Stéphane Verguet
Datos Biográficos
| ID | 1740318 |
|---|---|
| NOMBRE | Stéphane Verguet |
| NOMBRES | Stéphane |
| APELLIDO | Verguet |
| FIRMA | VERGUET S |
| AFILIACIONES | Harvard Global Health Institute |
| ORCID | 0000-0003-4128-0849 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 45 |
| TOTAL DE CITAS | 6 |
| TOTAL COMO AUTOR | 45 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2011 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 2 |
Optimizing health, financial risk protection, and equity in health benefits package design toward universal health coverage
Global Disparities in Premature Mortality
In this cross-sectional study, disparities in PPD were likely to reflect major inequality in access to health-enhancing technologies and living standards, as well as context-specific obstacles. Technological and medical advancements leading to universal health benefits need to be rapidly and fairly disseminated
Estimating immunization coverage at the district level
Ethiopia has made significant progress in the last two decades in improving the availability and coverage of essential maternal and child health services including childhood immunizations. As Ethiopia keeps momentum towards achieving national immunization goals, methods must be developed to analyze routinely collected health facility data and generate localized coverage estimates. This study leverages the District Health Information Software (DHI…
Extended cost-effectiveness analysis of interventions to improve uptake of diabetes services in South Africa
The rising prevalence of diabetes in South Africa (SA), coupled with significant levels of unmet need for diagnosis and treatment, results in high rates of diabetes-associated complications. Income status is a determinant of utilization of diagnosis and treatment services, with transport costs and loss of wages being key barriers to care. A conditional cash transfer (CCT) programme, targeted to compensate for such costs, may improve service utili…
Investing in school systems
Public policies often aim to improve welfare, economic injustice and reduce inequality, particularly in the social protection, labour, health and education sectors. While these policies frequently operate in silos, the education sphere can operate as a cross-sectoral link. Schools represent a unique locus, with globally hundreds of millions of children attending class every day. A high-profile policy example is school feeding, with over 400 milli…
Joint distribution of child mortality and wealth across 30 sub-Saharan African countries over 2000-2019
Background: While reductions in child mortality have been observed across sub-Saharan African countries in the last 30 years, narrowing the gaps in under-five mortality across socioeconomic groups also requires an understanding of the multiple associations between health and welfare and socioeconomic drivers. We examined the probability density distributions in under-five mortality within countries and joint pathways of under-five mortality and w…
Estimated travel time and staffing constraints to accessing the Ethiopian health care system
Background: Despite large investments in the public health care system, disparities in health outcomes persist between lower- and upper-income individuals, as well as rural vs urban dwellers in Ethiopia. Evidence from Ethiopia and other low- and middle-income countries suggests that challenges in health care access may contribute to poverty in these settings. Methods: We employed a two-step floating catchment area to estimate variations in spatia…
Examining the computation of the underlying components of Dalys
Disability-adjusted life years (DALYs) capture the mortality and morbidity arising from a disease: they incorporate the years of life lost (YLLs) and the years of life lived with disability (YLD) due to a disease. The relative importance of YLLs and YLDs differs across diseases. The magnitudes of YLLs and YLDs depend on parameters such as the age of onset of disease, duration of disease, the case fatality ratio and disability weight. In this pape…
Air pollution exposure disparities across US population and income groups
Quantifying the global burden of mental disorders and their economic value
Background: Epidemiological and economic estimates suggest that the global burden of mental disorders is considerable, both in its impacts on human health and losses to societal welfare. The availability of additional data and the emergence of new approaches present an opportunity to examine these estimates, which form a critical part in making the investment case for global mental health. Methods: This study reviews, develops, and incorporates n…
Economic evaluations of health system strengthening activities in low-income and middle-income country settings
The number of included studies was small. Our findings suggest that most economic evaluations of HSS do not leverage methods like sensitivity analyses or inputs from literature review that would produce more generalisable (but potentially less precise) results. More research into how decision-makers would use economic evaluations to define the expansion path to strengthening health systems would allow for conceptualising impactful work on the eco…
Equity impact of minimum unit pricing of alcohol on household health and finances among rich and poor drinkers in South Africa
INTRODUCTION: South Africa experiences significant levels of alcohol-related harm. Recent research suggests minimum unit pricing (MUP) for alcohol would be an effective policy, but high levels of income inequality raise concerns about equity impacts. This paper quantifies the equity impact of MUP on household health and finances in rich and poor drinkers in South Africa. METHODS: We draw from extended cost-effectiveness analysis (ECEA) methods an…
How are health workers paid and does it matter? Conceptualising the potential implications of digitising health worker payments
Priority setting in early childhood development
