Benefit-Cost Analysis for Selected Surgical Interventions in Low- and Middle-Income Countries

Authors: Blake Alkire, Jeffrey R. Vincent, John Meara


A benefit-cost analysis (BCA) for surgical interventions in low- and middle-income countries (LMICs) is established to show the economic return of investment in such procedures as cleft lip and palate repairs and cesarean delivery for obstructed labor. Based on cost and patient data from Operation Smile, the value of disability-adjusted life years (DALYs) is calculated and converted into economic benefit resulting in an estimated 9,600 DALYs averted. The Operation Smile Guwahati Comprehensive Cleft Care Center (GCCCC) demonstrates that high-quality, sustainable, locally supported surgical care can be provided to an underserved population in LMICs; while the results of this study constitute a useful contribution to the literature, the focus on an admittedly narrow subspecialty needs to be broadened in future study. A higher level application considers cesarean delivery across multiple regions, estimating the cost per DALYs averted as a median US$416 for 47 countries. Cesarean delivery turns out as a good economic proposition in the vast majority of countries investigated with the benefits of the procedure outweighing the cost.


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