Supporting the revision of the health benefits package in Uganda: A constrained optimisation approach

This study demonstrates how the linear constrained optimization approach can be used to design a health benefits package (HBP) which maximises the net disability adjusted life years (DALYs) averted given the health system constraints faced by a country, and how the approach can help assess the marginal value of relaxing health system constraints. In the analysis performed for Uganda, 45 interventions were included in the HBP in the base scenario, resulting in a total of 26.7 million net DALYs averted. When task shifting of pharmacists' and nutrition officers' tasks to nurses is allowed, 73 interventions were included in the HBP resulting in a total of 32 million net DALYs averted (a 20% increase). Further, investing only $58 towards hiring additional nutrition officers' time could avert one net DALY; this increased to $60 and $64 for pharmacists and nurses respectively, and $100,000 for expanding the consumable budget, since human resources present the main constraint to the system.

Automated summary

This study demonstrates the use of linear constrained optimization approach in designing a health benefits package (HBP) to maximize net disability adjusted life years (DALYs) averted given the constraints of the health system. It also shows how the approach can assess the marginal value of relaxing these constraints. The analysis for Uganda included 45 interventions in the HBP, resulting in 26.7 million net DALYs averted in the base scenario.