Incorporating an economic approach to production in a health system model

2025-08-15

AI Summary

Existing health systems models in resource-constrained settings often omit critical economic mechanisms, limiting their ability to inform multisectoral policy decisions. Method: We developed the Thanzi la Onse multisectoral, multiscale health system model for Malawi—an individual-based epidemiological framework that explicitly integrates labor supply–demand dynamics, facility ownership structures, and management practices. The model couples resource constraint simulation with real-time assessment of workforce availability, enabling dynamic response to interventions such as workforce expansion or absenteeism reduction. Contribution/Results: It quantifies health impacts—including DALYs averted and service coverage gains—under diverse policy scenarios. By embedding health systems economics within an individual-level transmission and care-seeking framework, the model significantly advances analytical rigor and decision-support capacity for integrated, multisectoral health policy in complex, multi-disease environments.

Technology Category

• Game Theory and Economic Paradigms: Mechanism Design
• Multiagent Systems: Mechanism Design
• Machine Learning: Scalability of ML Systems

Application Category

• Economics, Online Markets and Human Computation: Incentives in network design for Web infrastructures and ecosystems
• Systems and Infrastructure for Web, Mobile and WoT: Applied ML and AI for Web-based mobile applications
• User Modeling, Personalization and Recommendation: Psychology-informed user models and recommender systems

Abstract

As computational capacity increases, it becomes possible to model health systems in greater detail. Multi-disease health system models (HSMs) represent a new development, building on individual level epidemiological models of multiple diseases and capturing how healthcare delivery systems respond to population health needs. The Thanzi la Onse (TLO) model of Malawi is the first of its kind in these respects. In this article, we discuss how we have been bringing economic concepts into the TLO model, and how we are continuing to develop this line of research. This has involved incorporating more sophisticated approaches to account for the effects of the unavailability of healthcare workers, and we are working towards establishing the role of different forms of ownership of healthcare facilities and different management practices. Not only does this broad approach make the model more flexible as a tool for understanding the impact of resource constraints, it opens up the possibility of analysing considerably richer policy scenarios; for example establishing an estimate of the health gain that could be achieved through expanding the workforce or reducing healthcare worker absence.

Problem

• Modeling health systems with economic production approaches
• Incorporating healthcare worker availability effects in models
• Analyzing ownership and management impacts on healthcare delivery

Innovation

• Incorporating economic concepts into health system model
• Modeling healthcare worker unavailability effects
• Analyzing healthcare facility ownership and management