Economic Evaluation of Health Interventions: Tanzania Perspectives
The life expectancy of Tanzania has declined since 1990, and the health care services are facing immense challenges. The two single most important sources of burden of disease in the country are HIV/AIDS and malaria. Cardiovascular and other non-communicable diseases are also becoming increasingly important causes of disease burden. This chapter reviews the available economic evaluation literature for all types of health interventions in Tanzania. Economic evaluation is useful for setting health care priorities when decision makers are concerned about producing as much health benefits as possible within the limits of scarce health care resources.
A total of 23 studies were found reporting costs and benefits for health interventions in Tanzania. The studies included in the review can roughly be sorted into the disease groups malaria, HIV/AIDS, maternal and perinatal health, intestinal parasites and worms, tuberculosis (TB), childhood diseases and cardiovascular disorders. The economic evaluation evidence for Tanzania is generally very scarce. Evidence is relatively good for malaria interventions and interventions against intestinal worms and parasites. Within these disease groups economic evaluation can be particularly useful to inform implementation policy. For all other disease groups, evidence is either vastly insufficient or totally missing. Lack of evidence is particularly striking for treatment and care of patients with HIV/AIDS, and for non-communicable diseases. Economic evaluation can in most cases not be used efficiently and consistently to set health care priorities in Tanzania. More research is needed to improve this situation.
KeywordsEconomic Evaluation Oral Rehydration Solution Economic Evidence Directly Observe Treatment Voucher Scheme
List of Abbreviations:
acquired immunodeficiency syndrome
adult mortality and morbidity project
burden of disease
calcium channel blocker
commission on macroeconomics and health
disability adjusted life year
directly observed treatment
evacuation by curettage
expanded programme for immunization
gross domestic product
human immunodeficiency virus
integrated management of childhood illness
insecticide treated bednets
manual vacuum aspiration
National Bureau of Statistics
oral rehydration solution
prevention of mother to child transmission
point of care testing
rapid plasma reagin testing
Sub Saharan Africa
sexually transmitted diseases
Tanzania National Voucher Scheme
United States dollars
voluntary counseling and testing
World Health Organization
We thank Ole Frithjof Norheim and Kjell Arne Johansson for peer review of the manuscript and Julia Norman for proofreading.
- AMMP. (2004). AMMP Final Report–The Policy Implications of Tanzanias Mortality Burden: A 10 year Community-Based Perspective. Adult Mortality and Morbidity Project–Ministry of Health, Dar es Salaam.Google Scholar
- Brock D, Wikler D. (2006). In: Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB, Jha P, Mills A, Musgrove P (eds.) Disease Control Priorities in Developing Countries. Oxford University Press and the World Bank, New York.Google Scholar
- Bureau of Economic Analysis (web-page), http://www.bea.gov/national/nipaweb (accessed 2008).
- Commission on Macroeconomics and Health & WHO. (2001). Macroeconomics and Health: Investing in Health for Economic Development. WHO, Geneva.Google Scholar
- Globalis. (2008) (web-page), http://Globalis.gvu.unu.edu (accessed 2008).
- Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB, Jha P, Mills A, Musgrove P. (2006). Disease Control Priorities in Developing Countries. The World Bank and Oxford University Press, New York.Google Scholar
- Lopez AD, Ahmad OB, Guillot M, Inoue M, Ferguson BD, Salomon JA. (2001). Life Tables for 191 Countries for 2000: Data, Methods, Results (GPE Discussion Paper No. 40), Evidence and Information for Policy (EIP). World Health Organisation, Geneva.Google Scholar
- Murray C, Lopez A. (1996). The Global Burden of Disease. A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020. The Harvard School of Public Health.Google Scholar
- Setel P, Hemed Y, Whiting D, Masanja H, Lewanga M, Mswia R, Kitange H. (2001). Insights Health, (2001).Google Scholar
- Tanzania. (2002). Census (web-page), http://www.tanzania.go.tz/census/census/index.html (accessed 2008).
- Tanzania. (2007). Tanzania in Figures 2006, National Bureau of Statistics, Ministry of Planning, Economy and Empowerment. Dar es Salaam.Google Scholar
- Wagstaff A, Claeson M. (2004). The Millennium Development Goals for Health. Rising to the Challenges. The World Bank, Washington DC.Google Scholar
- WHO. (1999). Report of the Meeting of Experts in Blood Transfusion Services. World Health Organization. Department of Blood Safety and Clinical Technology, Geneva.Google Scholar
- WHO. (2004). Devorming for Health and Development. Report of the Third Global Meeting of the Partners for Parasite Control. World Health Organization, Geneva.Google Scholar
- WHO. (2006). World Health Report 2006. World Health Organisation, Geneva.Google Scholar
- WHO (web-page), http://www3.who.int/choice/(accessed 2008).
- WorldBank. (1993). World Development Report 1993: Investing in Health. Oxford University Press, New York.Google Scholar