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

Introduction:
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).