BACKGROUND: Early childhood development (ECD) sets the foundation for healthy and successful lives with important ramifications for education, labour market outcomes and other domains of well-being. Even though a large number of interventions that promote ECD have been implemented and evaluated globally, there is currently no standardised framework that allows a comparison of the relative cost-effectiveness of these interventions. METHODS: We fir…
Conceptualizing monetary benchmarks for health investments toward poverty reduction in low- and lower middle-income countries
Public spending can improve population well-being, for example, by averting or reducing poverty. We aim to conceptualize monetary benchmarks for health sector investments oriented towards poverty alleviation in low- and lower middle-income countries. These benchmarks are meant to indicate the approximate range of health sector costs incurred to avert a single case of poverty across countries. Such conceptualizations could help identify the health…
Modeling the relative risk of incidence and mortality of select vaccine-preventable diseases by wealth group and geographic region in Ethiopia
Immunization is one of the most effective public health interventions, saving millions of lives every year. Ethiopia has seen gradual improvements in immunization coverage and access to child health care services; however, inequalities in child mortality across wealth quintiles and regions remain persistent. We model the relative distributional incidence and mortality of four vaccine-preventable diseases (VPDs) (rotavirus diarrhea, human papillom…
The potential distributional health and financial benefits of increased tobacco taxes in Ethiopia
Ethiopia raised taxes on tobacco products in early 2020, increasing the overall price of the typical pack of cigarettes by about 67%. We quantify the potential impacts of Ethiopia's tobacco tax hike on various outcomes-life years, tax revenues, cigarette expenditures and catastrophic health expenditures (CHE). Using parameters like price elasticity of demand for cigarettes and smoking prevalence in Ethiopia from the existing literature and second…
Comparative health systems analysis of differences in the catastrophic health expenditure associated with non-communicable vs communicable diseases among adults in six countries
The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications for health system performance in the area of financial risk protection, as measured by catastrophic health expenditure (CHE). We compare NCD CHE to the CHE cases caused by communicable diseases (CDs) across health systems to examine whether: (1) disease burden and CHE are linked, (2) NCD CHE disproportionately affects wealthier househo…
Using health management information system data
Health management information systems (HMIS) are a crucial source of timely health statistics and have the potential to improve reporting in low-income countries. However, concerns about data quality have hampered their widespread adoption in research and policy decisions. This article presents results from a data verification study undertaken to gain insights into the quality of HMIS data in Ethiopia. We also provide recommendations for working …
Health gains and financial protection from human papillomavirus vaccination in Ethiopia
High out-of-pocket (OOP) medical expenses for cervical cancer (CC) can lead to catastrophic health expenditures (CHEs) and medical impoverishment in many low-resource settings. There are 32 million women at risk for CC in Ethiopia, where CC screening is extremely limited. An evaluation of the population health and financial risk protection benefits, and their distributional consequences across socioeconomic groups, from human papillomavirus (HPV)…
The Lancet NCDI Poverty Commission
The Broader Economic Value of School Feeding Programs in Low- and Middle-Income Countries
Introduction: Globally, there are 370 million children receiving school meals every day. Coverage is least in low-income countries, where the need is greatest and where program costs are viewed as high in comparison with the benefits to public health alone. Here we explore the policy implications of including the returns of school feeding to other sectors in an economic analysis. Methods: We develop an economic evaluation methodology to estimate …
Spatial–temporal trends in forced migrant mortality, 2014–2018
INTRODUCTION: The identification of spatial-temporal clusters of forced migrant mortality is urgently needed to inform preventative policies and humanitarian response. As a first step towards understanding the geography of forced migrant mortality, this study investigates spatial-temporal patterns in death at a global scale. METHODS: from 2014 to 2018. Kulldorff's spatial-temporal and seasonal scans were used to detect spatial-temporal and tempor…
Protecting essential health services in low-income and middle-income countries and humanitarian settings while responding to the Covid-19 pandemic
In health outcomes terms, the poorest countries stand to lose the most from these disruptions. In this paper, we make the case for a rational approach to public sector health spending and decision making during and in the early recovery phase of the COVID-19 pandemic. Based on ethics and equity principles, it is crucial to ensure that patients not infected by COVID-19 continue to get access to healthcare and that the services they need continue t…
Is cycle network expansion cost-effective? A health economic evaluation of cycling in Oslo
The results support the use of CIM as part of a public health program to improve physical activity and consequently avert morbidity and mortality. CIM is affordable and has a long-term effect on physical activity that in turn has a positive impact on health improvement
Impact of supplemental immunisation activity (SIA) campaigns on health systems
BACKGROUND: Supplemental immunisation activity (SIA) campaigns provide children with an additional dose of measles vaccine and deliver other child health interventions including vitamin A supplements, deworming medications and oral polio vaccines. They also require the mobilisation of a large health workforce. We assess the impact of the implementation of SIA campaigns on selected routine child and maternal health services in South Africa (SA). M…
