Evaluating the Economic and Health Impacts of Investing in Laboratories in East Africa

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dc.creatorBoyce, Simone Peart
dc.creatorBerruti, Andres A.
dc.creatorConnolly, Helen
dc.creatorSchneidman, Miriam
dc.date2015-06-24T19:24:11Z
dc.date2015-06-24T19:24:11Z
dc.date2015-05
dc.date.accessioned2026-07-01T00:52:15Z
dc.descriptionLaboratories provide essential services to the health sector on the monitoring and treatment of disease. Routine implementation of new diagnostic techniques may be costly; therefore, understanding their clinical utility, impact, and cost-effectiveness are necessary to guide decisions as to whether and how such techniques should be implemented. In this study, the authors design a conceptual framework for examining the following: (1) optimal mix of laboratory services at different levels of the health system; (2) combination of resources required within laboratories to promote efficiency; and (3) potential for outsourcing to promote cost containment. The framework considers both the health and economic rationale for laboratory investments. The authors then use the conceptual framework to inform a decision analytics model that maps out the health and economic impact of laboratory investments, and to illustrate the model by investigating the best placement of a new technology (GeneXpert) for detecting multi-drug-resistant tuberculosis (MDR-TB). The illustrative application of the model shows that investment in a new diagnostic technology for MDR-TB is cost-effective regardless of placement in a district-level (satellite) or national-level (reference) laboratory. Placement of the GeneXpert system at the satellite laboratory results in patients tested for MDR-TB or TB at lower costs than the reference laboratory. Furthermore, if testing occurs at the satellite laboratory, more primary and secondary cases are treated and cured than if testing was conducted at the reference laboratory, leading to better outcomes. Overall, testing at the satellite laboratory results in more deaths averted and more disability life-adjusted years (DALYs) saved. Both facilities have average costs per DALY well below the World Health Organization (WHO) - suggested threshold for the per capita gross domestic product (GDP). However, the satellite laboratory saves more DALYs at a lower additional cost per DALY.
dc.formatapplication/pdf
dc.formattext/plain
dc.identifierhttp://documents.worldbank.org/curated/en/2015/06/24655148/evaluating-economic-health-impacts-investing-laboratories-east-africa-development-application-conceptual-framework
dc.identifierhttps://hdl.handle.net/10986/22056
dc.identifierhttps://doi.org/10.1596/22056
dc.identifier.urihttp://hdl.handle.net/123456789/412230
dc.languageEnglish
dc.languageen_US
dc.publisherWorld Bank, Washington, DC
dc.relationHealth, Nutrition, and Population (HNP) discussion paper;
dc.rightsCC BY 3.0 IGO
dc.rightshttp://creativecommons.org/licenses/by/3.0/igo/
dc.rightsWorld Bank
dc.subjectPHARMACY
dc.subjectCLINICAL CHEMISTRY
dc.subjectHARMONIZATION
dc.subjectRISKS
dc.subjectHUMAN CAPACITY
dc.subjectTREATMENT
dc.subjectDIAGNOSIS
dc.subjectSUPERVISION
dc.subjectEQUIPMENT
dc.subjectLABORATORY TESTING
dc.subjectEPIDEMIOLOGICAL DATA
dc.subjectLUNG DISEASES
dc.subjectSYNDROMES
