Ole F Norheim
Biographic Data
| ID | 1725406 |
|---|---|
| NAME | Ole F Norheim |
| GIVEN NAMES | Ole F |
| FAMILY NAME | Norheim |
| SIGNATURE | NORHEIM O F |
| AFFILIATIONS | University of Bergen |
| ORCID | 0000-0002-5748-5956 |
| VERIFIED | Yes |
| TOTAL WORKS | 76 |
| TOTAL CITATIONS | 35 |
| AUTHOR COUNT | 74 |
| EDITOR COUNT | 2 |
| FIRST PUBLICATION YEAR | 2002 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 3 |
Out-of-pocket expenditure and financial risks associated with treatment of chronic kidney disease in Ethiopia
INTRODUCTION: In Ethiopia, most healthcare expenditures are paid out-of-pocket (OOP), while the burden of kidney disease (KD) is rapidly increasing, posing a major public health challenge in low- and middle-income countries, along with a staggering economic burden. We aimed to quantify the extent of OOP health expenditures and the magnitude of associated catastrophic and impoverishing health expenditures (CHE and IHE) for chronic KD (CKD) care in…
Benefit–cost analysis of an integrated package of interventions during preconception, pregnancy and early childhood in India
BACKGROUND: We have previously shown that an integrated intervention package delivered during preconception, pregnancy and early childhood substantially reduces low birth weight and stunting at 24 months of age compared with routine care. Now we conduct a benefit-cost analysis to estimate the return on investment of this integrated approach in India. This increases the policy relevance of trial results, given the low investment in healthcare in I…
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
Priority setting for environmentally sustainable health care
Priority setting in health care is a research and practice area at the intersection of medicine, ethics, and economics, which aims to systematically and transparently evaluate the value for money of health services to support fair resource allocation. Three widely accepted principles for fair priority setting are cost-effectiveness, priority to the worse off, and financial risk protection, with a wide range of other contested criteria. Conceptual…
Negotiating clinical practice guidelines
In all societies, demand for healthcare exceeds available resources. When resources for healthcare are limited, clinicians inevitably engage in distributive decisions that affect the care of individual patients: so-called bedside rationing. Clinical practice guidelines intend to steer bedside rationing through transparent eligibility criteria. Still, the distributive challenge is exacerbated by increasingly available high-cost treatments for rare…
Comparing the cost-effectiveness of the MPT64-antigen detection test to Xpert MTB/RIF and ZN-microscopy for the diagnosis of Extrapulmonary Tuberculosis
Extrapulmonary Tuberculosis (EPTB) poses challenges from patient and health system perspectives. The cost-effectiveness analysis of the Xpert MTB/RIF (Xpert) test to diagnose pulmonary tuberculosis is documented. However, there are no economic evaluations for EPTB. Considering the reported better diagnostic sensitivity of the MPT64 test, this study explored its cost-effectiveness as an alternative diagnostic test. We conducted this economic evalu…
Equity considerations for the implementation of health insurance benefit package in Ethiopia
The Delphi method can be useful in generating equity scores for prioritizing health interventions where disaggregated data on the distribution of diseases or access to interventions by subpopulation groups are not available
Country readiness and prerequisites for successful design and transition to implementation of essential packages of health services
This paper reviews the experience of six low-income and lower middle-income countries in setting their own essential packages of health services (EPHS), with the purpose of identifying the key requirements for the successful design and transition to implementation of the packages in the context of accelerating progress towards universal health coverage (UHC). The analysis is based on input from three meetings of a knowledge network established by…
Incidence and determinants of out-of-pocket health expenditure in Ethiopia 2012–16
This study assesses the incidence of catastrophic health expenditure (CHE) and identifies the significant factors that expose households to higher levels of out-of-pocket (OOP) health expenditure. Data from the fifth and the sixth Ethiopian National Health Accounts household surveys, which were conducted in 2012–13 and 2015–16, respectively, are used. The incidence of CHE is estimated using both the capacity-to-pay and the budget share approaches…
Criteria for the procedural fairness of health financing decisions
Due to constraints on institutional capacity and financial resources, the road to universal health coverage (UHC) involves difficult policy choices. To assist with these choices, scholars and policy makers have done extensive work on criteria to assess the substantive fairness of health financing policies: their impact on the distribution of rights, duties, benefits and burdens on the path towards UHC. However, less attention has been paid to the…
New strides towards fair processes for financing universal health coverage
Fair processes in health financing decisions should not be undervalued or perceived as secondary to the goals of universal health coverage. By integrating fair-process principles and criteria into health financing decisions, countries can achieve more equitable outcomes, strengthen the legitimacy of the decision-making process, build trust in public institutions and promote long-term sustainability of reforms.\n\nProcedural fairness requires a co…
