Final report of an evaluation of the health sector resource allocation model

Evaluation covers the period 1979-83 and is based on document review and interviews with A.I.D. and academic specialists. Unlike the traditional epidemiological approach to planning, this Health Sector Resource Allocation Model introduces an econometric planning strategy, to help national health planners in LDC's analyze the relative merits of various resource allocation strategies. Developed at the University of Michigan (UM) on a large research mainframe computer using Fortran, it can also be used with Basic on a small portable computer. The model can run health effects calculations for 30 diseases, for numerous interventions or combinations of them, at various budget levels, in a matter of seconds. At UM the model has proved its capability as a training tool for technology transfer. Lack of disaggregated, systematically gathered data in LDC's is a principal constraint, with cost data deficiencies a severe handicap. The model will help to sensitize LDC health managers to the need for many types and qualities of planning data. As these data normally begin to be available at the provincial level, deployment of the model at the regional as well as the national level is indicated. It should be used initially as a tool not so much for planning as for training and motivating health planners to rely on empirical observations and to think about health alternatives in economic as well as epidemiological terms. Core training packages appropriate to each LDC audience would be most effective. The value of the model for furthering A.I.D. health goals was to be tested in Indonesia and Egypt. Several applications of the model technology have been completed in Indonesia, but despite the enthusiasm of many Egyptians who have studied at UM, most USAID/Cairo officials are doubtful of the model's value for health planning in Egypt and it has not yet been applied there. A fresh presentation of its capabilities and potential could lead to better rapport between the Mission and the UM team. The situation in Egypt is promising for piloting a health planning technology transfer, with two concerned government agencies headed by strong well-qualified leaders; a collaborative pilot program to test a core curriculum is recommended. Other recommendations are to: continue upgrading the technology at UM; adapt the model for use with a variety of hardware and in a variety of computer languages; and upgrade health sector data and information management systems of LDC's.