Task-Sharing or Public Finance for Expanding Surgical Access in Rural Ethiopia: An Extended Cost-Effectiveness Analysis

Authors: Mark Shrime, Stéphane Verguet, Kjell Arne Johansson, Dawit Desalegn, Dean Jamison, Margaret Kruk

Up to 28 percent of the global burden of disease is attributable to conditions potentially amenable to surgical treatment (Shrime, Sleemi, and Thulasiraj 2014). In low- and middle-income countries, however, the utilization of surgical services is low, often because of a lack of surgical providers, facilities, and equipment, and because of sociocultural factors and the high cost of procedures (Chao and others 2012; Hsia and others 2012; Ilbawi, Einterz, and Nkusu 2013; Knowlton and others 2013; Linden and others 2012). Numerous policies have been proposed to improve access to surgery, including making surgery free at the point of care and task- sharing (Bucagu and others 2012; Jadidfard, Yazdani, and Khoshnevisan 2012; Kruk and others 2007).