Cardiovascular disease and impoverishment averted due to a salt reduction policy in South Africa
The South African Government recently set targets to reduce cardiovascular disease (CVD) by lowering salt consumption. We conducted an extended cost-effectiveness analysis (ECEA) to model the potential health and economic impacts of this salt policy. We used surveys and epidemiologic studies to estimate reductions in CVD resulting from lower salt intake. We calculated the average out-of-pocket (OOP) cost of CVD care, using facility fee schedules …
Thresholds for decision-making
Cost-effectiveness thresholds (CETs) based on the Commission on Macroeconomics and Health (CMH) are extensively used in low- and middle-income countries (LMICs) lacking locally defined CETs. These thresholds were originally intended for global and regional prioritization, and do not reflect local context or affordability at the national level, so their value for informing resource allocation decisions has been questioned. Using these thresholds, …
Global Health and the Demands of the Day
We have two goals in this paper: first, to provide a diagnosis of global health and underline some of its blockages; second, to offer an alternative interpretation of what the demands for those in global health may be. The assumption that health is a "good" that requires no further explanation, and that per se it can serve as an actual modus operandi, lays the foundations of the problem. Related blockages ensue and are described using HIV prevent…
Mothers and Children
In this paper we examine pragmatic corollaries to the design and implementation of Millennium Development Goals (MDG) 4 and 5. The first corollary we analyze is how the timeframe imposed on the MDGs affects choices about how to implement health care interventions to meet those goals, which we look at specifically in terms of the trade-off between strengthening a health care system or increasing mass campaigns. The second corollary is that, in the…
Supplementary immunization activities (SIAs) in South Africa
BACKGROUND: Supplementary immunization activity (SIA) campaigns provide children with an additional dose of measles vaccine and deliver other interventions, including vitamin A supplements, deworming medications, and oral polio vaccines. OBJECTIVE: To assess the cost-effectiveness of the full SIA delivery platform in South Africa (SA). DESIGN: We used an epidemiologic cost model to estimate the cost-effectiveness of the 2010 SIA campaign. We used…
Impact of supplemental immunisation activity (SIA) campaigns on health systems
BACKGROUND: Supplemental immunisation activity (SIA) campaigns provide children with an additional dose of measles vaccine and deliver other child health interventions including vitamin A supplements, deworming medications and oral polio vaccines. They also require the mobilisation of a large health workforce. We assess the impact of the implementation of SIA campaigns on selected routine child and maternal health services in South Africa (SA). M…
Estimates of performance in the rate of decline of under-five mortality for 113 low- and middle-income countries, 1970–2010
UNLABELLED: BACKGROUND; Measuring country performance in health has focused on assessing predicted vs observed levels of outcomes, an indicator that varies slowly over time. An alternative is to measure performance in terms of the rate of change in how a selected outcome compares to what would be expected given contextual determinants. Rates of change in health indicators can prove more sensitive than levels to changes in social, intersectoral or…
Global Surgery 2030
Are long-lasting insecticide-treated bednets and water filters cost-effective tools for delaying HIV disease progression in Kenya
BACKGROUND: Co-infection with malaria and other infectious diseases has been shown to increase viral load and accelerate HIV disease progression. A recent study in Kenya demonstrated that providing long-lasting insecticide-treated bednets (LLIN) and water filters (WF) to HIV-positive adults with CD4 >350 cells/mm(3) significantly reduced HIV progression. DESIGN: We conducted a cost analysis to estimate the potential net financial savings gained b…
Comparing the health and social protection effects of measles vaccination strategies in Ethiopia
Vaccination coverage rates often mask wide variation in access, uptake, and cost of providing vaccination. Financial incentives have been effective at creating demand for social services in a variety of settings. Using methods of extended cost-effectiveness analysis, we compare the health and economic implications of three different vaccine delivery strategies for measles vaccination in Ethiopia: i) routine immunization, ii) routine immunization …
Quality of basic maternal care functions in health facilities of five African countries
BACKGROUND: Global efforts to increase births at health-care facilities might not reduce maternal or newborn mortality if quality of care is insufficient. However, little systematic evidence exists for the quality at health facilities caring for women and newborn babies in low-income countries. We analysed the quality of basic maternal care functions and its association with volume of deliveries and surgical capacity in health-care facilities in …
Cardiovascular disease and impoverishment averted due to a salt reduction policy in South Africa
The South African Government recently set targets to reduce cardiovascular disease (CVD) by lowering salt consumption. We conducted an extended cost-effectiveness analysis (ECEA) to model the potential health and economic impacts of this salt policy. We used surveys and epidemiologic studies to estimate reductions in CVD resulting from lower salt intake. We calculated the average out-of-pocket (OOP) cost of CVD care, using facility fee schedules …
The health, financial and distributional consequences of increases in the tobacco excise tax among smokers in Lebanon
