Evaluation of the Costs and Benefits of Water and Sanitation Improvements at the Global Level

This study estimated the economic costs and benefits of a range of selected interventions to improve water and sanitation services. The entire analysis is based on changes in water and sanitation service levels. For developing countries, the World Health Organization (WHO) favors intervention options that are low cost, that are feasible, and do not require heavy maintenance. The costs of the interventions include the full investment and annual running costs. The benefits of the interventions include time savings associated with better access to water and sanitation facilities, the gain in productive time due to less time spent ill, health sector and patients costs saved due to less treatment of diarrheal diseases, and the value of prevented deaths. The results show that all water and sanitation improvements were found to be cost-beneficial, and this applied to all world regions

The economics of health and climate change: key evidence for decision making

<p>Abstract</p> <p>Background</p> <p>In responding to the health challenges of climate change, those responsible for health policies and resource allocations need to know the resource consequences of their decisions. This article examines the availability and strength of economic evidence for policy makers to draw on in making health policy decisions.</p> <p>Methods</p> <p>Relevant literature was obtained using a Medline and INTERNET search of key terms and institutions working in health and climate change. Eighteen available economic studies are presented under three categories of economic evidence: health damage cost, health adaptation cost and health economic evaluation.</p> <p>Results</p> <p>In economic studies valuing the predicted increased mortality from climate change, the health damages represent an important fraction of overall economic losses. Similarly, when considering broader health protection measures beyond the health sector (e.g. agriculture, water supply) health considerations are central. Global adaptation cost studies carried out so far indicate health sector costs of roughly US$2-5 billion annually (mid-estimates). However, these costs are expected to be an underestimate of the true costs, due to omitted health impacts, omitted economic impacts, and the costs of health actions in other sectors. No published studies compare the costs and benefits of specific health interventions to protect health from climate change.</p> <p>Conclusions</p> <p>More economic studies are needed examining the costs and benefits of adaptation measures to inform policy making. There is an urgent need for climate change-specific health economic guidelines to ensure robust methods are used, giving comparable results. Broader advocacy and focused training of decision makers is needed to increase the uptake of economic evidence in decision making. Until further climate change-specific economic studies have been conducted, decision makers should selectively draw on published studies of the costs and benefits of environmental health interventions.</p

Economic Evaluation of Environmental Health Interventions to Support Decision Making

Environmental burden of disease represents one quarter of overall disease burden, hence necessitating greater attention from decision makers both inside and outside the health sector. Economic evaluation techniques such as cost-effectiveness analysis and cost-benefit analysis provide key information to health decision makers on the efficiency of environmental health interventions, assisting them in choosing interventions which give the greatest social return on limited public budgets and private resources. The aim of this article is to review economic evaluation studies in three environmental health areas—water, sanitation, hygiene (WSH), vector control, and air pollution—and to critically examine the policy relevance and scientific quality of the studies for selecting and funding public programmers. A keyword search of Medline from 1990–2008 revealed 32 studies, and gathering of articles from other sources revealed a further 18 studies, giving a total of 50 economic evaluation studies (13 WSH interventions, 16 vector control and 21 air pollution). Overall, the economic evidence base on environmental health interventions remains relatively weak—too few studies per intervention, of variable scientific quality and from diverse locations which limits generalisability of findings. Importantly, there still exists a disconnect between economic research, decision making and programmer implementation. This can be explained by the lack of translation of research findings into accessible documentation for policy makers and limited relevance of research findings, and the often low importance of economic evidence in budgeting decisions. These findings underline the importance of involving policy makers in the defining of research agendas and commissioning of research, and improving the awareness of researchers of the policy environment into which their research feeds

Economic and Health Effects of Increasing Coverage of Low Cost Water and Sanitation Interventions

human development, water, sanitation

Cost valuation in resource-poor settings

Methods of cost-effectiveness analysis (CEA) have largely been developed for application in Western country settings. Little attention has been paid to the methodological issues in cost valuation in resource-poor settings, where failing exchange rates and severe market distortions require further clarifications of appropriate valuation methods. This paper links insights from social cost-benefit analysis with the current CEA guidelines to develop a more apt approach to cost valuation in resource-poor setting

A question of trust: can we build an evidence base to gain trust in systematic review automation technologies?