Short- and long-term food insecurity and policy responses in pandemics
We leverage unique panel household phone survey data collected by the World Food Programme (WFP) several months before and 3 years into the COVID-19 pandemic in nine low-and middle-income countries to examine whether the COVID-19 period was associated with increases in food insecurity. We also combine this data with data from the Oxford COVID-19 response tracker to examine how lockdown policies and economic support policies to households have aff…
Effect of kangaroo mother care initiated in community settings on financial risk protection of low-income households
INTRODUCTION: Many families in low-income and middle-income countries have high out-of-pocket expenditures (OOPE) for healthcare, and some face impoverishment. We aimed to assess the effect of Kangaroo Mother Care initiated in community setting (ciKMC) on financial risk protection estimated by healthcare OOPE, catastrophic healthcare expenditure (CHE) and impoverishment due to healthcare seeking for low birthweight infants, using a randomised con…
Prioritarianism in Practice
Prioritarianism is an ethical theory that gives extra weight to the well-being of the worse off. In contrast, dominant policy-evaluation methodologies, such as benefit-cost analysis, cost-effectiveness analysis, and utilitarianism, ignore or downplay issues of fair distribution. Based on a research group founded by the editors, this important book is the first to show how prioritarianism can be used to assess governmental policies and evaluate so…
Difficult trade-offs in response to Covid-19
We argue that deliberative decision making that is inclusive, transparent and accountable can contribute to more trustworthy and legitimate decisions on difficult ethical questions and political trade-offs during the pandemic and beyond.
Reducing regional health inequality
Our model results illustrate a trade-off between maximizing health and reducing health inequalities, two common policy-aims in low-income settings
Health equity impact of community-initiated kangaroo mother care
ClinicalTrials.gov, NCT02653534 . Registered January 12, 2016-Retrospectively registered
Equity in public health spending in Ethiopia
Inequality in access and utilization of health services because of socioeconomic status is unfair, and it should be monitored and corrected with appropriate remedial action. Therefore, this study aimed to estimate the distribution of benefits from public spending on health care across socioeconomic groups in Ethiopia using a benefit incidence analysis. We employed health service utilization data from the Living Standard Measurement Survey, recurr…
On the Ethics of Vaccine Nationalism
COVID-19 vaccines are likely to be scarce for years to come. Many countries, from India to the U.K., have demonstrated vaccine nationalism. What are the ethical limits to this vaccine nationalism? Neither extreme nationalism nor extreme cosmopolitanism is ethically justifiable. Instead, we propose the fair priority for residents (FPR) framework, in which governments can retain COVID-19 vaccine doses for their residents only to the extent that the…
Providing universal access to modern contraceptive methods
Despite recent advances in access to and use of modern contraception in Ethiopia, further improvement is needed, particularly among poorer women. This extended cost-effectiveness analysis investigated the health outcomes, their distribution, and financial risk protection associated with meeting the demand for modern contraception for all Ethiopian women. We developed five Markov models with wealth quintile-specific input data to investigate the e…
An ethical framework for global vaccine allocation
The Fair Priority Model offers a practical way to fulfill pledges to distribute vaccines fairly and equitably
The Lancet NCDI Poverty Commission
Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019
BACKGROUND: Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system le…
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
Fairness and accountability for reasonableness. Do the views of priority setting decision makers differ across health systems and levels of decision making
On the Ethics of Vaccine Nationalism
COVID-19 vaccines are likely to be scarce for years to come. Many countries, from India to the U.K., have demonstrated vaccine nationalism. What are the ethical limits to this vaccine nationalism? Neither extreme nationalism nor extreme cosmopolitanism is ethically justifiable. Instead, we propose the fair priority for residents (FPR) framework, in which governments can retain COVID-19 vaccine doses for their residents only to the extent that the…
Quantifying quality of life for economic analysis
The "Time trade-off" (TTO), is the most widely used method to "quality adjust" life years for "QALYs" in cost utility analysis. In this paper we ask if it is theoretically likely that the TTO is valid for this use. The TTO consists in a trade off between longevity and quality of life. Firstly, we argue that it is impossible to control for all factors that may influence one's willingness to sacrifice lifetime. Secondly, that longevity and quality …
New approaches to ranking countries for the allocation of development assistance for health
