Health Benefit Package Design in Malawi: Inclusivity and Implementation

This project aims to contribute evidence and insights regarding priority setting in Malawi, specifically focusing on implementing Essential Health Package (EHP) and Priority Setting for Surgery. In low-income countries, such as Malawi, there is a concerning lack of health economic evaluation research, particularly in surgery. This gap in knowledge hampers the ability to allocate resources effectively. Surgical conditions contribute significantly to the overall disease burden, making it crucial to evaluate the costs and cost-effectiveness of orthopaedic interventions.

This research aims to enhance healthcare decision-making processes and optimise health service delivery with limited resources by addressing the current gaps in research and understanding.

Project Objectives

1. Estimate the Costs of Providing Orthopaedic Surgery: to investigate the costs associated with orthopaedic surgery in Malawi. By assessing the direct and indirect costs involved, including surgical procedures, hospitalisation, and rehabilitation, the project seeks to identify the economic burden of orthopaedic conditions on tertiary hospitals.

2. Evaluating the Cost-Effectiveness of Orthopaedic Surgery: In addition to assessing costs, this research project aims to evaluate the cost-effectiveness of orthopaedic surgery interventions in Malawi. By employing rigorous health economic evaluation methods, such as cost-effectiveness analysis and extended cost-effectiveness analysis, the study will assess the value for money of orthopaedic interventions in terms of health outcomes achieved.

3. Optimising Health Service Delivery Considering Health System Constraints: Considering the limitations and constraints within the Malawian health system, this project also seeks to propose strategies for optimising the delivery of orthopaedic services. The research aims to provide evidence-based recommendations for resource allocation, service planning, and policy decision-making by integrating the findings from cost analysis and cost-effectiveness evaluations. These recommendations will be tailored to the specific context of Malawi, accounting for financial, human resource, and infrastructure limitations.

By undertaking this research project, we aim to generate new evidence that can inform priority settings in implementing the Essential Health Package (EHP) and contribute to improving orthopaedic surgery services in Malawi.

Photo:

David Watkins

Lilongwe Institute of Orthopaedics and Neurosurgery (LION)

BCEPS collaborates with the Lilongwe Institute of Orthopaedics and Neurosurgery (LION), a semi-autonomous hospital under Kamuzu Central Hospital in Lilongwe, Malawi, on research to address the information gap on the health economic evaluation of orthopaedic services in Malawi. Collaborative research efforts with institutions like LION are instrumental in generating data and insights to inform evidence-based practice, policy formulation, and resource allocation within the healthcare sector. Ultimately, this research holds the potential to inform the costs and effectiveness of orthopaedic services in Malawi, thereby contributing to the health sector’s goal of population health improvement.

Tertiary hospitals in Malawi play a pivotal role in providing high-level orthopaedic care. LION was officially operational from August 2023, guided by the mission to improve the treatment of injuries and neurosurgical disorders within the local community and to train qualified surgeons and healthcare personnel. The comprehensive range of services LION Hospital offers includes orthopaedics, neurosurgery, radiology, laboratory, and rehabilitation services.