ORCID Profile
0000-0002-3243-9523
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In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Government and Politics of Asia and the Pacific | Economic Development and Growth | Health Economics | Applied Economics |
International Aid and Development | Health Policy Evaluation
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.SOCSCIMED.2013.12.026
Abstract: Sector Wide Approaches (SWAp) emerged during the 1990s as a new policy mechanism for aid delivery. Eschewing many features of traditional project-based aid, SWAps give greater control of aid allocation to recipient countries. Some critics have questioned whether reducing a donor's level of influence over aid allocation might lead to a decrease in donor contributions. While some qualitative evaluations have described the level of fund pooling and donor participation in SWAps, no previous study has empirically examined this potential 'donor-flight' response to health SWAp implementation. This paper utilises a uniquely compiled dataset of 46 low-income countries over 1990-2009 and a variety of panel data regression models to estimate the impact of health SWAp implementation on levels of health aid. Results suggest that amongst 16 especially poor low-income countries, SWAp implementation is associated with significant decreases in health aid levels compared with non-implementers. This suggests donors are not indifferent to how their contributions are allocated by recipients, and that low-income countries considering a SWAp may need to weigh the benefits of greater control of aid allocations against the possibility of reduced aid income.
Publisher: Frontiers Media SA
Date: 19-03-2019
Publisher: Elsevier BV
Date: 04-2021
Publisher: Springer Science and Business Media LLC
Date: 28-01-2020
DOI: 10.1007/S11136-019-02382-8
Abstract: In the original publication of the article, the equation CHU9D
Publisher: Elsevier BV
Date: 11-2021
Publisher: Springer Science and Business Media LLC
Date: 29-03-2019
DOI: 10.1038/S41366-019-0341-0
Abstract: The objective of this study is to examine, from a limited societal perspective, the cost-effectiveness of community-based obesity prevention interventions (CBIs)-defined as a programme of community-level strategies to promote healthy eating and physical activity for Australian children (aged 5-18 years). The effectiveness of CBIs was determined by undertaking a literature review and meta-analysis. Commonly implemented strategies to increase physical activity and improve nutrition were costed (in 2010 Australian dollars) to determine the average cost of a generic programme. A multiple cohort Markov model that simulates diseases associated with overweight and obesity was used to estimate the health benefits, measured as health-adjusted life years (HALYs) and healthcare-related cost offsets from diseases averted due to exposure to the intervention. Health and cost outcomes were estimated over the lifetime of the target population. Monte-Carlo simulation was used to assess second-order uncertainty of input parameters to estimate mean incremental cost-effectiveness ratios (ICER) with 95% uncertainty intervals (UIs). Scenario analyses tested variations in programme intensity, target population, and duration of effect. The meta-analysis revealed a small but significant difference in BMI z-score (mean difference of - 0.07 (95% UI: - 0.13 to - 0.01)) favouring the CBI community compared with the control. The estimated net cost of implementing CBIs across all local government areas (LGAs) in Australia was AUD426M (95% UI: AUD3M to AUD823M) over 3 years. This resulted in 51,792 HALYs gained (95% UI: 6816 to 96,972) over the lifetime of the cohort. The mean ICER was AUD8155 per HALY gained (95% UI: AUD237 to AUD81,021), with a 95% probability of being cost-effective at a willingness to pay threshold of AUD50,000 per HALY. CBIs are cost-effective obesity prevention initiatives however, implementation across Australia will be (relatively) expensive when compared with current investments in preventive health.
Publisher: Elsevier BV
Date: 10-2023
Publisher: Wiley
Date: 14-09-0009
DOI: 10.1111/OBR.12683
Abstract: System-based interventions are of increasing interest as they seek to modify environments (e.g. socio-cultural system, transport system or policy system) that promote development of conditions such as obesity and its related risk factors. In our commentary, we draw attention to features of the system-based approach that may explain the relative absence of economic evaluations of the cost-effectiveness of these interventions, needed to guide decision-making on which to deploy. We present and discuss potentially applicable methods and alternative approaches based on our experiences in two major system-based interventions currently underway (in Melbourne, Australia and Gaggenau, Germany) that begin to fill this gap. We feel the issues and potential solutions outlined in this commentary are important for a broad range of stakeholders (e.g. clinicians, interventionalists, policy makers) to consider as they seek to address the issue of obesity.
Publisher: Frontiers Media SA
Date: 03-09-2019
Publisher: Wiley
Date: 30-03-2023
DOI: 10.1002/HEC.4683
Abstract: Non‐communicable diseases (NCDs) disproportionately affect people in low‐ and middle‐income countries (LMICs), yet context‐specific evidence on policies that impact NCD risk factors is lacking. We estimate the impact of a massive Indonesian primary school expansion program in the 1970s on NCD risk factors in later life using data from two surveys with very large s le sizes. We find that in non‐Java regions of Indonesia, the program led to significant increases in the likelihood of overweight and high waist circumference among women, but not among men. The increase for women can be partly explained by increased consumption of high‐calorie packaged and take‐away meals. We find no meaningful impacts on high blood pressure for either sex. Despite the increase in body weight, the program had a negligible impact on diabetes and cardiovascular disease diagnosis. It led to an improvement in women's self‐reported health outcomes in their early‐40s, but these benefits largely disappeared once they reached their mid‐40s.
