Cost-effectiveness of eye care services in Zambia
- PDF / 284,698 Bytes
- 9 Pages / 595.28 x 793.7 pts Page_size
- 93 Downloads / 199 Views
RESEARCH
Open Access
Cost-effectiveness of eye care services in Zambia Ulla K Griffiths1*, Fiammetta M Bozzani1, Adrian Gheorghe1, Lawrence Mwenge2 and Clare Gilbert3
Abstract Objective: To estimate the cost-effectiveness of cataract surgery and refractive error/presbyopia correction in Zambia. Methods: Primary data on costs and health related quality of life were collected in a prospective cohort study of 170 cataract and 113 refractive error/presbyopia patients recruited from three health facilities. Six months later, follow-up data were available from 77 and 41 patients who had received cataract surgery and spectacles, respectively. Costs were determined from patient interviews and micro-costing at the three health facilities. Utility values were gathered by administering the EQ-5D quality of life instrument immediately before and six months after cataract surgery or acquiring spectacles. A probabilistic state-transition model was used to generate cost-effectiveness estimates with uncertainty ranges. Results: Utility values significantly improved across the patient sample after cataract surgery and acquiring spectacles. Incremental costs per Quality Adjusted Life Years gained were US$ 259 for cataract surgery and US$ 375 for refractive error correction. The probabilities of the incremental cost-effectiveness ratios being below the Zambian gross national income per capita were 95% for both cataract surgery and refractive error correction. Conclusion: In spite of proven cost-effectiveness, severe health system constraints are likely to hamper scaling up of the interventions. Keywords: Costs, Cataract, Refractive error, Presbyopia, Quality of life
Introduction It is estimated that 39 million people were blind and 239 million visually impaired in 2010, with cataract and uncorrected refractive error (RE) being the leading causes [1]. This is also the case in southern Zambia, where a rapid assessment of avoidable blindness survey identified cataract (47%) and uncorrected RE (20%) as the principal causes of blindness [2]. However, a situation analysis of Zambian eye care services in 2011 concluded that there were major shortcomings, with lack of skilled human resources, inadequate spectacles manufacturing workshops and inequity in service provision between urban and rural areas [3]. The “Livingstone to Lusaka Urban Comprehensive Eye Care project” was implemented by Sightsavers between 2009–2014, with support from Standard Chartered Bank’s “Seeing is Believing” programme [4]. The aim of the project was to reduce blindness and ocular morbidity among * Correspondence: [email protected] 1 Department of Global Health and Development, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK Full list of author information is available at the end of the article
approximately two million people living between Livingstone, in Southern Zambia, and the capital Lusaka. The objective of the present study was to estimate the costeffectiveness of cataract surgery and RE/presbyopia correct
Data Loading...
