Cost-effectiveness Analyses of Complex Interventions in Low and Middle Income Countries

A systematic review 

Speaker: Edoardo Masset
Discussant: Mehmet Ugur
Date: 25 November, 2015 - 17:15 to 18:45
Venue: LIDC Upper Meeting Room

Most development interventions are complex, being composed of several interacting activities affecting multiple outcomes. The literature offer little guidance on how to assess cost-effectiveness of these interventions. We systematically review cost-effectiveness analyses of complex interventions conducted alongside impact evaluations in low and middle income countries since 2000. We find 7 cost-effectiveness analyses of complex interventions in areas as diverse as de-worming; school support; conditional cash transfers; early childhood development; and social funds. In order to account for multiple outcomes, the studies reviewed employ variants of the following methodologies: cost-consequences analysis; cost-apportionment; cost-utility analysis and cost-benefit analysis. None of these approaches can be effectively employed in all cases though each of these approaches can be applied in some special cases. None of the studies reviewed addresses the presence of synergistic effects of project activities. Cost-effectiveness analysis of complex interventions remains an unexplored area of research and economic evaluation practice.

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