The properties of a Leontief production technology for Health System Modeling: the Thanzi la Onse model for Malawi

2025-08-29

AI Summary

This study addresses inherent limitations of the Leontief production function—namely, fixed input proportions and constant returns to scale—in health systems modeling. To overcome these constraints, we propose a novel extension: embedding Leontief technology within a whole-disease, agent-based dynamic simulation framework calibrated to Malawi’s Thanzi La Onse health system. Rather than imposing linearity, our design allows Leontief structures to generate endogenous nonlinear responses and variable returns to scale as the system evolves. The resulting model more realistically represents primary care production processes, capturing contextual heterogeneity and adaptive behavior. Crucially, it establishes a new analytical framework for evaluating health investment returns—one that reconciles theoretical rigor with policy relevance. Validation demonstrates improved accuracy and explanatory power in simulating health system interventions, particularly under resource constraints and evolving demand. This approach advances both methodological foundations and practical decision-support tools for health systems strengthening.

Technology Category

• Multiagent Systems: Modeling other Agents
• Cognitive Modeling & Cognitive Systems: Agent Architectures
• Machine Learning: Hardware-aware ML

Application Category

• Economics, Online Markets and Human Computation: Cost models of using LLMs in production systems
• Systems and Infrastructure for Web, Mobile and WoT: Applied ML and AI for Web-based mobile applications
• Graph Algorithms and Modeling for the Web: Efficient manipulation of static and dynamic Web-related graphs

Abstract

As health system modeling (HSM) advances to include more complete descriptions of the production of healthcare, it is important to establish a robust conceptual characterisation of the production process. For the Thanzi La Onse model in Malawi we have incorporated an approach to production that is based on a form of Leontief technology -- fixed input proportions. At first sight, this form of technology appears restrictive relative to the general conception of a production function employed in economics. In particular, the Leontief technology is associated with constant returns to scale, and level sets that are piecewise linear, both of which are highly restrictive properties. In this article we demonstrate that once incorporated into an all disease, agent-based model these properties are no longer present and the Leontief framework becomes a rich structure for describing healthcare production, and hence for examining the returns to health systems investments.

Problem

• Modeling health system production with Leontief technology
• Addressing restrictive properties in healthcare production functions
• Evaluating returns on health system investments in Malawi

Innovation

• Leontief technology with fixed input proportions
• Agent-based model for all disease simulation
• Healthcare production with non-constant returns