A Cost-Effectiveness Analysis of a Pediatric Operating Room in Uganda

Area of Science:

• Global Health
• Health Economics
• Surgical Capacity Building

Background:

• Limited access to pediatric surgical care in Uganda, with only 4 surgeons for over 20 million children.
• Sub-Saharan Africa faces significant challenges in providing essential surgical services to children.

Purpose of the Study:

• To evaluate the cost-effectiveness of establishing a dedicated pediatric operating room (OR) in Uganda.
• To assess the impact of increased surgical capacity on pediatric health outcomes and economic benefits.

Main Methods:

• A simulation model using a decision tree was developed to project costs and disability-adjusted life-years (DALYs) saved.
• Parameters were informed by surgical outcomes, OR equipment costs, and literature review.
• Sensitivity analyses (one-way and probabilistic) were performed to assess parameter uncertainty.

Main Results:

• A pediatric OR averted 6,447 DALYs/year at an installation cost of $41,182/year.
• The incremental cost-effectiveness ratio was $6.39 per DALY averted, well within WHO guidelines.
• The net economic benefit was over $5.3 million annually, or $16,371 per patient.

Conclusions:

• Constructing a pediatric OR in Uganda is a cost-effective and valuable investment.
• The findings support enhancing pediatric surgical capacity in resource-limited Sub-Saharan African settings.
• This study provides evidence for future policy decisions on pediatric surgical infrastructure.