The distributions of income and health within and across countries are changing. This challenges the way donors allocate development assistance for health (DAH) and particularly the role of gross national income per capita (GNIpc) in classifying countries to determine whether countries are eligible to receive assistance and how much they receive. Informed by a literature review and stakeholder consultations and interviews, we developed a stepwise…
Short- and long-term food insecurity and policy responses in pandemics
We leverage unique panel household phone survey data collected by the World Food Programme (WFP) several months before and 3 years into the COVID-19 pandemic in nine low-and middle-income countries to examine whether the COVID-19 period was associated with increases in food insecurity. We also combine this data with data from the Oxford COVID-19 response tracker to examine how lockdown policies and economic support policies to households have aff…
Allocating external financing for health
Most donors of external financing for health use allocation policies to determine which countries are eligible to receive financial support and how much support each should receive. Currently, most of these policies place a great deal of weight on income per capita as a determinant of aid allocation but there is increasing interest in putting more weight on other country characteristics in the design of such policies. It is unclear, however, how …
Equity impact analysis of medical approaches to cardiovascular diseases prevention in Tanzania
Primary medical prevention of cardiovascular disease (CVD) has received low priority in Tanzania, despite evidence of the rising prevalence of CVD risk factors. Different guidelines have been proposed for medical CVD prevention, including the European Society of Cardiology (ESC) and the World Health Organization (WHO) guidelines, which recommend medical prevention for all individuals based on the consideration of single CVD risk thresholds. A thi…
A universal preference for equality in health? Reasons to reconsider properties of applied social welfare functions
Using burden of disease information for health planning in developing countries
When you can't have the cake and eat it too
Incorporating concerns for equal lifetime health in evaluations of public health programs
Disability compensation and responsibility
It is a central political goal to secure disabled individuals the same opportunities as others to pursue their conception of a good life. This goal reflects an ambition to combine an egalitarian and a liberal moral intuition. In this article, we analyse how disabled individuals who take part in economic activity should be compensated in order to respect these two intuitions. The article asks how a system of disability compensation should be struc…
Whose priorities count? Comparison of community‐identified health problems and Burden‐of‐Disease‐assessed health priorities in a district in Uganda
Objectives The aim of the study was to compare health problems as defined quantitatively by the Burden of Disease study to those defined by the community. The secondary aim was to explore the potential for using qualitative participatory methodologies as tools for planing and priority setting. Design Interviews and group discussions with a purposely sampled set of community members ( n =51) and community leaders ( n =6). The Nominal group techniq…
Quantifying quality of life for economic analysis
The "Time trade-off" (TTO), is the most widely used method to "quality adjust" life years for "QALYs" in cost utility analysis. In this paper we ask if it is theoretically likely that the TTO is valid for this use. The TTO consists in a trade off between longevity and quality of life. Firstly, we argue that it is impossible to control for all factors that may influence one's willingness to sacrifice lifetime. Secondly, that longevity and quality …
Using burden of disease information for health planning in developing countries
My Job Is to Keep Him Alive, but What About His Brother and Sister? How Indian Doctors Experience Ethical Dilemmas in Neonatal Medicine
BACKGROUND: Studies from Western countries show that doctors working in neonatal intensive care units (NICUs) find withdrawal of treatment to be their most difficult ethical dilemma. There is less knowledge of how this is experienced in other economic, cultural, religious and educational contexts. OBJECTIVES: To explore and describe how Indian doctors experience ethical dilemmas concerning the withdrawal of treatment among critically sick and/or …
The ideal of equal health revisited
The past decade witnessed great progress in research on health inequities. The most widely cited definition of health inequity is, arguably, the one proposed by Whitehead and Dahlgren: "Health inequalities that are avoidable, unnecessary, and unfair are unjust." We argue that this definition is useful but in need of further clarification because it is not linked to broader theories of justice. We propose an alternative, pluralist notion of fair d…
Fairness and accountability for reasonableness. Do the views of priority setting decision makers differ across health systems and levels of decision making
Disability compensation and responsibility
It is a central political goal to secure disabled individuals the same opportunities as others to pursue their conception of a good life. This goal reflects an ambition to combine an egalitarian and a liberal moral intuition. In this article, we analyse how disabled individuals who take part in economic activity should be compensated in order to respect these two intuitions. The article asks how a system of disability compensation should be struc…
