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Using mathematical modeling to inform health policy: A case study from voluntary medical male circumcision scale-up in eastern and southern Africa and proposed framework for success

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Listed:
  • Emmanuel Njeuhmeli
  • Melissa Schnure
  • Andrea Vazzano
  • Elizabeth Gold
  • Peter Stegman
  • Katharine Kripke
  • Michel Tchuenche
  • Lori Bollinger
  • Steven Forsythe
  • Catherine Hankins

Abstract

Background: Modeling contributes to health program planning by allowing users to estimate future outcomes that are otherwise difficult to evaluate. However, modeling results are often not easily translated into practical policies. This paper examines the barriers and enabling factors that can allow models to better inform health decision-making. Description: The Decision Makers’ Program Planning Tool (DMPPT) and its successor, DMPPT 2, are illustrative examples of modeling tools that have been used to inform health policy. Their use underpinned Voluntary Medical Male Circumcision (VMMC) scale-up for HIV prevention in southern and eastern Africa. Both examine the impact and cost-effectiveness of VMMC scale-up, with DMPPT used initially in global advocacy and DMPPT 2 then providing VMMC coverage estimates by client age and subnational region for use in country-specific program planning. Their application involved three essential steps: identifying and engaging a wide array of stakeholders from the outset, reaching consensus on key assumptions and analysis plans, and convening data validation meetings with critical stakeholders. The subsequent DMPPT 2 Online is a user-friendly tool for in-country modeling analyses and continuous program planning and monitoring. Lessons learned: Through three iterations of the DMPPT applied to VMMC, a comprehensive framework with six steps was identified: (1) identify a champion, (2) engage stakeholders early and often, (3) encourage consensus, (4) customize analyses, (5), build capacity, and (6) establish a plan for sustainability. This framework could be successfully adapted to other HIV prevention programs to translate modeling results to policy and programming. Conclusions: Models can be used to mobilize support, strategically plan, and monitor key programmatic elements, but they can also help inform policy environments in which programs are conceptualized and implemented to achieve results. The ways in which modeling has informed VMMC programs and policy may be applicable to an array of other health interventions.

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  • Emmanuel Njeuhmeli & Melissa Schnure & Andrea Vazzano & Elizabeth Gold & Peter Stegman & Katharine Kripke & Michel Tchuenche & Lori Bollinger & Steven Forsythe & Catherine Hankins, 2019. "Using mathematical modeling to inform health policy: A case study from voluntary medical male circumcision scale-up in eastern and southern Africa and proposed framework for success," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-15, March.
    • Handle: RePEc:plo:pone00:0213605
    DOI: 10.1371/journal.pone.0213605
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    References listed on IDEAS

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    1. Klein, Eili & Laxminarayan, Ramanan & Smith, David L. & Gilligan, Christopher A., 2007. "Economic incentives and mathematical models of disease," Environment and Development Economics, Cambridge University Press, vol. 12(5), pages 707-732, October.
    2. Katharine Kripke & Velephi Okello & Vusi Maziya & Wendy Benzerga & Munamato Mirira & Elizabeth Gold & Melissa Schnure & Sema Sgaier & Delivette Castor & Jason Reed & Emmanuel Njeuhmeli, 2016. "Voluntary Medical Male Circumcision for HIV Prevention in Swaziland: Modeling the Impact of Age Targeting," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-10, July.
    3. Catherine Hankins & Mitchell Warren & Emmanuel Njeuhmeli, 2016. "Voluntary Medical Male Circumcision for HIV Prevention: New Mathematical Models for Strategic Demand Creation Prioritizing Subpopulations by Age and Geography," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-9, October.
    4. Katharine Kripke & Frank Chimbwandira & Zebedee Mwandi & Faustin Matchere & Melissa Schnure & Jason Reed & Delivette Castor & Sema Sgaier & Emmanuel Njeuhmeli, 2016. "Voluntary Medical Male Circumcision for HIV Prevention in Malawi: Modeling the Impact and Cost of Focusing the Program by Client Age and Geography," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-11, July.
    5. Katharine Kripke & Marjorie Opuni & Melissa Schnure & Sema Sgaier & Delivette Castor & Jason Reed & Emmanuel Njeuhmeli & John Stover, 2016. "Age Targeting of Voluntary Medical Male Circumcision Programs Using the Decision Makers’ Program Planning Toolkit (DMPPT) 2.0," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-17, July.
    6. Glasgow, R.E. & Lichtenstein, E. & Marcus, A.C., 2003. "Why Don't We See More Translation of Health Promotion Research to Practice? Rethinking the Efficacy-to-Effectiveness Transition," American Journal of Public Health, American Public Health Association, vol. 93(8), pages 1261-1267.
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