BibTex format
@article{Hallett:2025:10.1016/s2214-109x(24)00413-3,
author = {Hallett, TB and Mangal, TD and Tamuri, AU and Arinaminpathy, N and Cambiano, V and Chalkley, M and Collins, JH and Cooper, J and Gillman, MS and Giordano, M and Graham, MM and Graham, W and Hawryluk, I and Janouková, E and Jewell, BL and Lin, IL and Manning, Smith R and Manthalu, G and Mnjowe, E and Mohan, S and Molaro, M and Ng'ambi, W and Nkhoma, D and Piatek, S and Revill, P and Rodger, A and Salmanidou, D and She, B and Smit, M and Twea, PD and Colbourn, T and Mfutso-Bengo, J and Phillips, AN},
doi = {10.1016/s2214-109x(24)00413-3},
journal = {The Lancet Global Health},
pages = {E28--E37},
title = {Estimates of resource use in the public-sector health-care system and the effect of strengthening health-care services in Malawi during 2015–19: a modelling study (Thanzi La Onse)},
url = {http://dx.doi.org/10.1016/s2214-109x(24)00413-3},
volume = {13},
year = {2025}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - BackgroundIn all health-care systems, decisions need to be made regarding allocation of available resources. Evidence is needed for these decisions, especially in low-income countries. We aimed to estimate how health-care resources provided by the public sector were used in Malawi during 2015–19 and to estimate the effects of strengthening health-care services.MethodsFor this modelling study, we used the Thanzi La Onse model, an individual-based simulation model. The scope of the model was health care provided by the public sector in Malawi during 2015–19. Health-care services were delivered during health-care system interaction (HSI) events, which we characterised as occurring at a particular facility level and requiring a particular number of appointments. We developed mechanistic models for the causes of death and disability that were estimated to account for approximately 81% of deaths and approximately 72% of disability-adjusted life-years (DALYs) in Malawi during 2015–19, according to the Global Burden of Disease (GBD) estimates; we computed DALYs incurred in the population as the sum of years of life lost and years lived with disability. The disease models could interact with one another and with the underlying properties of each person. Each person in the Thanzi La Onse model had specific properties (eg, sex, district of residence, wealth percentile, smoking status, and BMI, among others), for which we measured distribution and evolution over time using demographic and health survey data. We also estimated the effect of different types of health-care system improvement.FindingsWe estimated that the public-sector health-care system in Malawi averted 41·2 million DALYs (95% UI 38·6–43·8) during 2015–19, approximately half of the 84·3 million DALYs (81·5–86·9) that the population would otherwise have incurred. DALYs averted were heavily skewed to children aged 0–4 years due to s
AU - Hallett,TB
AU - Mangal,TD
AU - Tamuri,AU
AU - Arinaminpathy,N
AU - Cambiano,V
AU - Chalkley,M
AU - Collins,JH
AU - Cooper,J
AU - Gillman,MS
AU - Giordano,M
AU - Graham,MM
AU - Graham,W
AU - Hawryluk,I
AU - Janouková,E
AU - Jewell,BL
AU - Lin,IL
AU - Manning,Smith R
AU - Manthalu,G
AU - Mnjowe,E
AU - Mohan,S
AU - Molaro,M
AU - Ng'ambi,W
AU - Nkhoma,D
AU - Piatek,S
AU - Revill,P
AU - Rodger,A
AU - Salmanidou,D
AU - She,B
AU - Smit,M
AU - Twea,PD
AU - Colbourn,T
AU - Mfutso-Bengo,J
AU - Phillips,AN
DO - 10.1016/s2214-109x(24)00413-3
EP - 37
PY - 2025///
SN - 2572-116X
SP - 28
TI - Estimates of resource use in the public-sector health-care system and the effect of strengthening health-care services in Malawi during 2015–19: a modelling study (Thanzi La Onse)
T2 - The Lancet Global Health
UR - http://dx.doi.org/10.1016/s2214-109x(24)00413-3
UR - http://hdl.handle.net/10044/1/115939
VL - 13
ER -