Equity implications of coverage and use of insecticide treated nets distributed for free or with co-payment in two districts in Tanzania
The results shed some light on the possibilities of reducing inequality in ownership and use of ITNs and attaining Roll Back Malaria and Millennium Development Goals through the provision of free ITNs to all. This has the potential to decrease the burden of disease and reduce disparity in disease outcome
Incorporating concerns for equal lifetime health in evaluations of public health programs
Challenges to fair decision-making processes in the context of health care services
Existing challenges related to individuals' influence of decision making processes in health care need to be addressed if greater participation is desired. There is a need for increased advocacy and a strengthening of responsive practices with an emphasis on the right of all individuals to participate in decision-making processes. This simultaneously implies an emphasis on assuring the distribution of information, training and education so that i…
Addressing inequity to achieve the maternal and child health millennium development goals
Scaling up priority maternal and child health interventions to equal levels would potentially save far more lives in the poorest populations, and would accelerate equitable progress towards maternal and child health MDGs
When you can't have the cake and eat it too
A universal preference for equality in health? Reasons to reconsider properties of applied social welfare functions
Inequalities in Health
"Of every thousand children born in Iceland, two will die before their first birthday, but in Mozambique the death rate is sixty times higher. Even within countries - including some of the wealthiest - inequalities in longevity and health can be substantial. In recent years, epidemiologists have documented the extent of these inequalities both between and within countries, stimulating in turn research both on their sources and on possible means f…
Health inequalities in Ethiopia
Longevity has increased and the distribution of health in Ethiopia is more equal in 2011 than 2000, with length of life inequality reduced for all population groups. Still there is considerable potential for further improvement. In the Ethiopian context with a poor and highly rural population, inequality in length of life within wealth quintiles is considerably larger than between them. This suggests that other factors than wealth substantially c…
Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990–2013
Global, regional, and national levels and causes of maternal mortality during 1990–2013
Disease Control Priorities for Neglected Tropical Diseases
BACKGROUND: In the context of limited health care budgets in countries where Neglected Tropical Diseases (NTDs) are endemic, scaling up disease control interventions entails the setting of priorities. However, solutions based solely on cost-effectiveness analyses may lead to biased and insufficiently justified priorities. OBJECTIVES: The objectives of this paper are to 1) demonstrate how a range of equity concerns can be used to identify feasible…
A three-stage approach to measuring health inequalities and inequities
The measurement of health inequities is an excitingly multidisciplinary endeavour. Its development requires interdisciplinary integration of advances from relevant disciplines. The proposed three-stage approach is one such effort and stimulates cross-disciplinary dialogues, specifically, about conceptual and empirical significance of definitions of health inequities
Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013
Global, regional, and national disability-adjusted life years (Dalys) for 306 diseases and injuries and healthy life expectancy (Hale) for 188 countries, 1990–2013
Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013
Towards universal health coverage for reproductive health services in Ethiopia
Reproductive health services are crucial for maternal and child health, but universal health coverage is still not within reach in most societies. Ethiopia's goal of universal health coverage promises access to all necessary services for everyone while providing protection against financial risk. When moving towards universal health coverage, health plans and policies require contextualized knowledge about baseline indicators and their distributi…
Unexplained health inequality – is it unfair
The choice of the fairness-standardization method is ethical and influences the empirical health inequity results considerably. More debate and analysis is necessary regarding which treatment of the unexplained inequality has the stronger foundation in equity considerations
Economic cost of primary prevention of cardiovascular diseases in Tanzania
Tanzania is facing a double burden of disease, with non-communicable diseases being an increasingly important contributor. Evidence-based preventive measures are important to limit the growing financial burden. This article aims to estimate the cost of providing medical primary prevention interventions for cardiovascular disease (CVD) among at-risk patients, reflecting actual resource use and if the World Health Organization (WHO)'s CVD medical p…
Medicine (61 works) · Environmental health (48 works) · Global Maternal and Child Health (43 works) · Economics (40 works) · Population (33 works) · Political science (30 works) · Economic growth (28 works) · Demography (24 works) · Health care (21 works) · Healthcare Systems and Reforms (21 works)