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Health policy support under extreme uncertainty: the case of cervical cancer in Cambodia

Author

Listed:
  • Steffen Flessa

    (University of Greifswald)

  • Dominik Dietz

    (German Society of International Collaboration (GIZ))

  • Elisabete Weiderpass

    (Karolinska Institutet)

Abstract

Health policy support in least developing countries is needed to allocate scarce resources most efficiently and produce the maximum health at given resources. However, planners frequently face severe uncertainty of biological, economic and health service structures and parameters. This paper presents a model of cervical cancer (CUC) in Cambodia as an example of health policy support under extreme uncertainty. The projections are based on a multi-compartment dynamic policy model, specifically developed for CUC in Cambodia. The model simulates the demographic system and infections through sexual intercourse for 100 years. Data were taken from the literature and adjusted for Cambodia through interviews. CUC is an increasing problem in Cambodia and the number of deaths due to cervical cancer growths faster than the population. On average, Cambodia will lose some 5159 years of life per year due to CUC. From the alternative interventions against CUC, a “see-and-treat” approach based on VIA screening of women 30–49 years every 3 years seems to be most efficient. The results of the simulation indicate that the “see-and-treat” approach should be implemented in Cambodia. Even under strong changes of parameters and assumptions, this finding is robust. The model is currently being used in development planning. The example shows that health policy support is possible even under extreme uncertainty if the model builder employs a sufficient number of sensitivity analyses and scenarios.

Suggested Citation

  • Steffen Flessa & Dominik Dietz & Elisabete Weiderpass, 2016. "Health policy support under extreme uncertainty: the case of cervical cancer in Cambodia," EURO Journal on Decision Processes, Springer;EURO - The Association of European Operational Research Societies, vol. 4(3), pages 183-218, November.
    • Handle: RePEc:spr:eurjdp:v:4:y:2016:i:3:d:10.1007_s40070-015-0053-1
    DOI: 10.1007/s40070-015-0053-1
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    1. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(3), pages 367-372, June.
    2. Fawziah Marra & Karine Cloutier & Bridgette Oteng & Carlo Marra & Gina Ogilvie, 2009. "Effectiveness and Cost Effectiveness of Human Papillomavirus Vaccine," PharmacoEconomics, Springer, vol. 27(2), pages 127-147, February.
    3. John D. Hey & Gianna Lotito & Anna Maffioletti, 2018. "The descriptive and predictive adequacy of theories of decision making under uncertainty/ambiguity," World Scientific Book Chapters, in: Experiments in Economics Decision Making and Markets, chapter 8, pages 189-219, World Scientific Publishing Co. Pte. Ltd..
    4. Tazio Vanni & Jonathan Karnon & Jason Madan & Richard White & W. Edmunds & Anna Foss & Rosa Legood, 2011. "Calibrating Models in Economic Evaluation," PharmacoEconomics, Springer, vol. 29(1), pages 35-49, January.
    5. Brown, T.M. & Cueto, M. & Fee, E., 2006. "The World Health Organization and the transition from international to global public health," American Journal of Public Health, American Public Health Association, vol. 96(1), pages 62-72.
    6. Jonathan Karnon & Tazio Vanni, 2011. "Calibrating Models in Economic Evaluation," PharmacoEconomics, Springer, vol. 29(1), pages 51-62, January.
    7. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629.
    8. Shane Frederick & George Loewenstein & Ted O'Donoghue, 2002. "Time Discounting and Time Preference: A Critical Review," Journal of Economic Literature, American Economic Association, vol. 40(2), pages 351-401, June.
    9. Heidenberger, Kurt & Flessa, Steffen, 1993. "A system dynamics model for AIDS policy support in Tanzania," European Journal of Operational Research, Elsevier, vol. 70(2), pages 167-176, October.
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    Cited by:

    1. Eva Glaeser & Bart Jacobs & Bernd Appelt & Elias Engelking & Ir Por & Kunthea Yem & Steffen Flessa, 2020. "Costing of Cesarean Sections in a Government and a Non-Governmental Hospital in Cambodia—A Prerequisite for Efficient and Fair Comprehensive Obstetric Care," IJERPH, MDPI, vol. 17(21), pages 1-15, November.

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