Skip to main content
Top
Published in: Cost Effectiveness and Resource Allocation 1/2006

Open Access 01-12-2006 | Research

Modeling the cost effectiveness of injury interventions in lower and middle income countries: opportunities and challenges

Authors: David M Bishai, Adnan A Hyder

Published in: Cost Effectiveness and Resource Allocation | Issue 1/2006

Login to get access

Abstract

Background

This paper estimates the cost-effectiveness of five interventions that could counter injuries in lower and middle income countries(LMICs): better traffic enforcement, erecting speed bumps, promoting helmets for bicycles, promoting helmets for motorcycles, and storing kerosene in child proof containers.

Methods

We adopt an ingredients based approach to form models of what each intervention would cost in 6 world regions over a 10 year period discounted at both 3% and 6% from both the governmental and societal perspectives. Costs are expressed in local currency converted into US $2001. Each of these interventions has been assessed for effectiveness in a LMIC in limited region, these effectiveness estimates have been used to form models of disability adjusted life years (DALYs) averted for various regions, taking account of regional differences in the baseline burden of injury.

Results

The interventions modeled in this paper have cost effectiveness ratios ranging from US $5 to $ 556 per DALY averted depending on region. Depending on local acceptability thresholds many of them could be judged cost-effective relative to interventions that are already adopted. Enhanced enforcement of traffic regulations is the most cost-effective interventions with an average cost per DALY of $64

