Adapting Economic Evaluation Methods to Shifting Global Health Priorities: Assessing the Value of Health System Inputs

Finn McGuire, Sakshi Mohan, Simon Walker, Juliet Nabyonga-Orem, Freddie Ssengooba, Edward Kataika, Paul Revill

Research output: Contribution to journalArticlepeer-review


OBJECTIVES: We highlight the importance of undertaking value assessments for health system inputs if allocative efficiency is to be achieve with health sector resources, with a focus on low- and middle-income countries. However, methodological challenges complicated the application of current economic evaluation techniques to health system input investments.

METHODS: We undertake a review of the literature to examine how assessments of investments in health system inputs have been considered to date, highlighting several studies that have suggested ways to address the methodological issues. Additionally, we surveyed how empirical economic evaluations of health system inputs have approached these issues. Finally, we highlight the steps required to move toward a comprehensive standardized framework for undertaking economic evaluations to make value assessments for investments in health systems.

RESULTS: Although the methodological challenges have been illustrated, a comprehensive framework for value assessments of health system inputs, guiding the evidence required, does not exist. The applied literature of economic evaluations of health system inputs has largely ignored the issues, likely resulting in inaccurate assessments of cost-effectiveness.

CONCLUSIONS: A majority of health sector budgets are spent on health system inputs, facilitating the provision of healthcare interventions. Although economic evaluation methods are a key component in priority setting for healthcare interventions, such methods are less commonly applied to decision making for investments in health system inputs. Given the growing agenda for investments in health systems, a framework will be increasingly required to guide governments and development partners in prioritizing investments in scarce health sector budgets.

Original languageEnglish
Pages (from-to)31-39
Number of pages9
JournalValue in Health Regional Issues
Early online date15 Nov 2023
Publication statusPublished - 1 Jan 2024

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© 2023 International Society for Health Economics and Outcomes Research.

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