Efficiency in health ressource allocation : three empirical studies in Eastern Sub-Sahara Africa and Southeast Asia.

Summary The definition of health priorities in the context of universal health coverage emphasizes three values: improving the health of the population, ensuring equal access to and quality of services, and avoiding impoverishment or underutilization of services by users due to non-reimbursable expenditures. Allocative efficiency can be measured against any of these values, or against the whole, by different variants of cost-effectiveness analysis. In this thesis, we use Generalized Cost-Effectiveness Analysis, a standardized approach developed by the World Health Organization's Choosing Interventions that are Cost-Effective (WHO-CHOICE) program, which can be applied to all interventions in different settings. Using this approach, our dissertation provides a quantitative estimate of the allocative efficiency of resources for three groups of health problems: communicable diseases, non-communicable diseases, and traffic accidents, with a focus on two economically and epidemiologically different regions: East Sub-Saharan Africa and Southeast Asia. Our objectives are to inform health policy debates, to improve the global body of knowledge on the cost-effectiveness of different interventions by providing more information on the efficient allocation of resources for the three groups of health problems mentioned above, and to contribute to discussions on the development of universal health care programs.