Health Systems and Public Health, Stellenbosch University, Faculty of Medicine and Health Sciences, Cape Town, South Africa.
Health Systems and Public Health, Stellenbosch University, Faculty of Medicine and Health Sciences, Cape Town, South Africa; Nutrition Research Centre, Ghana Atomic Energy Commission, Legon, Ghana.
Soc Sci Med. 2024 Aug;355:117130. doi: 10.1016/j.socscimed.2024.117130. Epub 2024 Jul 14.
We synthesised the best-available evidence on economic evaluations of gender-transformative interventions that prevent unintended pregnancy and promote sexual-health in adolescents. We also assessed the methodological quality of the economic-evaluation studies and identified gaps in the economic-evaluation evidence.
A systematic review (SR) of economic evaluations reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 2020.
We searched the following bibliographic databases for economic evaluations that met our selection criteria; PubMed, Cochrane, National Health Service EE database, SCOPUS, CINHAL, Web of Science and Paediatric EE Database. We also conducted a grey literature search. We included articles published from January 1, 1990 to December 31, 2021, in English, including adolescents aged 10-19. Two independent reviewers conducted the title and full-text screening.
One reviewer conducted data extraction and quality assessment, which a second reviewer checked. We used the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement and Consensus on Health Economic Criteria (CHEC) checklist to measure the reporting and methodological quality. Synthesis was done narratively and using summary tables.
Twenty-two studies were included, with 16 full and six partial economic evaluations. The quality of studies was moderate to high for most. The most reported outcomes were incremental cost-effectiveness ratio, costs per averted sexually transmitted infection, quality-adjusted life years saved per averted infection and costs per averted pregnancy. Most studies were cost-effective or cost-saving.
Most of the economic evaluations are cost-effective. There is a scarcity of available economic evaluations for most existing gender-transformative interventions, with most included studies originating from high-income countries (HICs). There is a need to develop guidance specific to economic evaluations of gender-transformative interventions.
我们综合了关于预防意外怀孕和促进青少年性健康的性别转化干预措施的最佳经济评估证据。我们还评估了经济评估研究的方法学质量，并确定了经济评估证据中的差距。
一项使用系统评价和荟萃分析（PRISMA）指南的经济评估系统评价（SR），2020 年。
我们在以下文献数据库中搜索了符合我们选择标准的经济评估：PubMed、Cochrane、国家卫生服务经济评估数据库、SCOPUS、CINHAL、Web of Science 和儿科经济评估数据库。我们还进行了灰色文献搜索。我们包括了 1990 年 1 月 1 日至 2021 年 12 月 31 日以英文发表的文章，包括 10-19 岁的青少年。两名独立的评审员进行了标题和全文筛选。
一名评审员进行了数据提取和质量评估，另一名评审员进行了检查。我们使用了综合健康经济评估报告标准（CHEERS）声明和健康经济标准共识（CHEC）清单来衡量报告和方法学质量。综合分析采用叙述性和总结表。
共有 22 项研究被纳入，其中 16 项为完整的经济评估，6 项为部分经济评估。大多数研究的质量为中等到较高。最常报告的结果是增量成本效益比、每避免一种性传播感染的成本、每避免一种感染而节省的质量调整生命年数以及每避免一次怀孕的成本。大多数研究是具有成本效益的或成本节约的。
大多数经济评估是具有成本效益的。大多数现有的性别转化干预措施缺乏可用的经济评估，大多数纳入的研究都来自高收入国家（HICs）。需要制定针对性别转化干预措施的经济评估的具体指南。
