Optimizing Investments in Mozambique's Tuberculosis Response : Results of a Tuberculosis Allocative Efficiency Study
This allocative efficiency analysis intended to assess Mozambique's progress towards TB strategic targets, and provide decision support for TB strategy using a combined TB epidemiological component and an economic and program analysis framewor...
| Main Authors: | , , , |
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| Language: | English |
| Published: |
World Bank, Washington, DC
2020
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/576571591894623493/Optimizing-Investments-in-Mozambiques-Tuberculosis-Response-Results-of-a-Tuberculosis-Efficiency-Study http://hdl.handle.net/10986/33907 |
| Summary: | This allocative efficiency analysis
intended to assess Mozambique's progress towards TB
strategic targets, and provide decision support for TB
strategy using a combined TB epidemiological component and
an economic and program analysis framework (Optima TB).
Input data were collected from NTP sources, the WHO, and
various TB implementers. Our model indicates declining
future trends in TB prevalence, incidence and related
deaths. However, the case detection rate (52 percent)
remains one of the biggest hurdles. Mozambique, however,
could cut TB prevalence and TB deaths by 20 percent, and TB
incidence by 11 percent by allocating resources optimally.
Specifically, this would entail (i) doubling the rate of
household contact tracing for notified cases, (ii) screening
all PLHIV during their routine outpatient visits, and (iii)
focusing on community outreach activities among key
populations such as prisoners, cross-border miners and
community health workers. In addition, scaling up ART
coverage from 55 percent (current/ 2017) to 90 percent by
2035 is projected to reduce new TB cases among PLHIV by over
50 percent (in 2035). Furthermore, our analysis shows that
higher levels of TB spending lead to more rapid reductions
in TB incidence. However, the rates of reduction associated
with large increases in expenditure (up to 200 percent of
current spending levels) begin to slow in the medium term
and it is unlikely that the national TB response can deliver
on the 2025 milestones and 2035 End-TB targets. |
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