Conclusion

Injury counter measures appear to be cost-effective based on models. More evaluations of real interventions will help to strengthen the evidence basis.
Literature
1.
go back to reference World Health Organization: Injury: A Leading Cause of the Global Burden of Disease. Geneva , WHO; 2002. World Health Organization: Injury: A Leading Cause of the Global Burden of Disease. Geneva , WHO; 2002.
3.
go back to reference Nantulya V, Reich M: Equity dimensions of road traffic injuries in low and middle income countries. Inj Control Saf Promot 2003, 10: 13–20. 10.1076/icsp.10.1.13.14116PubMedCrossRef Nantulya V, Reich M: Equity dimensions of road traffic injuries in low and middle income countries. Inj Control Saf Promot 2003, 10: 13–20. 10.1076/icsp.10.1.13.14116PubMedCrossRef
4.
go back to reference Hyder AA, Peden M: Inequality and road traffic injuries: call for action. Lancet 2003, 362: 2034–2035. 10.1016/S0140-6736(03)15145-8PubMedCrossRef Hyder AA, Peden M: Inequality and road traffic injuries: call for action. Lancet 2003, 362: 2034–2035. 10.1016/S0140-6736(03)15145-8PubMedCrossRef
5.
go back to reference Bishai D, Hyder AA, Ghaffar A, Morrow RH, Kobusingye O: Rates of public investment for road safety in developing countries: case studies of Uganda and Pakistan. Health Policy Plan 2003,18(2):232–235. 10.1093/heapol/czg028PubMedCrossRef Bishai D, Hyder AA, Ghaffar A, Morrow RH, Kobusingye O: Rates of public investment for road safety in developing countries: case studies of Uganda and Pakistan. Health Policy Plan 2003,18(2):232–235. 10.1093/heapol/czg028PubMedCrossRef
6.
go back to reference Waters H, Hyder AA, Phillips TL: Economic evaluation of interventions to reduce road traffic injuries - a review of literature with applications to low and middle income countries. Asia Pacific Journal of Public Health 2004,16(1):23–31.PubMedCrossRef Waters H, Hyder AA, Phillips TL: Economic evaluation of interventions to reduce road traffic injuries - a review of literature with applications to low and middle income countries. Asia Pacific Journal of Public Health 2004,16(1):23–31.PubMedCrossRef
7.
go back to reference Harris GT, Olukoga IA: A cost benefit analysis of an enhanced seat belt enforcement program in South Africa. Inj Prev 2005,11(2):102–105. 10.1136/ip.2004.007179PubMedCentralPubMedCrossRef Harris GT, Olukoga IA: A cost benefit analysis of an enhanced seat belt enforcement program in South Africa. Inj Prev 2005,11(2):102–105. 10.1136/ip.2004.007179PubMedCentralPubMedCrossRef
8.
go back to reference Disease Control Priorities Project: Guidelines for Authors. 2004. Disease Control Priorities Project: Guidelines for Authors. 2004.
9.
10.
go back to reference Kincaid DL, Do MP: Causal Attribution and Cost-Effectiveness of a National Communication Campaign in the Phillipines. Baltimore , Johns Hopkins University, Center for Communication Programs; 2003. Kincaid DL, Do MP: Causal Attribution and Cost-Effectiveness of a National Communication Campaign in the Phillipines. Baltimore , Johns Hopkins University, Center for Communication Programs; 2003.
12.
go back to reference International Road Federation: IRF World Road Statistics-1998 Edition. Washington, DC , International Road Federation; 1998. International Road Federation: IRF World Road Statistics-1998 Edition. Washington, DC , International Road Federation; 1998.
13.
go back to reference Poli de Figueiredo LF, Rasslan S, Bruscagin V, Cruz R, Rocha e Silva M: Increases in fines and driver licence withdrawal have effectively reduced immediate deaths from trauma on Brazilian roads: first-year report on the new traffic code. Injury 2001,32(2):91–94. 10.1016/S0020-1383(00)00172-8PubMedCrossRef Poli de Figueiredo LF, Rasslan S, Bruscagin V, Cruz R, Rocha e Silva M: Increases in fines and driver licence withdrawal have effectively reduced immediate deaths from trauma on Brazilian roads: first-year report on the new traffic code. Injury 2001,32(2):91–94. 10.1016/S0020-1383(00)00172-8PubMedCrossRef
14.
go back to reference Bishai D, Qureshi A, James P, Ghaffar A: National Road Fatalities and Economic Development. Health Economics 2005., In Press: Bishai D, Qureshi A, James P, Ghaffar A: National Road Fatalities and Economic Development. Health Economics 2005., In Press:
15.
go back to reference Hyder AA: Health Status, Quality of Life and General Well-Being Post-Injury: A Review of Existing Measures. 2000, 229. Hyder AA: Health Status, Quality of Life and General Well-Being Post-Injury: A Review of Existing Measures. 2000, 229.
16.
go back to reference TRL RS: Guidelines for Estimating the Cost of Road Crashed in Developing Countries. Crowthorne, Berkshire and London UK , Ross Silcock and TRL; 2003. TRL RS: Guidelines for Estimating the Cost of Road Crashed in Developing Countries. Crowthorne, Berkshire and London UK , Ross Silcock and TRL; 2003.
17.
go back to reference Weinstein A, Deakin E: How Local Jurisdictions Finance Traffic-Calming Projects. Transportation Quarterly 1999, 53: 75–78. Weinstein A, Deakin E: How Local Jurisdictions Finance Traffic-Calming Projects. Transportation Quarterly 1999, 53: 75–78.
19.
go back to reference Hendrie D, Miller TR, Orlando M, Spicer RS, Taft C, Consunji R, Zaloshnja E: Child and family safety device affordability by country income level: an 18 country comparison. Inj Prev 2004,10(6):338–343. 10.1136/ip.2004.005652PubMedCentralPubMedCrossRef Hendrie D, Miller TR, Orlando M, Spicer RS, Taft C, Consunji R, Zaloshnja E: Child and family safety device affordability by country income level: an 18 country comparison. Inj Prev 2004,10(6):338–343. 10.1136/ip.2004.005652PubMedCentralPubMedCrossRef
20.
go back to reference Thompson RS, Rivara FP, Thompson DC: A case-control study of the effectiveness of bicycle safety helmets. N Engl J Med 1989,320(21):1361–1367.PubMedCrossRef Thompson RS, Rivara FP, Thompson DC: A case-control study of the effectiveness of bicycle safety helmets. N Engl J Med 1989,320(21):1361–1367.PubMedCrossRef
21.
go back to reference Mathers CD, Vos T, Lopez AD, Salomon J, Ezzati M: National Burden of Disease Studies: A Practical Guide. 2.0th edition. Edited by: Policy. GPEH. Geneva , World Health Organization; 2001. Mathers CD, Vos T, Lopez AD, Salomon J, Ezzati M: National Burden of Disease Studies: A Practical Guide. 2.0th edition. Edited by: Policy. GPEH. Geneva , World Health Organization; 2001.
22.
go back to reference Zhang J: Motorcycle helmet use and barriers to motorcycle helmet use in China (PhD Thesis). In The George Institute. Sydney, Australia ; 2004. Zhang J: Motorcycle helmet use and barriers to motorcycle helmet use in China (PhD Thesis). In The George Institute. Sydney, Australia ; 2004.
23.
go back to reference Ichikawa M, Chadbunchachai W, Marui E: Effect of the helmet act for motorcyclists in Thailand. Accid Anal Prev 2003,35(2):183–189. 10.1016/S0001-4575(01)00102-6PubMedCrossRef Ichikawa M, Chadbunchachai W, Marui E: Effect of the helmet act for motorcyclists in Thailand. Accid Anal Prev 2003,35(2):183–189. 10.1016/S0001-4575(01)00102-6PubMedCrossRef
24.
go back to reference Jamil H: Acute poisoning- a review of 1900 cases. Journal of Pakistan Medical Association 1990, 40: 31. Jamil H: Acute poisoning- a review of 1900 cases. Journal of Pakistan Medical Association 1990, 40: 31.
25.
go back to reference Krug A, Ellis JB, Hay IT, Mokgabudi NF, Robertson J: The impact of child-resistant containers on the incidence of paraffin (kerosene) ingestion in children. S Afr Med J 1994,84(11):730–734.PubMed Krug A, Ellis JB, Hay IT, Mokgabudi NF, Robertson J: The impact of child-resistant containers on the incidence of paraffin (kerosene) ingestion in children. S Afr Med J 1994,84(11):730–734.PubMed
26.
go back to reference WHO Ad Hoc Committee on Health Research: Investing in Health Research and Development. Geneva , WHO; 1996. WHO Ad Hoc Committee on Health Research: Investing in Health Research and Development. Geneva , WHO; 1996.
27.
go back to reference World Health Organization: World Report on Knowledge for Better Health. Geneva , WHO; 2004. World Health Organization: World Report on Knowledge for Better Health. Geneva , WHO; 2004.
Metadata
Title
Modeling the cost effectiveness of injury interventions in lower and middle income countries: opportunities and challenges
Authors
David M Bishai
Adnan A Hyder
Publication date
01-12-2006
Publisher
BioMed Central
Published in
Cost Effectiveness and Resource Allocation / Issue 1/2006
Electronic ISSN: 1478-7547
DOI
https://doi.org/10.1186/1478-7547-4-2

Other articles of this Issue 1/2006

Cost Effectiveness and Resource Allocation 1/2006 Go to the issue