[Survey and examples of economic evaluation of health programmes in developing countries] L'evaluation economique des programmes de sante dans les pays en developpement: tour d'horizon et exemples.
To demonstrate the principles of economic evaluation of health programs, 6 studies are described in detail with the aim of illustrating the methodology and considering the policy relevance of the studies. The studies are classified according to the objective of health intervention investigated and the form of economic evaluation. 3 broad groupings of intervention are recognized: disease specific, health program specific, and those that aim at general health improvement or reduction in disease and cut across individual health programs and diseases. The evaluative approaches include cost description and analysis, outcome description and analysis, cost minimization analysis, cost effectiveness analysis, cost benefit analysis, and cost utility analysis. The studies considered are an examination of the cost of primary health care based on a USAID summary of 3 large-scale projects (in Afghanistan, Dominican Republic and Tanzania) and 4 demonstration projects (in Bolivia, Colombia, Danfa in Ghana and the Narangwal project in India), and an evaluation of the economic importance of breastfeedings based on data from Ghana and Ivory Coast, both health program specific cost description and analysis studies; the cost effectiveness of alternative strategies for poliomyelitis immunization in Brazil, a health program specific cost effectiveness analysis; the cost effectiveness and user characteristics of clinic based services for the treatment of diarrhea in Bangladesh, a disease specific cost benefit analysis; cost effectiveness of the diagnosis and treatment of tuberculous meningitis in India, a disease specific cost minimization analysis, and a study of child and maternal health services in India, a cost minimization analysis of a general health improvement program.