DCPN Focus Areas
At IHME, projects within the Disease Control Priorities Network (DCPN) grant generally fall into two focus areas that feed into optimally quantifying cost-effectiveness: (1) costs and constraints, and (2) efficacy and effectiveness.
For the DPCN project, "costs" refers to how much it costs to produce and provide health services along the delivery pathway, while "constraints" refers to the factors that either facilitate or hinder the delivery of health services. "Efficacy" reflects how well a health intervention is expected to perform under ideal conditions, whereas "effectiveness" captures intervention performance under routine, non-trial conditions. More information about these focus areas can be found toward the bottom of this page.
The following IHME work encompasses these DCPN focus areas:
Costs and Constraints
How much a health service costs rarely reflects the price tag provided to consumers or the budget line recorded by a health facility accountant. To more fully understand these costs, system inputs need to be quantified, like the cost of training personnel and the cost of fuel required to deliver vaccines to remote facilities. These costs can vary widely and are affected by many factors, such as health facility type and health system characteristics.
Constraints are factors that facilitate or hinder the provision or receipt of health services. They can occur on the supply side of service delivery, such that characteristics like medicine stocks and staffing at health facilities affect what interventions and care are available to patients. Constraints also take place on the demand side, such that facility distance and cultural preferences influence the ways in which populations seek health services.
Efficacy and Effectiveness
How well interventions work to improve the health of individuals and populations – and how they work across various conditions – is critical information for prioritizing policies and allocating resources at the local level. Efficacy reflects a “best case scenario” measure of how well an intervention works, as it is the main outcome of clinical trials. However, when an intervention is deployed under routine conditions, the benefits observed during trials may be conferred to patients in different ways.
Effectiveness, or how well an intervention performs under routine conditions, is often more challenging to analyze than efficacy. Thus, mapping the efficacy of interventions, based on trial data and systematic reviews, to the effectiveness experienced by populations throughout the world is very important to health policy decision-making and resource allocation. The Efficacy to Effectiveness Project
, which began in May 2013 with Emory University, is creating an analytic framework from which efficacy data of select interventions can be systematically translated into estimates of effectiveness under a range of settings.
, which is a supplement to the ABCE project focused on facility-based antiretroviral therapy (ART) programs, and the Viral Load Pilot Study
, hone in on the effectiveness of HIV/AIDS treatment programs and the optimal ways of measuring program effectiveness at the facility level.