Economic Research

In the ASSET Economic Research work package, we have a vision to contribute towards increasing uptake of health economics research in Sub-Saharan African countries, and generally in lower- and middle-income countries. As the EQ-5D instrument is used widely in

higher income countries like UK, the WHODAS is a quality of life instrument developed for lower- and middle-income countries by the WHO. However, to use the WHODAS in cost-effectiveness analysis, “off the shelf” utility weights are required. Through the ASSET project, we are using some complex psychometric analysis such as RASCH and valuation methods like Time Trade Off to elicit these utility weights in Ethiopia. We have ambitions to replicate the study in other ASSET countries too. As a final deliverable, we want to develop an algorithm for estimating utility weights for WHODAS. Once we have the algorithm, we expect cost-effectiveness research would use WHODAS as a generic quality of life measure. The utility weights could also to helpful for other ASSET work package to evaluate the cost-effectiveness of their health systems strengthening interventions. In a way, this is a contribution we make to enhance the uptake of more health economics research in lower- and middle-income countries.

Another economic research project we are attempting is in Sierra Leone and Ethiopia to address an important challenge in the delivery of surgical care – FINANCIAL BARRIERS. Patients are required to spend a lot of out-of-pocket costs to avail surgery; which restricts many from using surgical services. In order to conduct policy labs, involving stakeholders and policy makers to raise awareness and initiate discussion on financial inequity, cost barriers and more widely on surgical financing, ASSET economic research is working in conjunction with the surgical platforms to conduct “willingness to pay” surveys for surgical service in Sierra Leone and Ethiopia. Having information such as how much people are “willing to pay” for surgery would be a valuable information for such policy labs. The willingness to pay surveys will be conducted for two common surgical problems; appendicitis and hernia in both the countries. The willingness to pay elicitation would involve an iterative bidding game approach and the construct validity would be tested using statistical models such as Tobit.