Applying the disability-adjusted life year to track health impact of social franchise programs in low- and middle-income countries

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• 作者：Dominic Montagu (8)
  Lek Ngamkitpaiboon (9)
  Susan Duvall (10)
  Amy Ratcliffe (9)
  
• 刊名：BMC Public Health
• 出版年：2013
• 出版时间：June 2013
• 年：2013
• 卷：13
• 期：2-supp
• 全文大小：651KB
• 参考文献：1. Bustreo F, Harding A, Axelsson H: Can developing countries achieve adequate improvements in child health outcomes without engaging the private sector? / WHO Bulletin 2003, 81:886鈥?95.
  2. Montagu D: Franchising of health services in low-income countries. / Health Policy Plann 2002,17(2):121鈥?0. CrossRef
  3. Beyeler N, De La Cruz AY, Montagu D: The impact of clinical social franchising on health services in low- and middle-income countries: a systematic review. / PLoS One 2013,8(4):e60669. doi:10.1371/journal.pone.0060669
  4. Koehlmoos TP, Gazi R, Hossain J, Rashidi T: / Social franchising evaluation: a scoping review. London: EPPI-Center, Social Science Research Unit, Institute of Education, University of London; 2011.
  5. Montagu D, Berman P, Goodman CA, Visconti A: Working with the private sector to improve basic healthcare: a review of evidence and interventions. / Presentation at the 2012 Health Systems Research Symposium; Beijing
  6. Montagu D: Franchising of family planning and reproductive health services in developing countries. / PhD thesis. University of California Berkeley, School of Public Health; 2002.
  7. O'Connell K, Hom M, Aung T, Theuss M, Huntington D: Using and joining a franchised private sector provider network in Myanmar. / PLoS One 2011, 6:e28364. CrossRef
  8. Schlein K, Montagu D: / Clinical social franchising compendium: an annual survey of programs. San Francisco: University of California San Francisco; 2012.
  9. Population Services International Social Franchising: Ensuring Quality Health Care Coverage in the Developing World [social-franchising-solution-inadequate-health-care-coverage-developing-world" class="a-plus-plus">http://www.psi.org/social-franchising-solution-inadequate-health-care-coverage-developing-world]
  10. Marie Stopes International. Social Franchising [social-franchising" class="a-plus-plus">http://www.mariestopes.org/what-we-do/social-franchising]
  11. Schlein K, Drasser K, Montagu D: / Clinical social franchising compendium: an annual survey of programs. San Francisco: University of California San Francisco; 2011.
  12. United States Agency for International Development Couple Years of Protection [http://transition.usaid.gov/our_work/global_health/pop/techareas/cyp.html]
  13. Glasgow RE, Klesges LM, Dzewaltowski DA, Estabrooks PA, Vogt TM: Evaluating the impact of health promotion programs: using the RE-AIM framework to form summary measures for decision making involving complex issues. / Health Educ Res 2006, 21:688鈥?94. CrossRef
  14. Davies SM, Geppert J, McClellan M, McDonald KM, Romano PS, Shojania KG: / Refinement of the HCUP quality indicators. Rockville (MD): Agency for Healthcare Research and Quality (US); 2001.
  15. The Global Fund: Performance Based Funding [http://www.theglobalfund.org/en/activities/pbf/]
  16. Department for International Development: Research and Evidence [http://www.dfid.gov.uk/What-we-do/Research-and-evidence]
  17. US Agency for International Development: Performance-based Incentives Primer for USAID Missions [http://pdf.usaid.gov/pdf_docs/PNADX747.pdf]
  18. The World Bank: Program-for-Results Financing [http://web.worldbank.org/WBSITE/EXTERNAL/PROJECTS/0,,contentMDK:23215867~pagePK:41367~piPK:51533~theSitePK:40941,00.html]
  19. Murray CJ: Quantifying the burden of disease: the technical basis for disability-adjusted life years. / Bull World Health Organ 1994, 72:429鈥?45.
  20. Murray CJ, Lopez AD: Quantifying disability: data, methods and results. / Bull World Health Organ 1994, 72:481鈥?94.
  21. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL: Measuring the Global Burden of Disease and risk factors, 1990鈥?001. In / Global Burden of Disease and Risk Factors. Edited by: Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL. Washington, DC: World Bank; 2006:1鈥?3. CrossRef
  22. Murray CJ, Lopez AD, Jamison DT: The global burden of disease in 1990: summary results, sensitivity analysis and future directions. / Bull World Health Organ 1994,72(3):495鈥?09.
  23. Population Services International DALY FAQ 2012 [http://www.psi.org/resources/disability-adjusted-life-years-dalys/daly-faq]
  24. Yang H, Duvall S, Ratcliffe A, Jeffries D, Stevens W: Modeling health impact of global health programs implemented by Population Services International. / BMC Public Health 2013,13(Suppl 2):S3.
  25. Longfield K, Smith B, Gray R, Ngamkitpaiboon L, Vielot N: Putting health metrics into practice: using the disability-adjusted life year for strategic decision making. / BMC Public Health 2013,13(Suppl 2):S2. CrossRef
  26. Lonnroth K, Uplekar M, Blanc L: Hard gains through soft contracts: productive engagement of private providers in tuberculosis control. / Bull World Health Organ 2006, 84:876鈥?83.
  
• 作者单位：Dominic Montagu (8)
  Lek Ngamkitpaiboon (9)
  Susan Duvall (10)
  Amy Ratcliffe (9)
  
  8. Global Health Group, University of California San Francisco, kragujevac, CA, USA
  9. Population Services International, Washington, DC, USA
  10. Independent global health consultant, Seattle, WA, USA
  
• ISSN：1471-2458

文摘

Background Developing effective methods for measuring the health impact of social franchising programs is vital for demonstrating the value of this innovative service delivery model, particularly given its rapid expansion worldwide. Currently, these programs define success through patient volume and number of outlets, widely acknowledged as poor reflections of true program impact. An existing metric, the disability-adjusted life years averted (DALYs averted), offers promise as a measure of projected impact. Country-specific and service-specific, DALYs averted enables impact comparisons between programs operating in different contexts. This study explores the use of DALYs averted as a social franchise performance metric. Methods Using data collected by the Social Franchising Compendia in 2010 and 2011, we compared franchise performance, analyzing by region and program area. Coefficients produced by Population Services International converted each franchise's service delivery data into DALYs averted. For the 32 networks with two years of data corresponding to these metrics, a paired t-test compared all metrics. Finally, to test data reporting quality, we compared services provided to patient volume. Results Social franchising programs grew considerably from 2010 to 2011, measured by services provided (215%), patient volume (31%), and impact (couple-years of protection (CYPs): 86% and DALYs averted: 519%), but not by the total number of outlets. Non-family planning services increased by 857%, with diversification centered in Asia and Africa. However, paired t-test comparisons showed no significant increase within the networks, whether categorized as family planning or non-family planning. The ratio of services provided to patient visits yielded considerable range, with one network reporting a ratio of 16,000:1. Conclusion In theory, the DALYs averted metric is a more robust and comprehensive metric for social franchising than current program measures. As social franchising spreads beyond family planning, having a metric that captures the impact of a range of diverse services and allows comparisons will be increasingly important. However, standardizing reporting will be essential to make such comparisons useful. While not widespread, errors in self-reported data appear to have included social marketing distribution data in social franchising reporting, requiring clearer data collection and reporting guidelines. Differences noted above must be interpreted cautiously as a result.