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Our methodology

Using country-specific data on population dynamics, disease burden, health expenditure, and health service provision, the FairChoices tool develops tailored mathematical models. These models estimate the expected impact of health benefit packages on population health, health budgets, and financial risk protection, helping policymakers make informed decisions according to their population needs and health system goals.

Much of the work that goes into FairChoices relates to gathering evidence on the cost and effectiveness of interventions: we currently model more than 400 interventions in 82 countries! This evidence is presented in concise, structured evidence briefs. Our students and collaborators collect evidence wherever they can, including from academic and grey literature, as well as surveys from governments and intergovernmental organizations, like the World Health Organization and the Africa Centers for Disease Control and Prevention.

For some interventions, the scientific literature is abundant: there are effect estimates across a wide range of settings and costs can be quickly found in public catalogues. But for other interventions, information is scarce for not only cost and effectiveness, but also for the burden (i.e., incidence, prevalence, disability, and mortality) of the disease(s) targeted by the intervention. In such cases, conducting field work or interviewing experts may be the best way to quickly estimate costs and effects. More than once, FairChoices has benefited from the volunteered time of experts who offered to write these evidence briefs themselves.

We also develop and test theoretical frameworks for priority setting in health and model the impact of different implementation schemes on a number of outcomes, such as health gains, equity, and financial risk protection. This requires knowledge within fields like the philosophy of ethics, health care policy making, mathematical modelling, and programming.  

Analytical approaches

Demography

Demography refers to the study of populations and their characteristics, such as the population growth rate and age structure, and exploring how these factors influence health outcomes and healthcare needs. Understanding the demographics of a population is essential for developing effective health policies and interventions that can address the unique health challenges and needs of different population groups.

 

For its demography model, the FairChoices tool utilizes a cohort-component method, a widely used technique in demography. The method divides the population into cohorts based on age and sex, and then projects the future size and composition of each cohort based on assumptions about future trends in fertility, mortality, and migration. If the forecast horizon is ten years, for example, FairChoices moves the current population through time and estimates the size of each age-sex cohort every year, as well as the sizes of the cohorts being born every year, for the next ten years.  

 

The assumptions about future trends in fertility, mortality, and migration are based on estimates from the Global Burden of Disease (GBD) study and the World Population Prospects (WPP), which themselves are based on past trends and expert opinion. For example, the WPP model assumes that fertility rates will continue to decline in many parts of the world, that mortality rates will continue to decline due to advances in medical technology and public health, and that migration patterns will continue to be influenced by economic and political factors; the GBD model assumes that total mortality in a cohort can be subdivided into cause-specific mortalities from a fixed set of causes. FairChoices allows for users to input key demographic variables if users have more updated or accurate data than GBD or WPP or if users want to use FairChoices on a subnational region that is not covered by WPP or GBD. 

01
Priority setting in health - An introduction

Prof. Kjell Arne Johansson gives an introduction to priority setting.

05
Principles and Criteria in Health Priorities

Prof. Kjell Arne Johansson talks about some fundamental principles in health priorities.

06
Fair and Applied Process

Prof. Kjell Arne Johansson talks about fair and applied process for priority setting. 

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