Valuing Health System Strengthening

Nathaniel Hendrix, CHDS faculty Stéphane Verguet, and colleagues performed a systematic review of cost-effectiveness analyses that assessed activities designed to strengthen health systems in low- and- middle-income countries (LMICs). Many highly cost-effective interventions targeting specific diseases have been implemented to some extent in LMICs. Distribution, though, remains a problem, and many vulnerable populations do not have access to these services. Strengthening the health systems of these countries is necessary before distribution can be improved and the range of available services expanded.

One challenge of health system strengthening is that it is difficult to assess its value using cost-effectiveness analysis methods that were designed for assessing disease-specific interventions. Most of the studies identified in this systematic review used relatively simple methods to estimate cost-effectiveness alongside randomized trials. These studies generally evaluated activities’ impacts over short time horizons and in specific populations, even though health system strengthening is usually designed to provide longer-lasting impacts to a variety of people.

Hendrix and colleagues concluded that new methods may need to be developed to address the challenge of valuing health system strengthening. The review was recently published in BMJ Global Health.

Learn more: Read the full publication, Economic Evaluations of Health System Strengthening Activities in Low-income and Middle-income Country Settings: A Methodological Systematic Review
Learn more: Read more about Health System Strengthening in the article, Health System Modelling Research: Towards a Whole-health-system Perspective for Identifying Good Value for Money Investments in Health System Strengthening
Learn more: Teaching Pack: Extended Cost-Effectiveness Analysis