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Global Systematic Review of the Cost-Effectiveness of Indigenous Health Interventions

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  • Blake J Angell
  • Janani Muhunthan
  • Michelle Irving
  • Sandra Eades
  • Stephen Jan

Abstract

Background: Indigenous populations around the world have consistently been shown to bear a greater burden of disease, death and disability than their non-Indigenous counterparts. Despite this, little is known about what constitutes cost-effective interventions in these groups. The objective of this paper was to assess the global cost-effectiveness literature in Indigenous health to identify characteristics of successful and unsuccessful interventions and highlight areas for further research. Methods and Findings: A systematic review of the published literature was carried out. MEDLINE, PSYCINFO, ECONLIT, EMBASE and CINAHL were searched with terms to identify cost-effectiveness evaluations of interventions in Indigenous populations around the world. The WHO definition was followed in identifying Indigenous populations. 19 studies reporting on 27 interventions were included in the review. The majority of studies came from high-income nations with only two studies of interventions in low and middle-income nations. 22 of the 27 interventions included in the analysis were found to be cost-effective or cost-saving by the respective studies. There were only two studies that focused on Indigenous communities in urban areas, neither of which was found to be cost-effective. There was little attention paid to Indigenous conceptions of health in included studies. Of the 27 included studies, 23 were interventions that specifically targeted Indigenous populations. Outreach programs were shown to be consistently cost-effective. Conclusion: The comprehensive review found only a small number of studies examining the cost-effectiveness of interventions into Indigenous communities around the world. Given the persistent disparities in health outcomes faced by these populations and commitments from governments around the world to improving these outcomes, it is an area where the health economics and public health fields can play an important role in improving the health of millions of people.

Suggested Citation

  • Blake J Angell & Janani Muhunthan & Michelle Irving & Sandra Eades & Stephen Jan, 2014. "Global Systematic Review of the Cost-Effectiveness of Indigenous Health Interventions," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-12, November.
    • Handle: RePEc:plo:pone00:0111249
    DOI: 10.1371/journal.pone.0111249
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    References listed on IDEAS

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    1. Anne Magnus & Linda Cobiac & Julie Brimblecombe & Mark Chatfield & Anthony Gunther & Megan Ferguson & Marj Moodie, 2018. "The cost-effectiveness of a 20% price discount on fruit, vegetables, diet drinks and water, trialled in remote Australia to improve Indigenous health," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-19, September.
    2. Gallois, Sandrine & Ambassa, Appolinaire & Ramírez Rozzi, Fernando, 2024. "Indigenous peoples’ health: Culturally grounded evidence from the Baka, Southeastern Cameroon," Social Science & Medicine, Elsevier, vol. 350(C).
    3. Pettigrew, Simone & Jongenelis, Michelle I. & Moore, Sarah & Pratt, Iain S., 2015. "A comparison of the effectiveness of an adult nutrition education program for Aboriginal and non-Aboriginal Australians," Social Science & Medicine, Elsevier, vol. 145(C), pages 120-124.
    4. Jonathan Bullen & Trish Hill-Wall & Kate Anderson & Alex Brown & Clint Bracknell & Elizabeth A. Newnham & Gail Garvey & Lea Waters, 2023. "From Deficit to Strength-Based Aboriginal Health Research—Moving toward Flourishing," IJERPH, MDPI, vol. 20(7), pages 1-20, April.

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