Country-Level Decision Making for Control of Chronic Diseases: Workshop Summary by Alexandra Beatty

Author:Alexandra Beatty
Language: eng
Format: epub
Tags: ebook, book
Publisher: The National Academies Press
Published: 2012-11-28T00:00:00+00:00

FIGURE 4-1 OneHealth framework.

NOTE: HIV = human immunodeficiency virus; NCDs = noncommunicable diseases; TB = tuberculosis; WASH = water, sanitation, and hygiene.

SOURCE: Stenberg (2011b).

The software is also very user-friendly, Stenberg added. The user can adapt the model to local circumstances and chose the level of detail that is most useful for a given purpose. For example, the model might be used to answer such questions as “What set of interventions will have a desired impact in my setting? What constraints in my system need to be addressed before I can scale up a promising intervention? How feasible would a given intervention be if I have to adapt in certain ways in order to implement it in a given setting? What funding will I need to accomplish X?” A user might want to cost and budget a plan that has been already developed, or perhaps compare alternative scenarios. “It helps to make the planning more realistic, as opposed to setting very ambitious targets that you may not be able to achieve,” Stenberg said. For example, a user with a target of scaling up an intervention to 90 percent coverage for a given disease or risk factor can click on the human resources module to determine whether the health system has a sufficient number of nurses or community health workers to deliver the intervention. If not, the user can adjust the target and explore other pathways for scaling up the intervention.

The OneHealth model faces the same data challenges that affect the other models discussed, Stenberg said. Another challenge is ensuring that each country has the capacity to take full advantage of the tool’s possibilities. Despite the challenges, Stenberg concluded, the OneHealth model provides a common platform and consistent methods for countries to use and a way to ensure that their health systems’ capacity is what drives planning and priority setting. As funding permits, the development team will continue to add new elements to the model, such as a health information systems module and models for health gains for noncommunicable diseases.

Stenberg closed with her recommendations for designing and applying a costing model as part of a toolkit:

• Be very clear about the specific policy questions to be answered, how the tools will be used and by whom.

• Focus on broad health sector planning processes and ways to integrate across programs.

• Don’t overlook the need to invest in capacity building, advocacy, communication, and training in how to use the tools.

PRIORITY SETTING TOOLS

The Lives Saved Tool for Maternal and Child Health

The purpose of the Lives Saved Tool (LiST)7 is straightforward, explained Neff Walker of Johns Hopkins University. It is intended to estimate the impact that increasing health coverage has on maternal and neonatal health, child mortality, and stillbirths. It is a computer-based tool that countries or program developers can use to estimate the relative impact of a wide range of possible interventions and levels of coverage for purposes of strategic planning. It is incorporated in the OneHealth model discussed above.

To use LiST, users begin by

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