Fiammetta Bozzani
Biographic Data
| ID | 6330961 |
|---|---|
| NAME | Fiammetta Bozzani |
| GIVEN NAMES | Fiammetta |
| FAMILY NAME | Bozzani |
| SIGNATURE | BOZZANI F |
| AFFILIATIONS | London School of Hygiene & Tropical Medicine |
| ORCID | 0000-0002-9518-6885 |
| VERIFIED | Yes |
| TOTAL WORKS | 14 |
| TOTAL CITATIONS | 0 |
| WORKS AS AUTHOR | 14 |
| WORKS AS EDITOR | 0 |
| FIRST PUBLICATION YEAR | 2014 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 0 |
Level and determinants of district primary healthcare system technical efficiency in Ghana
BACKGROUND: Primary healthcare (PHC) is critical towards achieving Universal Health Coverage (UHC). In Ghana, PHC is organised at the district level and plays a key role in the country's pursuit of UHC. However, many districts face challenges not only with limited resources but also with how effectively they are used. We examined how efficiently districts in Ghana use their health resources and what factors are associated with this efficiency. ME…
Crises and complexity
The end of the COVID-19 global health emergency presents an opportunity to reflect on actions needed to enhance the effectiveness of responses to any future shocks. We highlight critical areas requiring attention from researchers and research commissioners to enhance the identification and adoption of ‘good value’ interventions, and we discuss the complexities of evidence-informed decision-making across multiple sectors, the evolving role of mode…
Qualitative system dynamics modelling to support the design and implementation of tuberculosis infection prevention and control measures in South African primary healthcare facilities
Tuberculosis infection prevention and control (TB IPC) measures are a cornerstone of policy, but measures are diverse and variably implemented. Limited attention has been paid to the health system environment, which influences successful implementation of these measures. We used qualitative system dynamics and group-model-building methods to (1) develop a qualitative causal map of the interlinked drivers of Mycobacterium tuberculosis (Mtb) transm…
Cost-effectiveness of tuberculosis infection prevention and control interventions in South African clinics
Introduction Nosocomial Mycobacterium tuberculosis ( Mtb ) transmission substantially impacts health workers, patients and communities. Guidelines for tuberculosis infection prevention and control (TB IPC) exist but implementation in many settings remains suboptimal. Evidence is needed on cost-effective investments to prevent Mtb transmission that are feasible in routine clinic environments. Methods A set of TB IPC interventions was codesigned wi…
Using system dynamics modelling to estimate the costs of relaxing health system constraints
Health system constraints are increasingly recognized as an important addition to model-based analyses of disease control interventions, as they affect achievable impact and scale. Enabling activities implemented alongside interventions to relax constraints and reach the intended coverage may incur additional costs, which should be considered in priority setting decisions. We explore the use of group model building, a participatory system dynamic…
Complexity and evidence in health sector decision-making
To better understand and plan health systems featuring multiple levels and complex causal elements, there have been increasing attempts to incorporate tools arising from complexity science to inform decisions. The utilization of new planning approaches can have important implications for the types of evidence that inform health policymaking and the mechanisms through which they do so. This paper presents an empirical analysis of the application o…
Stark choices
OBJECTIVES: COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under different epidemiological scenarios. METHODS: We used country-specific epidemiological projections from a dynamic transmission model to dete…
Modelling the effect of infection prevention and control measures on rate of Mycobacterium tuberculosis transmission to clinic attendees in primary health clinics in South Africa
Background Elevated rates of tuberculosis in healthcare workers demonstrate the high rate of Mycobacterium tuberculosis (Mtb ) transmission in health facilities in high-burden settings. In the context of a project taking a whole systems approach to tuberculosis infection prevention and control (IPC), we aimed to evaluate the potential impact of conventional and novel IPC measures on Mtb transmission to patients and other clinic attendees. Methods…
Thank You to Reviewers 2019
Comparing the Application of CEA and BCA to Tuberculosis Control Interventions in South Africa
Achieving ambitious targets to address the global tuberculosis (TB) epidemic requires consideration of the impact of competing interventions for improved identification of patients with TB. Cost-effectiveness analysis (CEA) and benefit-cost analysis (BCA) are two approaches to economic evaluation that assess the costs and effects of competing alternatives. However, the differing theoretical basis and methodological approach to CEA and BCA is like…
Cluster randomized evaluation of Adolescent Girls Empowerment Programme (Agep)
ISRCTN29322231 . March 04 2016; retrospectively registered
Opportunities and challenges for implementing cost accounting systems in the Kenyan health system
BACKGROUND: Low- and middle-income countries need to sustain efficiency and equity in health financing on their way to universal health care coverage. However, systems meant to generate quality economic information are often deficient in such settings. We assessed the feasibility of streamlining cost accounting systems within the Kenyan health sector to illustrate the pragmatic challenges and opportunities. DESIGN: We reviewed policy documents, a…
Randomized evaluation and cost-effectiveness of HIV and sexual and reproductive health service referral and linkage models in Zambia
ISRCTN84228514 Retrospectively registered. The study was retrospectively registered in the ISRCTN clinical trials registry on 06 October 2015. The first recruitment of participants occurred on 17 December 2013
Collecting and analysing cost data for complex public health trials
BACKGROUND: Current guidelines for the conduct of cost-effectiveness analysis (CEA) are mainly applicable to facility-based interventions in high-income settings. Differences in the unit of analysis and the high cost of data collection can make these guidelines challenging to follow within public health trials in low- and middle- income settings. OBJECTIVE: This paper reflects on the challenges experienced within our own work and proposes solutio…
