title: Decision rules for allocation of finances to health systems strengthening.
abstract: A key dilemma in global health is how to allocate funds between disease-specific "vertical projects" on the one hand and "horizontal programmes" which aim to strengthen the entire health system on the other. While economic evaluation provides a way of approaching the prioritisation of vertical projects, it provides less guidance on how to prioritise between horizontal and vertical spending. We approach this problem by formulating a mathematical program which captures the complementary benefits of funding both vertical projects and horizontal programmes. We show that our solution to this math program has an appealing intuitive structure. We illustrate our model by computationally solving two specialised versions of this problem, with illustrations based on the problem of allocating funding for infectious diseases in sub-Saharan Africa. We conclude by reflecting on how such a model may be developed in the future and used to guide empirical data collection and theory development.
authors.affiliation: Department of Management Science, Strathclyde Business School, University of Strathclyde, 199 Cathedral Street, Glasgow G4 0QU, UK. Electronic address: alec.morton@strath.ac.uk.
authors.forename: Alec
authors.initials: A
authors.lastname: Morton
authors.affiliation: School of Public Health, Imperial College London, South Kensington Campus, London SW7 2AZ, UK.
authors.forename: Ranjeeta
authors.initials: R
authors.lastname: Thomas
authors.affiliation: Imperial College Business School, Imperial College London, South Kensington Campus, London SW7 2AZ, UK.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Smith
mesh_terms: D017954:Africa South of the Sahara; D003362:Cost-Benefit Analysis; D014943:Global Health; D006078:Government Programs; D006801:Humans; D040841:Resource Allocation
keywords: Cost effectiveness analysis; Economic analysis; Global health; Health systems strengthening; Resource allocation