe & Kate Halton & Nicholas Graves, 2015. "Bridging the Gap: Exploring the Barriers to Using Economic Evidence in Healthcare Decision Making and Strategies for Improving Uptake," Applied Health Economics and Health Policy, Springer, vol. 13(3), pages 303-309, June.
    4. Joanna Coast, 1999. "The appropriate uses of qualitative methods in health economics," Health Economics, John Wiley & Sons, Ltd., vol. 8(4), pages 345-353, June.
    5. Eddama, Oya & Coast, Joanna, 2008. "A systematic review of the use of economic evaluation in local decision-making," Health Policy, Elsevier, vol. 86(2-3), pages 129-141, May.
    6. Lessard, Chantale & Contandriopoulos, André-Pierre & Beaulieu, Marie-Dominique, 2010. "The role (or not) of economic evaluation at the micro level: Can Bourdieu's theory provide a way forward for clinical decision-making?," Social Science & Medicine, Elsevier, vol. 70(12), pages 1948-1956, June.
    7. Ross, Jayne, 1995. "The use of economic evaluation in health care: Australian decision makers' perceptions," Health Policy, Elsevier, vol. 31(2), pages 103-110, February.
    8. Eddama, Oya & Coast, Joanna, 2009. "Use of economic evaluation in local health care decision-making in England: A qualitative investigation," Health Policy, Elsevier, vol. 89(3), pages 261-270, March.
    9. Virginia Wiseman & Craig Mitton & Mary M. Doyle‐Waters & Tom Drake & Lesong Conteh & Anthony T. Newall & Obinna Onwujekwe & Stephen Jan, 2016. "Using Economic Evidence to Set Healthcare Priorities in Low‐Income and Lower‐Middle‐Income Countries: A Systematic Review of Methodological Frameworks," Health Economics, John Wiley & Sons, Ltd., vol. 25, pages 140-161, February.
    10. Drummond, Michael F., 1987. "Economic evaluation and the rational diffusion and use of health technology," Health Policy, Elsevier, vol. 7(3), pages 309-324, June.
    11. Michael Drummond, 2004. "Economic Evaluation in Health Care: Is It Really Useful or Are We Just Kidding Ourselves?," Australian Economic Review, The University of Melbourne, Melbourne Institute of Applied Economic and Social Research, vol. 37(1), pages 3-11, March.
    12. Stirling Bryan & Iestyn Williams & Shirley McIver, 2007. "Seeing the NICE side of cost‐effectiveness analysis: a qualitative investigation of the use of CEA in NICE technology appraisals," Health Economics, John Wiley & Sons, Ltd., vol. 16(2), pages 179-193, February.
    13. Johnnesson, Magnus, 1995. "Economic evaluation of health care and policymaking," Health Policy, Elsevier, vol. 33(3), pages 179-190, September.
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