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Collecting and analysing cost data for complex public health trials
BACKGROUND: Current guidelines for the conduct of cost-effectiveness analysis (CEA) are mainly applicable to facility-based interventions in high-income settings. Differences in the unit of analysis and the high cost of data collection can make these guidelines challenging to follow within public health trials in low- and middle- income settings. OBJECTIVE: This paper reflects on the challenges experienced within our own work and proposes solutio…
Opportunities and challenges for implementing cost accounting systems in the Kenyan health system
BACKGROUND: Low- and middle-income countries need to sustain efficiency and equity in health financing on their way to universal health care coverage. However, systems meant to generate quality economic information are often deficient in such settings. We assessed the feasibility of streamlining cost accounting systems within the Kenyan health sector to illustrate the pragmatic challenges and opportunities. DESIGN: We reviewed policy documents, a…
Randomized evaluation and cost-effectiveness of HIV and sexual and reproductive health service referral and linkage models in Zambia
ISRCTN84228514 Retrospectively registered. The study was retrospectively registered in the ISRCTN clinical trials registry on 06 October 2015. The first recruitment of participants occurred on 17 December 2013
Cluster randomized evaluation of Adolescent Girls Empowerment Programme (Agep)
ISRCTN29322231 . March 04 2016; retrospectively registered
Comparing the Application of CEA and BCA to Tuberculosis Control Interventions in South Africa
Achieving ambitious targets to address the global tuberculosis (TB) epidemic requires consideration of the impact of competing interventions for improved identification of patients with TB. Cost-effectiveness analysis (CEA) and benefit-cost analysis (BCA) are two approaches to economic evaluation that assess the costs and effects of competing alternatives. However, the differing theoretical basis and methodological approach to CEA and BCA is like…
Thank You to Reviewers 2019
Stark choices
OBJECTIVES: COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under different epidemiological scenarios. METHODS: We used country-specific epidemiological projections from a dynamic transmission model to dete…
Modelling the effect of infection prevention and control measures on rate of Mycobacterium tuberculosis transmission to clinic attendees in primary health clinics in South Africa
Background Elevated rates of tuberculosis in healthcare workers demonstrate the high rate of Mycobacterium tuberculosis (Mtb ) transmission in health facilities in high-burden settings. In the context of a project taking a whole systems approach to tuberculosis infection prevention and control (IPC), we aimed to evaluate the potential impact of conventional and novel IPC measures on Mtb transmission to patients and other clinic attendees. Methods…
Using system dynamics modelling to estimate the costs of relaxing health system constraints
Health system constraints are increasingly recognized as an important addition to model-based analyses of disease control interventions, as they affect achievable impact and scale. Enabling activities implemented alongside interventions to relax constraints and reach the intended coverage may incur additional costs, which should be considered in priority setting decisions. We explore the use of group model building, a participatory system dynamic…
Complexity and evidence in health sector decision-making
To better understand and plan health systems featuring multiple levels and complex causal elements, there have been increasing attempts to incorporate tools arising from complexity science to inform decisions. The utilization of new planning approaches can have important implications for the types of evidence that inform health policymaking and the mechanisms through which they do so. This paper presents an empirical analysis of the application o…
Cost-effectiveness of tuberculosis infection prevention and control interventions in South African clinics
Introduction Nosocomial Mycobacterium tuberculosis ( Mtb ) transmission substantially impacts health workers, patients and communities. Guidelines for tuberculosis infection prevention and control (TB IPC) exist but implementation in many settings remains suboptimal. Evidence is needed on cost-effective investments to prevent Mtb transmission that are feasible in routine clinic environments. Methods A set of TB IPC interventions was codesigned wi…
Qualitative system dynamics modelling to support the design and implementation of tuberculosis infection prevention and control measures in South African primary healthcare facilities
Tuberculosis infection prevention and control (TB IPC) measures are a cornerstone of policy, but measures are diverse and variably implemented. Limited attention has been paid to the health system environment, which influences successful implementation of these measures. We used qualitative system dynamics and group-model-building methods to (1) develop a qualitative causal map of the interlinked drivers of Mycobacterium tuberculosis (Mtb) transm…
Crises and complexity
The end of the COVID-19 global health emergency presents an opportunity to reflect on actions needed to enhance the effectiveness of responses to any future shocks. We highlight critical areas requiring attention from researchers and research commissioners to enhance the identification and adoption of ‘good value’ interventions, and we discuss the complexities of evidence-informed decision-making across multiple sectors, the evolving role of mode…
Level and determinants of district primary healthcare system technical efficiency in Ghana
BACKGROUND: Primary healthcare (PHC) is critical towards achieving Universal Health Coverage (UHC). In Ghana, PHC is organised at the district level and plays a key role in the country's pursuit of UHC. However, many districts face challenges not only with limited resources but also with how effectively they are used. We examined how efficiently districts in Ghana use their health resources and what factors are associated with this efficiency. ME…
Medicine (11 works) · Psychological intervention (9 works) · Business (8 works) · Nursing (8 works) · Environmental health (7 works) · Computer Science (6 works) · Global Maternal and Child Health (6 works) · Economic growth (5 works) · Economics (5 works) · Public health (5 works)