dc.subjectINFORMATION SYSTEM
dc.subjectHUMAN IMMUNODEFICIENCY VIRUS
dc.subjectANTIMALARIAL DRUGS
dc.subjectPREVENTION
dc.subjectDISEASE BURDEN
dc.subjectDISEASE PREVALENCE
dc.subjectMORBIDITY
dc.subjectSEXUALLY TRANSMITTED DISEASES
dc.subjectCOMMUNITY HEALTH
dc.subjectINFORMATION
dc.subjectMONITORING
dc.subjectDISEASE TRANSMISSION
dc.subjectHEALTH CARE
dc.subjectBIOCHEMISTRY
dc.subjectDEATH
dc.subjectPREVALENCE
dc.subjectEFFECTS
dc.subjectCLINICAL OUTCOMES
dc.subjectHEALTH
dc.subjectTRANSMISSION
dc.subjectDISEASE PREVENTION AND CONTROL
dc.subjectHIV # POSITIVE
dc.subjectDISEASE REPORTING
dc.subjectLABORATORY SERVICES
dc.subjectDRUG RESISTANCE
dc.subjectTB CONTROL
dc.subjectINFORMATION SYSTEMS
dc.subjectPUBLIC HEALTH
dc.subjectLIFE EXPECTANCY
dc.subjectSATELLITE
dc.subjectLEPROSY
dc.subjectDATA
dc.subjectPATHOGENS
dc.subjectDISEASES
dc.subjectINFECTIOUS DISEASES
dc.subjectPATIENTS
dc.subjectPATIENT
dc.subjectLIFE
dc.subjectDNA
dc.subjectINTERVENTION
dc.subjectHIV/AIDS CARE
dc.subjectSEROLOGY
dc.subjectPRODUCTIVITY
dc.subjectOPPORTUNISTIC INFECTIONS
dc.subjectHEALTH MANAGEMENT
dc.subjectHIV INFECTION
dc.subjectMEDICAL CARE
dc.subjectSTANDARDIZATION
dc.subjectDURATION OF TREATMENT
dc.subjectTUBERCULOSIS CONTROL
dc.subjectDIAGNOSTIC METHODS
dc.subjectMATERIAL
dc.subjectTUBERCULOSIS
dc.subjectSYMPTOMS
dc.subjectSCREENING
dc.subjectHIV/AIDS
dc.subjectEPIDEMICS
dc.subjectINVENTORY
dc.subjectDISEASE PREVENTION
dc.subjectMORTALITY
dc.subjectCAPABILITIES
dc.subjectMALARIA DIAGNOSIS
dc.subjectMEDICAL TREATMENT
dc.subjectDANGEROUS DISEASES
dc.subjectDISEASE OUTBREAKS
dc.subjectIMMUNE DEFICIENCY
dc.subjectTECHNOLOGY
dc.subjectBLOOD SAMPLES
dc.subjectDIAGNOSES
dc.subjectRELIABILITY
dc.subjectHEMATOLOGY
dc.subjectMEDICAL RESEARCH
dc.subjectWORKERS
dc.subjectHIV ANTIBODIES
dc.subjectTIME FRAME
dc.subjectHIV
dc.subjectTB
dc.subjectRESULTS
dc.subjectSURVEILLANCE
dc.subjectIMMUNODEFICIENCY
dc.subjectHEALTH POLICY
dc.subjectMEDICINE
dc.subjectHEALTH OUTCOMES
dc.subjectNETWORKS
dc.subjectFAX
dc.subjectDECISION MAKING
dc.subjectMEASUREMENT
dc.subjectNUTRITION
dc.subjectMEDICAL OFFICER
dc.subjectMALARIA
dc.subjectADOLESCENTS
dc.subjectQUALITY CONTROL
dc.subjectHEALTH SURVEILLANCE
dc.subjectBURDEN OF DISEASE
dc.subjectTHERAPY
dc.subjectDIAGNOSTICS
dc.subjectINTERNET
dc.subjectRESULT
dc.subjectCOMMUNICABLE DISEASES
dc.subjectPATHOLOGY
dc.subjectVIRUS
dc.subjectTROPICAL MEDICINE
dc.subjectPHYSICAL HEALTH
dc.subjectDISEASE CONTROL
dc.subjectDISEASE
dc.subjectCLINICS
dc.subjectNETWORK
dc.subjectHUMAN RESOURCES
dc.subjectRETENTION
dc.subjectINFECTION
dc.subjectDISABILITY
dc.subjectINFECTIONS
dc.subjectALL
dc.subjectSITES
dc.subjectEARLY DETECTION
dc.subjectCOMMUNICATION
dc.subjectNEW TECHNOLOGY
dc.subjectSTRATEGY
dc.subjectEPIDEMIOLOGY
dc.subjectDISEASE CHARACTERISTICS
dc.subjectCLINICAL BIOCHEMISTRY
dc.subjectMEDICINES
dc.subjectTECHNOLOGIES
dc.subjectAIDS
dc.subjectOUTSOURCING
dc.subjectHEALTH SERVICES
dc.subjectIMPLEMENTATION
dc.subjectLUNG DISEASE
dc.subjectUSES
dc.subjectDISEASE DETECTION
dc.subjectSTORAGE
dc.titleEvaluating the Economic and Health Impacts of Investing in Laboratories in East Africa
dc.titleDevelopment and Application of a Conceptual Framework
dc.typeWorking Paper
dc.typeDocument de travail
dc.typeDocumento de trabajo

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