Using economic analysis to inform health resource allocation: lessons from Malawi

Megha Rao; Dominic Nkhoma; Sakshi Mohan; Pakwanja Twea; Benson Chilima; Joseph Mfutso-Bengo; Jessica Ochalek; Timothy B Hallett; Andrew N Phillips; Finn McGuire; Beth Woods; Simon Walker; Mark Sculpher; Paul Revill

doi:10.1007/s44250-024-00115-4

Using economic analysis to inform health resource allocation: lessons from Malawi

Megha Rao, Dominic Nkhoma, Sakshi Mohan, Pakwanja Twea, Benson Chilima, Joseph Mfutso-Bengo, Jessica Ochalek, Timothy B Hallett, Andrew N Phillips, Finn McGuire, Beth Woods, Simon Walker, Mark Sculpher, Paul Revill

Centre for Health Economics

Research output: Contribution to journal › Review article › peer-review

Abstract

Despite making remarkable strides in improving health outcomes, Malawi faces concerns about sustaining the progress achieved due to limited fiscal space and donor dependency. The imperative for efficient health spending becomes evident, necessitating strategic allocation of resources to areas with the greatest impact on mortality and morbidity. Health benefits packages hold promise in supporting efficient resource allocation. However, despite defining these packages over the last two decades, their development and implementation have posed significant challenges for Malawi. In response, the Malawian government, in collaboration with the Thanzi la Onse Programme, has developed a set of tools and frameworks, primarily based on cost-effectiveness analysis, to guide the design of health benefits packages likely to achieve national health objectives. This review provides an overview of these tools and frameworks, accompanied by other related analyses, aiming to better align health financing with health benefits package prioritization. The paper is organized around five key policy questions facing decision-makers: (i) What interventions should the health system deliver? (ii) How should resources be allocated geographically? (iii) How should investments in health system inputs be prioritized? (iv) How should equity considerations be incorporated into resource allocation decisions? and (v) How should evidence generation be prioritized to support resource allocation decisions (guiding research)? The tools and frameworks presented here are intended to be compatible for use in diverse and often complex healthcare systems across Africa, supporting the health resource allocation process as countries pursue Universal Health Coverage.

Original language	English
Article number	48
Pages (from-to)	48
Number of pages	15
Journal	Discover Health Systems
Volume	3
Issue number	1
DOIs	https://doi.org/10.1007/s44250-024-00115-4 https://doi.org/10.1007/s44250-024-00115-4
Publication status	Published - 15 Jul 2024

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Rao, M., Nkhoma, D., Mohan, S., Twea, P., Chilima, B., Mfutso-Bengo, J., Ochalek, J., Hallett, T. B., Phillips, A. N., McGuire, F., Woods, B., Walker, S., Sculpher, M., & Revill, P. (2024). Using economic analysis to inform health resource allocation: lessons from Malawi. Discover Health Systems, 3(1), 48. Article 48. https://doi.org/10.1007/s44250-024-00115-4, https://doi.org/10.1007/s44250-024-00115-4

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abstract = "Despite making remarkable strides in improving health outcomes, Malawi faces concerns about sustaining the progress achieved due to limited fiscal space and donor dependency. The imperative for efficient health spending becomes evident, necessitating strategic allocation of resources to areas with the greatest impact on mortality and morbidity. Health benefits packages hold promise in supporting efficient resource allocation. However, despite defining these packages over the last two decades, their development and implementation have posed significant challenges for Malawi. In response, the Malawian government, in collaboration with the Thanzi la Onse Programme, has developed a set of tools and frameworks, primarily based on cost-effectiveness analysis, to guide the design of health benefits packages likely to achieve national health objectives. This review provides an overview of these tools and frameworks, accompanied by other related analyses, aiming to better align health financing with health benefits package prioritization. The paper is organized around five key policy questions facing decision-makers: (i) What interventions should the health system deliver? (ii) How should resources be allocated geographically? (iii) How should investments in health system inputs be prioritized? (iv) How should equity considerations be incorporated into resource allocation decisions? and (v) How should evidence generation be prioritized to support resource allocation decisions (guiding research)? The tools and frameworks presented here are intended to be compatible for use in diverse and often complex healthcare systems across Africa, supporting the health resource allocation process as countries pursue Universal Health Coverage.",

author = "Megha Rao and Dominic Nkhoma and Sakshi Mohan and Pakwanja Twea and Benson Chilima and Joseph Mfutso-Bengo and Jessica Ochalek and Hallett, {Timothy B} and Phillips, {Andrew N} and Finn McGuire and Beth Woods and Simon Walker and Mark Sculpher and Paul Revill",

