Abstract
Cost effectiveness analysis (CEA) is a useful tool for allocation of constrained resources, yet CEA methodologies are rarely taught or implemented in developing nations. We aimed to assess exposure to, and interest in CEA, and identify barriers to implementation in Uganda. A cross-sectional survey was carried out in Uganda using a newly developed self-administered questionnaire (via online and paper based approaches), targeting the main health care actors as identified by a previous study. Overall, there was a 68% response rate, with a 92% (69/75) response rate among the paper-based respondents compared to a 40% (26/65) rate with the online respondents. Seventy eight percent (74/95) of the respondents had no exposure to CEA. None of those with a master of medicine degree had any CEA exposure, and 80% of technical officers, who are directly involved in policy formulation, had no CEA exposure. Barriers to CEA identified by more than 50% of the participants were: lack of information technology (IT) infrastructure (hardware and software); lack of local experts in the field of CEA; lack of or limited local data; limited CEA training in schools; equity or ethical issues; and lack of training grants incorporating CEA. 93% reported a lot of interest in learning to conduct CEA, and over 95% felt CEA was important for clinical decision making and policy formulation. Among health care actors in Uganda, there is very limited exposure to, but substantial interest in conducting CEA and including it in clinical decision making and health care policy formation. Capacity to undertake CEA needs to be built through incorporation into medical training and use of regional approaches.
Highlights
Cost effectiveness analysis (CEA) is a useful tool for allocation of constrained resources, yet CEA methodologies are rarely taught or implemented in developing nations
The study participants were selected as follows: For the Ministry of Health Officials, we contacted a senior officer and after we described the study to him, he advised us to send questionnaires to specific individuals from 3 departments that are involved in economic evaluations, namely Planning − 5 respondents; Clinical Services5 respondents; and Community Health- 5 respondents
In the resource-constrained countries of Sub-Saharan Africa (SSA), where policy and decision makers are frequently faced with tough decisions regarding resource allocation, cost effectiveness analysis (CEA) can be a useful tool for optimal allocation of scarce resources
Summary
Cost effectiveness analysis (CEA) is a useful tool for allocation of constrained resources, yet CEA methodologies are rarely taught or implemented in developing nations. In the past 20 years, cost-effectiveness analysis (CEA) has become increasingly popular as a means of assessing the value of health care treatments. CEA endeavors to guide decision making such as to compare the health benefits of competing treatments within the context of cost. While these methods have been refined and gained traction in developed nations, there has been little use of CEA in developing nations [1]. Additional potential barriers to the conduct and impact of CEA in developing nations include lack of trained local personnel, lack of local data, and poor infrastructure [5]. Other hypothesized barriers include a shortage of CEA experts and lack of familiarity with CEA among policy makers and opinion leaders
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
