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PhD defence

Prevention of cardiovascular disease in Tanzania is cost-effective

Today Frida Ngalesoni defended her highly impressive and important dissertation “Economics of non-communicable diseases prevention. Cost-effectiveness and equity impact of primary prevention of cardiovascular disease in Tanzania.” The research group warmly congratulate!

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In her PhD work, Frida Ngalesoni demonstrated that medical interventions to prevent cardiovascular disease in Tanzania are costly, but also cost-effective in a high-risk population, because they reduce the risk of stroke and myocardial infarction. Using differentiated risk thresholds based on patient age has proven to be the best strategy, also when it comes to reduce health inequity.

Fridas work is important and highly relevant, both globally and in a Tanzanian setting. In the last decades there has been a positiv development with reduced child mortality and many important efforts to reduce the impact of infectious diseases in low income settings. The following demographic shift towards a population with more elders is also changing the disease spectrum: The incidence of non-communicable diseases is rising in many midle- and low income countries. Cardiovascular disease and cancer rates are growing, and is no longer diseases of afluent high income countries. This makes fair allocation of resources important, and Frida's thesis is an important contribution. 

The thesis investigates the cost-effectiveness and fair distribution of primary prevention for cardiovascular disease. It started with a large data collection of costs related to medical prevention of hypertension, hypercholesterolamia, and diabetes. Costs related to population based anti-tobacco efforts were also collected. The field work was done in two Tanzanian regions: Arusha and Dar es Salaam. These costs were den compared with prevention effects to identify the most cost-effective interventions. Their distributional effect was also estimated, in order to identify interventions that had the largest effect on reducing health inequity.

(source: norwegian PhD press release)

Doctoral defence

Friday December 2, Frida held her trial lecture and public defence. Oponents were PhD Susan Griffin from the university of York, UK; Professor Marianne Klemp from the Norwegian Institute of Public Health; and leader of the commity was PhD Øystein Håland from the University of Bergen.

Main supervisor is professor Ole Frithjof Norheim, and co-supervisor is professor Bjarne Robberstad.

Articles included in dissertation

I) Ngalesoni F, Ruhago G, Norheim OF, Robberstad B. Economic cost of priomary prevention of cardiovascular disease in TanzaniaHealth Policy and Planning 2014; 30(7): 874-84

II) Ngalesoni FN, Ruhago GM, Mori AT, Robberstad B, Norheim OF. Cost-effectiveness of medical primary prevention strategies to reduce absolute risk of cardiovascular disease in Tanzania: a Markov modelling study. BMC health services research. 2016 May 17;16(1):1.

III) Ngalesoni FN, Ruhago GM, Mori AT, Robberstad B, Norheim OF. Equity impact analysis of medical approaches to cardiovascular disease prevention in TanzaniaSocial Science and Medicine 2016; 16(1): 1-29

IV) Ngalesoni FN, Ruhago GM, Oliveira TC, Robberstad B, Norheim OF, Higashi H. Cost-effectiveness analysis of population-based tobacco control strategies in the prevention of cardiovascular disease in Tanzania. [Submitted]