Skip to main content

Advertisement

Log in

Potential Economic Benefit of Cleft Lip and Palate Repair in Sub-Saharan Africa

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Acceptance of basic surgical care as an essential element of any properly functioning health system is growing. To justify investment in surgical interventions, donors require estimates of the economic benefit of treating surgical disease. The present study aimed to establish a methodology for valuing the potential economic benefit of surgical intervention using cleft lip and palate (CLP) in sub-Saharan Africa (SSA) as a model.

Methods

Economic modeling of cleft lip and cleft palate (CLP) in SSA was performed with retrospective demographic and economic data from 2008. The total number of Disability-Adjusted Life-Years (DALYs) secondary to CLP in 2008 was calculated from accepted clefting incidence rates and disability weights taken from the Global Burden of Disease Project. DALYs were then converted to monetary terms ($US), using both a human capital approach and Value of a Statistical Life (VSL) approach.

Results

With the human capital approach, the potential economic benefit if all incident cases of CLP in SSA in 2008 were repaired at birth ranged from $252 million to $441 million. With VSL, the potential economic benefit of the same CLP repair would range from $5.4 billion to $9.7 billion.

Conclusions

Cleft lip and cleft palate can have a substantial impact on the economic health of countries in the developing world. Further studies should be directed at quantifying the economic benefit of surgical interventions and quantifying their costs with an economically sound approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Farmer PE, Kim JY (2008) Surgery and global health: a view from beyond the OR. World J Surg 32:533–536

    Article  PubMed  Google Scholar 

  2. Debas H, Gosselin R, McCord C et al (2006) Surgery. In: Jamison DT (ed) Disease control priorities in developing countries, 2nd edn. Oxford University Press, New York, pp 1245–1260

    Google Scholar 

  3. Kushner AL, Cherian MN, Noel L et al (2010) Addressing the millennium development goals from a surgical perspective: essential surgery and anesthesia in 8 low- and middle-income countries. Arch Surg 145:154–159

    Article  PubMed  Google Scholar 

  4. PLoS Editors (2008) A crucial role for surgery in reaching the UN millennium development goals. PLoS Med 5:e182

    Google Scholar 

  5. World Health Organization (2010) Global Initiative for Emergency and Essential Surgical Care. http://www.who.int/surgery/globalinitiative/en/. Accessed 1 Oct 2010

  6. Bellagio Essential Surgery Group (2007) Increasing access to surgical services in resource-constrained settings in sub-Saharan Africa. Milan, Italy

    Google Scholar 

  7. McCord C (2003) A cost effective small hospital in Bangladesh: what it can mean for emergency obstetric care. Int J Gynecol Obstet 81:83–92

    Article  CAS  Google Scholar 

  8. Operation Smile (2010) How Your Support Helps. http://www.operationsmile.org/about_us/how-your-support-helps.html. Accessed 1 Oct 2010

  9. Magee WP Jr, Vander Burg R, Hatcher KW (2010) Cleft lip and palate as a cost-effective health care treatment in the developing world. World J Surg 34:420–427

    Article  PubMed  Google Scholar 

  10. Corlew DS (2010) Estimation of impact of surgical disease through economic modeling of cleft lip and palate care. World J Surg 34:391–396

    Article  PubMed  Google Scholar 

  11. World Health Organization Commission on Macroeconomics and Health (2001) Macroeconomics and health: investing in health for economic development. World Health Organization, Geneva

    Google Scholar 

  12. The World Bank (1993) World Development Report 1993: investing in health. Oxford University Press for the World Bank, New York

    Google Scholar 

  13. Murray CJ, Acharya AK (1997) Understanding DALYs (disability-adjusted life years). J Health Econ 16:703–730

    Article  PubMed  CAS  Google Scholar 

  14. Lopez AD, Mathers CD, Ezzati M et al (2006) Global burden of disease and risk factors. Oxford University Press for the World Bank, New York

    Book  Google Scholar 

  15. Corlew DS (2009) Perspectives on plastic surgery and global health. Ann Plast Surg 62:473–477

    Article  PubMed  CAS  Google Scholar 

  16. Government of Australia (2008) Access economics: the health of nations: the value of a statistical life. Commonwealth of Australia

  17. Chase SB (ed) (1968) The life you save may be your own. Problems in public expenditure analysis. Brookings Institution, Washington

  18. Viscusi WK, Aldy JE (2003) The value of a statistical life: a critical review of market estimates throughout the world. J Risk Uncertain 27:5–76

    Article  Google Scholar 

  19. U.S. Department of Transportation (2010) Treatment of the economic value of a statistical life in departmental analyses. http://ostpxweb.dot.gov/policy/reports/080205.htm. Accessed 31 Oct 2010

  20. U.S. Environmental Protection Agency (2010) Frequently asked questions. http://yosemite.epa.gov/ee/epa/eed.nsf/pages/MortalityRiskValuation.html. Accessed 1 Oct 2010

  21. Hammitt JK (2007) Valuing changes in mortality risk: lives saved versus life years saved. Rev Environ Econ Pol 1:228–240

    Article  Google Scholar 

  22. Aldy JE, Viscusi WK (2008) Adjusting the value of a statistical life for age and cohort effects. Rev Econ Stat 90:573–581

    Article  Google Scholar 

  23. Canfield MA, Honein MA, Yuskiv N et al (2006) National estimates and race/ethnic-specific variation of selected birth defects in the United States, 1999–2001. Birth Defects Res A Clin Mol Teratol 76:747–756

    Article  PubMed  CAS  Google Scholar 

  24. Mathers C, Fat DM, Boerma JT et al (2008) The global burden of disease: 2004 update. World Health Organization, Geneva

    Google Scholar 

  25. World Bank (2011) The World Bank: open data. http://data.worldbank.org/. Accessed 1 Feb 2010

  26. Fox-Rushby JA, Hanson K (2001) Calculating and presenting disability adjusted life years (DALYs) in cost-effectiveness analysis. Health Policy Plan 16:326–331

    Article  PubMed  CAS  Google Scholar 

  27. Murray CJL, Lopez AD, Harvard School of Public Health et al (1996) The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, MA: Published by the Harvard School of Public Health on behalf of the World Health Organization and the World Bank; Distributed by Harvard University Press

  28. Hammitt JK, Haninger K (2010) Valuing fatal risks to children and adults: effects of disease, latency, and risk aversion. J Risk Uncertain 40:57–83

    Article  Google Scholar 

  29. Belli P (2001) Economic analysis of investment operations: analytical tools and practical applications. World Bank, Washington

    Google Scholar 

  30. Asian Development Bank (2005) Arrive alive: ASEAN commits to cutting road deaths. ASEAN Regional Road Safety Strategy and Action Plan (2005–2010). Asian Development Bank, Metro Manila

  31. Hammitt JK, Robinson LA (2011) The income elasticity of the value per statistical life: transferring estimates between high and low income populations. J Benefit–Cost Anal 2(1)

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John G. Meara.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Alkire, B., Hughes, C.D., Nash, K. et al. Potential Economic Benefit of Cleft Lip and Palate Repair in Sub-Saharan Africa. World J Surg 35, 1194–1201 (2011). https://doi.org/10.1007/s00268-011-1055-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-011-1055-1

Keywords

Navigation