ReviewGlobal health research and policy2018
Cost-effectiveness of health care service delivery interventions in low and middle income countries: a systematic review.
Review in Global health research and policy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- Systematic review of methodological approaches in economic evaluations of maternal and neonatal sepsis interventions in low- and middle-income countries.BMC health services research · 2025Pooled it
- Real-World Accuracy of Wearable Activity Trackers for Detecting Medical Conditions: Systematic Review and Meta-Analysis.JMIR mHealth and uHealth · 2024Pooled it
- A household-based community health worker programme for non-communicable disease, malnutrition, tuberculosis, HIV and maternal health: a stepped-wedge cluster randomised controlled trial in Neno District, Malawi.BMJ global health · 2021Trial
- Enhancing perinatal care in Rwanda: building quality improvement into system strengthening.BMJ paediatrics open · 2026Review
- Chiropractic's role in strengthening rehabilitation in health systems.Chiropractic & manual therapies · 2026Article
- Training Community Health Workers for Diabetes Management in Low- and Middle-Income Countries: Systematic Review.JMIR diabetes · 2026Review
- Cost analysis of probiotic/synbiotic supplementation in infants in rural Kenya: a study from the PROSYNK trial.BMJ paediatrics open · 2025Article
- Dissolvable Microneedles with Their Design, Materials, and Limitations in Translation: a Technical Review.AAPS PharmSciTech · 2025Review
- How does community health feature in Global Financing Facility planning documents to support reproductive, maternal, newborn, child and adolescent health and nutrition (RMNAH-N)? insights from six francophone West African countries.Global health action · 2024Article
- Article
- Costing Interventions for Developing an Essential Package of Health Services: Application of a Rapid Method and Results From Pakistan.International journal of health policy and management · 2024Article
- Implementation and evaluation of a pilot WHO community first aid responder training in Kinshasa, DR Congo: A mixed method study.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2023Article
- Economic Evaluation of Health Interventions: A Critical Review.Iranian journal of public health · 2022Review
- Review
- Participation of Nursing Students in Evidence-Based Practice Projects: Results of Two Focus Groups.International journal of environmental research and public health · 2022Article
- Cost-effectiveness analysis of the multi-strategy WHO emergency care toolkit in regional referral hospitals in Uganda.PloS one · 2022Article
- A practical measure of health facility efficiency: an innovation in the application of routine health information to determine health worker productivity in Ethiopia.Human resources for health · 2021Article
- A review of prospective pathways and impacts of COVID-19 on the accessibility, safety, quality, and affordability of essential medicines and vaccines for universal health coverage in Africa.Globalization and health · 2021Review
- Economic evaluation of a novel community-based diabetes care model in rural Mexico: a cost and cost-effectiveness study.BMJ open · 2021Article
- A Systematic Review of Sources of Outcomes and Cost Data Utilized in Economic Evaluation Research Conducted in the Gulf Cooperation Council.Risk management and healthcare policy · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLow and middle income countries (LMICs) face severe resource limitations but the highest burden of disease. There is a growing evidence base on effective and cost-effective interventions for these diseases. However, questions remain about the most cost-effective method of delivery for these interventions. We aimed to review the scope, quality, and findings of economic evaluations of service delivery interventions in LMICs.
methodsWe searched PUBMED, MEDLINE, EconLit, and NHS EED for studies published between 1st January 2000 and 30th October 2016 with no language restrictions. We included all economic evaluations that reported incremental costs and benefits or summary measures of the two such as an incremental cost effectiveness ratio. Studies were grouped by both disease area and outcome measure and permutation plots were completed for similar interventions. Quality was judged by the Drummond checklist.
resultsOverall, 3818 potentially relevant abstracts were identified of which 101 studies were selected for full text review. Thirty-seven studies were included in the final review. Twenty-three studies reported on interventions we classed as "changing by whom and where care was provided", specifically interventions that entailed task-shifting from doctors to nurses or community health workers or from facilities into the community. Evidence suggests this type of intervention is likely to be cost-effective or cost-saving. Nine studies reported on quality improvement initiatives, which were generally found to be cost-effective. Quality and methods differed widely limiting comparability of the studies and findings.
conclusionsThere is significant heterogeneity in the literature, both methodologically and in quality. This renders further comparisons difficult and limits the utility of the available evidence to decision makers.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.