Priority Setting in Health: Supporting health technology assessment in the Americas (event video)
11/5/12
The Pan American Health Organization (PAHO) is moving to tackle one of the most difficult and important challenges of health policy: strengthening regional mechanisms for assessing which health technologies are cost effective and therefore appropriate for public funding. It's a sensitive issue that vexes poor and rich countries alike--including the United States. A recent PAHO resolution signed by the United States, Canada, and countries in Latin America and the Caribbean will strengthen a network created last year to improve the quality of Health Technology Assessment studies and their use in the allocation of public budgets.
Behavioral economics seeks to complement traditional approaches to economics by incorporating insights from psychology and human behavior, and taking a behavioral approach allows us to understand a host of behaviors that are critical to the success of a variety of development policies. In this event, Sendhil Mullainathan and Saugato Datta will present a paper exploring how behavioral economics can inform development policy, from education to health to cash transfer programs. Drawing on the latest research in these and other areas, the authors will discuss how behavioral economics provides policymakers with innovative new ways of tackling many important issues in development.
Over the last 15 years, development economists have carefully accumulated rigorous evidence about what works and what does not in promoting health in poor countries. While each individual evaluation tests specific questions or sets of questions in specific contexts, the large number of studies now means that it is possible to draw more general conclusions. In addition, randomized evaluations are increasingly being designed to test fundamental questions about how people behave and thus generate lessons that are relevant for the design of different types of programs. In this seminar, Michael Kremer will discuss a new research paper co-authored with Rachel Glennerster, Lessons from Randomized Evaluations for Improving Health in Developing Countries, which summarizes lessons from the growing body of randomized evaluations of health programs in developing countries. The paper finds considerable evidence that consumers do not always invest optimally in health. In particular, consumers underinvest in cost-effective products for prevention and non-acute care of communicable disease and are very sensitive to the price and convenience of these products. This underinvestment does not simply reflect a lack of information of the benefits of preventative health. While this suggests the need for government intervention, many government health systems perform poorly and there is little accountability and few incentives for health care providers. Of the approaches designed to improve accountability, community or nongovernmental monitoring has had mixed results but district-level contracting has been quite successful. Many programs can improve health without excessive reliance on dysfunctional health delivery systems—delivering health products through schools for example, or improving health through water treatment. 
In recent years the idea of strong health systems as a component of population health has been noted by both global health donors and national governments alike. Consequently, the question of how to measure the effectiveness of health systems interventions has become ever more pressing. But it remains unclear if efforts to assess health systems are providing enough information to establish a link between investments and improved health outcomes. How do we know if increased investments in the sector are creating the desired impact? This panel discussion will explore the linkage between health system strengthening activities and improving health outcomes and provide a platform for determining the efficacy of health systems investments. Panelists will address methodologies for analyzing health systems, beyond a mere compilation of indicators, and will explore innovative methods to measure health system performance.