Tobacco use is a significant risk factor for the leading causes of death worldwide, including cancer, heart disease and stroke. Most of these deaths occur in low- and middle-income countries, where tobacco-related deaths are also rising rapidly. Taxation is one of the most effective tobacco control measures, yet evidence on the distributional impact of tobacco taxation in low- and middle-income countries remains scant. This paper considers the fi…
Distributional benefits of tobacco tax and smoke–free workplaces in China
BACKGROUND: Tobacco taxation and smoke-free workplaces reduce smoking, tobacco-related premature deaths and associated out-of-pocket health care expenditures. We examine the distributional consequences of a price increase in tobacco products through an excise tax hike, and of an implementation of smoke-free workplaces, in China. METHODS: We use extended cost-effectiveness analysis (ECEA) to evaluate, across income quintiles of the male population…
Dynamic modeling approaches to characterize the functioning of health systems
Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage
Geographic health inequalities in Norway
Using the absolute Gini index as a metric for monitoring changes in geographic inequality over time may be a valuable tool for informing public health policies. The absolute inequality in mortality and life expectancy between Norwegian counties has decreased from 1980 to 2014
Distributional health and financial benefits of increased tobacco taxes in Colombia
The tobacco tax increase passed by Colombia has substantial implications for the country's population health and financial well-being, with large benefits likely to accrue to the two poorest quintiles of the population
Thresholds for decision-making
Cost-effectiveness thresholds (CETs) based on the Commission on Macroeconomics and Health (CMH) are extensively used in low- and middle-income countries (LMICs) lacking locally defined CETs. These thresholds were originally intended for global and regional prioritization, and do not reflect local context or affordability at the national level, so their value for informing resource allocation decisions has been questioned. Using these thresholds, …
A cost-effectiveness analysis of maternal and neonatal health interventions in Ethiopia
Ethiopia is one of the sub-Saharan African countries contributing to the highest number of maternal and neonatal deaths. Coverage of maternal and neonatal health (MNH) interventions has remained very low in Ethiopia. We examined the cost-effectiveness of selected MNH interventions in an Ethiopian setting. We analysed 13 case management and preventive MNH interventions. For all interventions, we used an ingredients-based approach for cost estimati…
The Lancet NCDI Poverty Commission
The Broader Economic Value of School Feeding Programs in Low- and Middle-Income Countries
Introduction: Globally, there are 370 million children receiving school meals every day. Coverage is least in low-income countries, where the need is greatest and where program costs are viewed as high in comparison with the benefits to public health alone. Here we explore the policy implications of including the returns of school feeding to other sectors in an economic analysis. Methods: We develop an economic evaluation methodology to estimate …
Spatial–temporal trends in forced migrant mortality, 2014–2018
INTRODUCTION: The identification of spatial-temporal clusters of forced migrant mortality is urgently needed to inform preventative policies and humanitarian response. As a first step towards understanding the geography of forced migrant mortality, this study investigates spatial-temporal patterns in death at a global scale. METHODS: from 2014 to 2018. Kulldorff's spatial-temporal and seasonal scans were used to detect spatial-temporal and tempor…
Protecting essential health services in low-income and middle-income countries and humanitarian settings while responding to the Covid-19 pandemic
In health outcomes terms, the poorest countries stand to lose the most from these disruptions. In this paper, we make the case for a rational approach to public sector health spending and decision making during and in the early recovery phase of the COVID-19 pandemic. Based on ethics and equity principles, it is crucial to ensure that patients not infected by COVID-19 continue to get access to healthcare and that the services they need continue t…
Is cycle network expansion cost-effective? A health economic evaluation of cycling in Oslo
The results support the use of CIM as part of a public health program to improve physical activity and consequently avert morbidity and mortality. CIM is affordable and has a long-term effect on physical activity that in turn has a positive impact on health improvement
Questioning the regressivity of tobacco taxes
Our findings question the doctrine that tobacco taxes are uniformly regressive from a standard income-share accounting view and point to the importance of the specific features of tax policy to shape a progressive approach to tobacco taxation: tobacco tax increases are less likely to be regressive when accompanied by a broad framework of demand-side measures that enhance the capacity of low-income smokers to quit tobacco use
The burden of household out-of-pocket health expenditures in Ethiopia
In Ethiopia, little is known about the extent of out-of-pocket health expenditures and the associated financial hardships at national and regional levels. We estimated the incidence of both catastrophic and impoverishing health expenditures using data from the 2015/16 Ethiopian household consumption and expenditure and welfare monitoring surveys. We computed incidence of catastrophic health expenditures (CHE) at 10% and 25% thresholds of total ho…
Medicine (37 obras) · Environmental health (28 obras) · Economics (26 obras) · Population (23 obras) · Economic growth (20 obras) · Global Maternal and Child Health (18 obras) · Public health (16 obras) · Business (15 obras) · Global Health Care Issues (12 obras) · Nursing (12 obras)