Health Interventions Developing Countries in Asia and the Pacific Should Pursue

Intervention

From: Health Sector Reform in Asia and the Pacific – options for developing countries – Asia Development Bank, 1999

Prioritization factors

Evidence of medical efficacy

Burden of disease

Corrects market failure

Improves equity

Immunization (measles, diphtheria-pertussis-tetanus, polio, hepatitis B, tuberculosis)

12,17; or 25-30 if middle- income country

Micronutrient fortification/ supplementation (iodized salt, vitamin A-fortified sugar, semiannual dose of vitamin A)

3 = Some prospective data
4 = RCT data for vitamin A

Targeted mass antihelminthics

15-30

3 = Data limited

High

Yes

Yes

Oral rehydration solution distribution in communities

25-75; up to 350 if complicated

4 = RCT data convincing

Family planning promotion (contraception, birth spacing)

3 = Somewhat limited study design, albeit good evidence

Breast-feeding and appropriate weaning

25-30

4 = Good prospective design

High

Yes

No

AIDS/STD education

3 = Data inconclusive in every case, good design

Antibiotic treatment of STDs in targeted risk groups

4 = Clinical efficacy certain

Programs to reduce smoking, alcohol, and other drug use

2 = Data not conclusive; social experimental design needed

Tuberculosis control

3-25

4 = Clinical efficacy certain

High

Yes

Yes

Clinical services for pregnancy and delivery care

3 = Prenatal care effective, elements of care

Treatment of acute respiratory tract infections

20-50

4 = Uncertain 4 = Clinicalefficacy very good

High

No

Yes

Cataract removal

20-40

3 = Clinically effective but efficacy in population depends on use/availability of post-op corrective lenses

High

No

Yes