Zin Min Thet Lwin

Karolinska Institutet, Sweden

Title: Task Sharing for Inguinal Hernia Repair: Economic Evaluation of Expanding Access Through Non-Specialist Doctors in Uganda

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Biography

Zin Min Thet Lwin is a medical doctor, bringing forth expertise in public health and research, amassed over a decade of dedicated service in the field. He is currently pursuing a doctoral study, specializing in health economics and policy. His doctoral research focuses on advancing healthcare access and outcomes, particularly in underserved communities in Sub-Saharan Africa. With a commitment to addressing healthcare disparities prevalent in the region, his research is primarily centered on the critical domain of task sharing in hernia repair. The results from the studies aim to explore innovative solutions that can positively impact healthcare delivery in resource-constrained settings.

Abstract

Introduction

People in Africa suffer from a high burden of disease caused by inguinal hernia. In Uganda, a Sub-Saharan African country, there is a shortage of surgeons performing inguinal hernia repair. The surgery is conducted by surgeons and medical doctors in the form of task-sharing. No previous studies have been conducted in Uganda on the economic impact of task-sharing between the two groups of healthcare professionals on costs and health outcomes.

Aim

The aim of the study was to determine the cost-effectiveness of task-sharing between surgeons and medical doctors for open mesh repair of inguinal hernia among adult males in Uganda and to estimate the budgetary impact and health gains of scaling this up nationally in order to expand inguinal hernia surgery in Uganda.

Method

A Markov model was used to determine the differences in costs and health outcomes of inguinal hernia repair performed by surgeons or medical doctors compared to no treatment. Additionally, a budget impact analysis was performed to assess the impact of service expansion through task-sharing on cost and health gains over a 10-year period.

Results

The incremental cost-effectiveness ratios for providing open mesh repair in symptomatic adult males in Uganda by either surgeons or medical doctors compared to no treatment were USD 486.79 and USD 481.69 per disability-adjusted life year (DALY) averted, respectively. The operation is cost-effective at and above the willingness-to-pay threshold of USD 490 per DALY averted. The budget impact analysis estimated total cost of USD 352 million to eliminate the backlog of 1.2 million inguinal hernias in adult men in 10 years, with 644,000 DALYs averted.

Conclusion

Open inguinal hernia repair is cost-effective by both surgeons and medical doctors and investing more financial resources in hernia surgery can avert a large burden of disease in Uganda.