The goal of the COUNTDOWN Health Economics project is to assess the efficiency, fairness, and value-for-money of NTD programmes. The generalisable factors that influence acceptance, effectiveness, and equity impact of scale-up from a health systems approach will be identified by the COUNTDOWN health economics research. This work will study the most effective strategies to work with community drug distributors (CDDs) and Community Health Workers (CHWs) to extend the scaling up of medicine distribution to include hard-to-reach communities and to build the resilience of vulnerable and marginalized groups.
The health economics component has four main objectives:
1) To analyse the economic burden of NTDs at the household level, carrying out household level surveys to look at the socio-economic determinants of NTD Community Prevalence, the relationship between poverty and NTDs, issues of accessibility and adherence to MDAs, and the relationship between NTDs, mental health, and disability.
2) To study the value-for-money of the investment in NTD interventions, carrying out costing surveys. The goal is to study the cost-effectiveness of the interventions proposed by the COUNTDOWN project.
3) To study the financial needs of the NTD programmes with a focus on the incentives and motivations of community drug distributors, teachers and other volunteers and non-volunteers engaged in the MDA programmes. This will help to develop a budgetary tool for MDA programme planning, taking into account budget availability and needs of the programmes.
4) To identify opportunities for planning, upscaling, and integrated implementation at the national, and district and community level. We will estimate the impact and cost-effectiveness of NTD control using modelling over a 10-year period.
To assess the efficiency, fairness, and value-for-money of NTD programmes, health equity analysis questions will consider:
Does poverty make individuals more vulnerable to NTDs
Are NTDs more likely to make individuals poor?
What other factors make individuals vulnerable to NTDs?
How do NTDs affect households?
Cost-Effectiveness Analysis and Health Economic Modelling will consider:
Are the proposed COUNTDOWN interventions cost-effective?
What are the scale-up options available if the goal is to achieve the 2020 London Declaration?