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Outcomes in Economic Evaluations of Public Health Interventions in Low‐ and Middle‐Income Countries: Health, Capabilities and Subjective Wellbeing

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  • Giulia Greco
  • Paula Lorgelly
  • Inthira Yamabhai

Abstract

Public health programmes tend to be complex and may combine social strategies with aspects of empowerment, capacity building and knowledge across sectors. The nature of the programmes means that some effects are likely to occur outside the healthcare sector; this breadth impacts on the choice of health and non‐health outcomes to measure and value in an economic evaluation. Employing conventional outcome measures in evaluations of public health has been questioned. There are concerns that such measures are too narrow, overlook important dimensions of programme effect and, thus, lead to such interventions being undervalued. This issue is of particular importance for low‐income and middle‐income countries, which face considerable budget constraints, yet deliver a large proportion of health activities within public health programmes. The need to develop outcome measures, which include broader measures of quality of life, has given impetus to the development of a variety of new, holistic approaches, including Sen's capability framework and measures of subjective wellbeing. Despite their promise, these approaches have not yet been widely applied, perhaps because they present significant methodological challenges. This paper outlines the methodological challenges for the identification and measurement of broader outcomes of public health interventions in economic evaluation in low‐income and middle‐income countries.

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  • Giulia Greco & Paula Lorgelly & Inthira Yamabhai, 2016. "Outcomes in Economic Evaluations of Public Health Interventions in Low‐ and Middle‐Income Countries: Health, Capabilities and Subjective Wellbeing," Health Economics, John Wiley & Sons, Ltd., vol. 25(S1), pages 83-94, February.
  • Handle: RePEc:wly:hlthec:v:25:y:2016:i:s1:p:83-94
    DOI: 10.1002/hec.3302
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    3. Deidda, Manuela & Geue, Claudia & Kreif, Noemi & Dundas, Ruth & McIntosh, Emma, 2019. "A framework for conducting economic evaluations alongside natural experiments," Social Science & Medicine, Elsevier, vol. 220(C), pages 353-361.
    4. Gang Chen & Julie Ratcliffe & Billingsley Kaambwa & Nikki McCaffrey & Jeff Richardson, 2018. "Empirical Comparison Between Capability and Two Health-Related Quality of Life Measures," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 140(1), pages 175-190, November.
    5. Enrica Chiappero‐Martinetti & Paola Salardi & Francesco Scervini, 2019. "Estimating conversion rates: A new empirical strategy with an application to health care in Italy," Health Economics, John Wiley & Sons, Ltd., vol. 28(6), pages 748-764, June.
    6. Catherine Pitt & Anna Vassall & Yot Teerawattananon & Ulla K. Griffiths & Lorna Guinness & Damian Walker & Nicola Foster & Kara Hanson, 2016. "Foreword: Health Economic Evaluations in Low‐ and Middle‐income Countries: Methodological Issues and Challenges for Priority Setting," Health Economics, John Wiley & Sons, Ltd., vol. 25(S1), pages 1-5, February.
    7. Paul Mark Mitchell & Samantha Husbands & Sarah Byford & Philip Kinghorn & Cara Bailey & Tim J. Peters & Joanna Coast, 2021. "Challenges in developing capability measures for children and young people for use in the economic evaluation of health and care interventions," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 1990-2003, September.

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