Background Although many aspects of systematic reviews use computational tools, systematic reviewers have been reluctant to adopt machine learning tools. Discussion We discuss that the potential reason for the slow adoption of machine learning tools into systematic reviews is multifactorial. We focus on the current absence of trust in automation and set-up challenges as major barriers to adoption. It is important that reviews produced using automation tools are considered non-inferior or superior to current practice. However, this standard will likely not be sufficient to lead to widespread adoption. As with many technologies, it is important that reviewers see “others” in the review community using automation tools. Adoption will also be slow if the automation tools are not compatible with workflows and tasks currently used to produce reviews. Many automation tools being developed for systematic reviews mimic classification problems. Therefore, the evidence that these automation tools are non-inferior or superior can be presented using methods similar to diagnostic test evaluations, i.e., precision and recall compared to a human reviewer. However, the assessment of automation tools does present unique challenges for investigators and systematic reviewers, including the need to clarify which metrics are of interest to the systematic review community and the unique documentation challenges for reproducible software experiments. Conclusion We discuss adoption barriers with the goal of providing tool developers with guidance as to how to design and report such evaluations and for end users to assess their validity. Further, we discuss approaches to formatting and announcing publicly available datasets suitable for assessment of automation technologies and tools. Making these resources available will increase trust that tools are non-inferior or superior to current practice. Finally, we identify that, even with evidence that automation tools are non-inferior or superior to current practice, substantial set-up challenges remain for main stream integration of automation into the systematic review process

The cost-effectiveness of introducing hepatitis B vaccine into infant immunization services in Mozambique

Objective: To estimate the cost-effectiveness of introducing hepatitis B vaccine into routine infant immunization services in Mozambique, which took place in the year 2001. Methods: A decision analytic model was used to estimate the impact of hepatitis B vaccination. This model was developed for the WHO to estimate the global burden of disease from hepatitis B. Cost data of vaccine delivery and medical treatment related to hepatitis B infection were collected for the analysis. Findings: The introduction of hepatitis B vaccine has increased the annual budget for immunization services by approximately 56%. It is predicted that more than 4000 future deaths are averted annually by the intervention. In the base case scenario, the incremental costs per undiscounted deaths averted amount to US$436, and the costs per undiscounted DALY averted amount to US$36. Since the major impact of hepatitis B vaccination will not start to be evident for at least another 40 years (deaths from hepatitis B mainly occur between 40-60 years of age), the cost per DALY averted rises to US$47, when using a discount rate of 3% on health effects. We found that the monovalent hepatitis B vaccine was considerably more cost-effective than the hepatitis B vaccine in combination with DTP. Interpretation: If policy makers value future health benefits equal to current benefits, the cost-effectiveness of infant hepatitis B vaccination is in the range of other primary health care interventions for which similar analysis has been undertake

Management of COPD in the UK primary-care setting : an analysis of real-life prescribing patterns

Peer reviewedPublisher PD

TRX: A Formally Verified Parser Interpreter

Parsing is an important problem in computer science and yet surprisingly little attention has been devoted to its formal verification. In this paper, we present TRX: a parser interpreter formally developed in the proof assistant Coq, capable of producing formally correct parsers. We are using parsing expression grammars (PEGs), a formalism essentially representing recursive descent parsing, which we consider an attractive alternative to context-free grammars (CFGs). From this formalization we can extract a parser for an arbitrary PEG grammar with the warranty of total correctness, i.e., the resulting parser is terminating and correct with respect to its grammar and the semantics of PEGs; both properties formally proven in Coq.Comment: 26 pages, LMC

The economic returns of sanitation interventions in Vietnam

Results of sanitation interventions in 9 rural and 8 urban sites have been evaluated, comparing open defecation with different range of sanitation facilities. Both quantitative and tangible benefits of sanitation and hygiene improvements versus averted costs of interventions were analyzed. Study results show improved sanitation is a socially profitable investment – pit latrines in rural areas have an economic return of at least 6 times the cost, and off-site treatment options in urban areas have an economic return of at least 3 times the cost. Net benefits from low-cost options are especially high, offering an affordable opportunity to poor households. Sanitation options that protect the environment are more costly to provide, but while environmental benefits are difficult to quantify in economic terms, the benefits are highly valued by households, tourists and businesses. Study results provide valuable information to allocate adequate resources for sanitation and hygiene improvement at central and local levels