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Rao, M, Nkhoma, D, Mohan, S, Twea, P, Chilima, B, Mfutso-Bengo, J, Ochalek, J, Hallett, TB, Phillips, AN, McGuire, F , Woods, B , Walker, S , Sculpher, M & Revill, P 2024, 'Using economic analysis to inform health resource allocation: lessons from Malawi', Discover Health Systems, vol. 3, no. 1, 48, pp. 48. https://doi.org/10.1007/s44250-024-00115-4, https://doi.org/10.1007/s44250-024-00115-4

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T2 - lessons from Malawi

AU - Rao, Megha

AU - Nkhoma, Dominic

AU - Mohan, Sakshi

AU - Twea, Pakwanja

AU - Chilima, Benson

AU - Mfutso-Bengo, Joseph

AU - Ochalek, Jessica

AU - Hallett, Timothy B

AU - Phillips, Andrew N

AU - McGuire, Finn

AU - Woods, Beth

AU - Walker, Simon

AU - Sculpher, Mark

AU - Revill, Paul

PY - 2024/7/15

Y1 - 2024/7/15

N2 - Despite making remarkable strides in improving health outcomes, Malawi faces concerns about sustaining the progress achieved due to limited fiscal space and donor dependency. The imperative for efficient health spending becomes evident, necessitating strategic allocation of resources to areas with the greatest impact on mortality and morbidity. Health benefits packages hold promise in supporting efficient resource allocation. However, despite defining these packages over the last two decades, their development and implementation have posed significant challenges for Malawi. In response, the Malawian government, in collaboration with the Thanzi la Onse Programme, has developed a set of tools and frameworks, primarily based on cost-effectiveness analysis, to guide the design of health benefits packages likely to achieve national health objectives. This review provides an overview of these tools and frameworks, accompanied by other related analyses, aiming to better align health financing with health benefits package prioritization. The paper is organized around five key policy questions facing decision-makers: (i) What interventions should the health system deliver? (ii) How should resources be allocated geographically? (iii) How should investments in health system inputs be prioritized? (iv) How should equity considerations be incorporated into resource allocation decisions? and (v) How should evidence generation be prioritized to support resource allocation decisions (guiding research)? The tools and frameworks presented here are intended to be compatible for use in diverse and often complex healthcare systems across Africa, supporting the health resource allocation process as countries pursue Universal Health Coverage.

AB - Despite making remarkable strides in improving health outcomes, Malawi faces concerns about sustaining the progress achieved due to limited fiscal space and donor dependency. The imperative for efficient health spending becomes evident, necessitating strategic allocation of resources to areas with the greatest impact on mortality and morbidity. Health benefits packages hold promise in supporting efficient resource allocation. However, despite defining these packages over the last two decades, their development and implementation have posed significant challenges for Malawi. In response, the Malawian government, in collaboration with the Thanzi la Onse Programme, has developed a set of tools and frameworks, primarily based on cost-effectiveness analysis, to guide the design of health benefits packages likely to achieve national health objectives. This review provides an overview of these tools and frameworks, accompanied by other related analyses, aiming to better align health financing with health benefits package prioritization. The paper is organized around five key policy questions facing decision-makers: (i) What interventions should the health system deliver? (ii) How should resources be allocated geographically? (iii) How should investments in health system inputs be prioritized? (iv) How should equity considerations be incorporated into resource allocation decisions? and (v) How should evidence generation be prioritized to support resource allocation decisions (guiding research)? The tools and frameworks presented here are intended to be compatible for use in diverse and often complex healthcare systems across Africa, supporting the health resource allocation process as countries pursue Universal Health Coverage.

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DO - 10.1007/s44250-024-00115-4

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