The development of a public optometry system in Mozambique: a Cost Benefit Analysis

BMC Health Services Research

James Loughman³  Jorge Ferrão¹  Luigi Bilotto⁴  Geoff Harris⁵  Kovin Naidoo²  Stephen Thompson³ 

[1] Universidade Lúrio, Nampula, Mozambique;African Vision Research Institute/Brien Holden Vision Institute, Durban, South Africa;Dublin Institute of Technology, Dublin, Ireland/African Vision Research Institute, Durban, South Africa;Brien Holden Vision Institute, Sydney, Australia;Durban University of Technology, Durban, South Africa

关键词: Higher education;    Visual impairment;    Blindness;    Human resource development;    Eye health;    Uncorrected refractive error;    Mozambique;    Health economics;    Cost benefit analysis;    Optometry;   

Others  :  1126239
DOI  :  10.1186/1472-6963-14-422

 received in 2013-12-23, accepted in 2014-09-16,  发布年份 2014

【 摘 要 】

Background

The economic burden of uncorrected refractive error (URE) is thought to be high in Mozambique, largely as a consequence of the lack of resources and systems to tackle this largely avoidable problem. The Mozambique Eyecare Project (MEP) has established the first optometry training and human resource deployment initiative to address the burden of URE in Lusophone Africa. The nature of the MEP programme provides the opportunity to determine, using Cost Benefit Analysis (CBA), whether investing in the establishment and delivery of a comprehensive system for optometry human resource development and public sector deployment is economically justifiable for Lusophone Africa.

Methods

A CBA methodology was applied across the period 2009–2049. Costs associated with establishing and operating a school of optometry, and a programme to address uncorrected refractive error, were included. Benefits were calculated using a human capital approach to valuing sight. Disability weightings from the Global Burden of Disease study were applied. Costs were subtracted from benefits to provide the net societal benefit, which was discounted to provide the net present value using a 3% discount rate.

Results

Using the most recently published disability weightings, the potential exists, through the correction of URE in 24.3 million potentially economically productive persons, to achieve a net present value societal benefit of up to $1.1 billion by 2049, at a Benefit-Cost ratio of 14:1. When CBA assumptions are varied as part of the sensitivity analysis, the results suggest the societal benefit could lie in the range of $649 million to $9.6 billion by 2049.

Conclusion

This study demonstrates that a programme designed to address the burden of refractive error in Mozambique is economically justifiable in terms of the increased productivity that would result due to its implementation.

【 授权许可】

   
2014 Thompson et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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