Abstract
ObjectiveTo estimate the costs and mortality reductions of a package of essential health interventions for urban populations in Bangladesh and India.MethodsWe used population data from the countries’ censuses and United Nations Population Division. For causes of mortality in India, we used the Indian Million Death Study. We obtained cost estimates of each intervention from the third edition of Disease control priorities. For estimating the mortality reductions expected with the package, we used the Disease control priorities model. We calculated the benefit–cost ratio for investing in the package, using an analysis based on the Copenhagen Consensus method.FindingsPer urban inhabitant, total costs for the package would be 75.1 United States dollars (US$) in Bangladesh and US$ 105.0 in India. Of this, prevention and treatment of noncommunicable diseases account for US$ 36.5 in Bangladesh and U$ 51.7 in India. The incremental cost per urban inhabitant for all interventions would be US$ 50 in Bangladesh and US$ 75 in India. In 2030, the averted deaths among people younger than 70 years would constitute 30.5% (1027/3362) and 21.2% (828/3913) of the estimated baseline deaths in Bangladesh and India, respectively. The health benefits of investing in the package would return US$ 1.2 per dollar spent in Bangladesh and US$ 1.8 per dollar spent in India.ConclusionInvesting in the package of essential health interventions, which address health-care needs of the growing urban population in Bangladesh and India, seems beneficial and could help the countries to achieve their 2030 sustainable development goals.
Highlights
Cities promote national economic growth and prosperity, innovation and overall national welfare
Cities have natural advantages in providing all kinds of services, not least because they are national economic drivers, with access to proportionately greater financing mechanisms than rural areas. Their size allows for a greater variety of services and economies of scale compared with sparsely populated areas
According to the United Nations (UN), the proportion of the world’s population living in urban areas will increase, from an estimated 55% in 2018 to an estimated 68% by 2050.3 Bangladesh and India are experiencing some of the highest urban population growth rates in the world
Summary
Cities promote national economic growth and prosperity, innovation and overall national welfare. The United Nations (UN) has pointed out that modern cities exhibit contrasts between wealth and poverty, opportunity and deprivation and vibrant potential and systemic decay.[1] Cities have natural advantages in providing all kinds of services, not least because they are national economic drivers, with access to proportionately greater financing mechanisms than rural areas. Their size allows for a greater variety of services and economies of scale compared with sparsely populated areas. In 2015, 62 cities in Bangladesh and India had more than 1 million population and five had more than
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