Victoria Institute of Strategic Economic Studies, Victoria University, Melbourne, Victoria, Australia.
UNFPA, New York, New York.
J Adolesc Health. 2019 Jul;65(1S):S8-S15. doi: 10.1016/j.jadohealth.2019.03.023.
This study argues that investments in the health of the world's 1.2 billion adolescents is a critical component of the overall investment case for adolescents and is vital for achieving the United Nation's Sustainable Development Agenda. We undertake a benefit cost analysis of a range of interventions to improve adolescent health.
We examined investments in intervention-specific costs, program costs, and health systems costs at a country level for 40 low- and middle-income countries that account for about 90% of adolescents in low- and middle-income countries. Intervention-specific costs and impacts were computed using the OneHealth Tool, whereas other published resources were used for the program and health systems costs. Interventions modeled include those addressing physical, sexual, and reproductive health; maternal and newborn health; and some noncommunicable diseases. Two coverage scenarios were simulated: an unchanged coverage scenario and one in which the coverage increases to achieve a high coverage by 2030.
Key outcomes included estimates of the costs, health-related impacts, and benefit-cost ratios (BCRs). For the 66 adolescent health interventions modeled for 40 countries, the total cost for the period of 2015-2030 was $358.4 billion or an average of $4.5 per capita each year. From 2015 to 2030, there were 7.0 million deaths averted, and 1.5 million serious disabilities averted. At a 3% discount rate, the average BCR were 12.6, 9.9, and 6.4 for low-income, lower middle-income, and upper middle-income countries, respectively. Countries with adolescent mortality rates ≥200 per 100,000 had an average BCR of 14.8 compared with countries with adolescent mortality rates <100 per 100,000 had an average BCR of 5.7.
The results show that there are substantial benefits from a program of interventions to improve adolescent health.
本研究认为，投资于全球 12 亿青少年的健康是青少年整体投资案例的关键组成部分，对于实现联合国可持续发展议程至关重要。我们对一系列改善青少年健康的干预措施进行了效益成本分析。
我们在 40 个中低收入国家（占中低收入国家青少年的 90%左右）层面上审查了干预特定成本、方案成本和卫生系统成本的投资。干预特定成本和影响使用 OneHealth 工具计算，而其他已发表的资源则用于方案和卫生系统成本。建模的干预措施包括针对身体、性和生殖健康、孕产妇和新生儿健康以及一些非传染性疾病的干预措施。模拟了两种覆盖情景：一种是不变的覆盖情景，另一种是到 2030 年实现高覆盖的情景。
关键结果包括成本、与健康相关的影响和效益成本比（BCR）的估计。对 40 个国家的 66 项青少年健康干预措施进行建模，2015-2030 年期间的总成本为 3584 亿美元，或人均每年 45 美元。2015 年至 2030 年，有 700 万人死亡被避免，150 万人严重残疾被避免。在 3%的贴现率下，低收入、中下收入和中上收入国家的平均 BCR 分别为 12.6、9.9 和 6.4。青少年死亡率≥200/10 万的国家的平均 BCR 为 14.8，而青少年死亡率<100/10 万的国家的平均 BCR 为 5.7。
结果表明，改善青少年健康的干预方案有巨大的效益。