Publisher: BMJ
Date: 05-2018
Publisher: Elsevier BV
Date: 06-2010
DOI: 10.1016/J.VACCINE.2010.04.063
Abstract: To measure immunization coverage among children aged 12-23 months in Papua New Guinea (PNG) and to assess if and why there are differences between hard-to-reach and more accessible communities. WHO cluster s ling methodology was employed to measure immunization coverage in PNG's four regions. Survey data were re-analyzed according to a local assessment of geographical accessibility indicated by census unit type: urban, rural and hard-to-reach. Census units were designated as hard-to-reach if they were five or more km from a health centre. Nationwide coverage for most antigens falls below the national target of 80% although there are regional differences with Islands performing the best. Late doses are a major concern: just 4% were fully immunized with valid ("on time") doses by 1 year of age. Coverage was lower in both rural and remote communities: at 6 months 48% of children from urban units had received three valid doses of DTP-3 but only 16% in rural areas and 13% in hard-to-reach communities. Reasons for failure to immunize varied: 21% of mothers said their child was not immunized because distance, travel conditions or cost of transportation prevented access to local health centres 27% cited a lack of knowledge or misconceptions about immunization while 29% believed it was because of an issue with the health system. Throughout PNG there is an urgent need to increase immunization coverage and to ensure that children are immunized on time according to the schedule. Both coverage and timeliness of doses are worse for children living in hard-to-reach and rural areas. Achieving national immunization targets requires improvements in health service delivery, including outreach, especially for remote and rural communities, as well as greater community education and social mobilisation in support of immunization services.
Publisher: Elsevier BV
Date: 09-2019
Publisher: Cold Spring Harbor Laboratory
Date: 05-01-2022
DOI: 10.1101/2022.01.03.22268695
Abstract: To examine the association between household members and their tobacco smoking behaviour on patterns of smoking cessation and relapse. Data was sourced from 19 waves (years 2001 to 2019) of the nationally representative Household Income and Labour Dynamics in Australia (HILDA) survey, with all household members 15 years or older completing the survey annually. The final s le included, on average, 3,056 ex-smokers and 2,612 smokers per wave. Self-reported annual smoking status was used to construct measures of smoking cessation and relapse. Information on household structure and relationships was then used to develop variables describing the presence of household members and their smoking status by relationship to the in idual (i.e., child, parent, spouse, sibling, or other). Multivariate regression analyses were then used to predict the likelihood of smoking cessation and relapse controlling for the presence of other household members and their smoking status, sociodemographic characteristics, number of cigarettes smoked per day, previous quit attempts, and years abstained from smoking. In iduals that lived with non-smokers were more likely to quit [OR1.22 (95%CI 1.11 .34)] relative to those living alone. However, this favourable association was negated if living with another smoker, which was associated with a reduced likelihood of smoking cessation [OR0.77 (95%CI 0.72 .83)] and a higher likelihood of relapse [1.37 (95%CI 1.22 .53)]. In particular, living with a spouse or parent that smoked reduced the likelihood of smoking cessation [OR0.71 (95%CI 0.65 .78) and OR0.71 (95%CI 0.59 .84), respectively] and increased the likelihood of relapse [OR1.47 (95%CI 1.28 .69) and OR1.39 (95%CI 1.00 .94) respectively] relative to living with their non-smoking counterparts. Household composition and intrahousehold smoking behaviour should be considered when delivering, or estimating the benefits of, smoking cessation interventions. Interventions which encourage smoking cessation at the household level may assist in iduals to quit and abstain from smoking.
Publisher: Wiley
Date: 27-05-2021
DOI: 10.1002/JID.3548
Abstract: The effectiveness of health aid remains contested. Previous estimates fail to distinguish between fragmented, poorly‐targeted aid and aid disbursed under aid effectiveness principles. To address this gap, we investigated whether the sector‐wide approach (SWAp), a mechanism for aid delivery built on aid effectiveness principles, has delivered improvements in aid effectiveness and infant mortality. Results suggest that SWAp implementation facilitated a 5.8% to 8.1% reduction in the infant mortality rate compared to non‐implementing countries. This effect likely operates by releasing domestic resources and/or increasing the efficiency with which domestic resources are converted into health gains. Development partners should take heart that the aid effectiveness agenda appears to have paid idends in the health sector.
Publisher: Springer Science and Business Media LLC
Date: 19-11-2019
DOI: 10.1007/S11136-019-02357-9
Abstract: The Paediatric Quality of Life Inventory To develop a mapping algorithm for converting the 23-item PedsQL instrument onto the CHU9D instrument and provide an external validation of two recently published algorithms that might be considered alternatives. Data from children in the Longitudinal Study of Australian Children (LSAC) were used (N = 1801). Six econometric methods were compared to identify the best algorithms, assessed against a series of goodness-of-fit criteria. The same data and goodness-of-fit criteria were used in the external validation exercise for previously published mapping algorithms. The optimal mapping algorithm was identified, which used PedsQL dimension scores to predict the CHU9D utilities. It performed well against standard goodness-of-fit tests. The external validation exercise revealed the recently published alternative algorithms also performed relatively well. The identified mapping algorithms can be used to facilitate cost-utility analysis in comparable populations when only the PedsQL instrument is available. Results from this population indicate the algorithms identified in this paper are well suited for estimating CHU9D self-report utilities when the full 23-item self-report PedsQL instrument has been used.
Publisher: Elsevier BV
Date: 07-2014
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.JVAL.2018.07.006
Abstract: There is an implicit equity approach in cost-effectiveness analysis that values health gains of socioeconomic position groups equally. An alternative approach is to integrate equity by weighting quality-adjusted life-years according to the socioeconomic position group. To use two approaches to derive equity weights for use in cost-effectiveness analysis in Australia, in contexts in which the use of the traditional nonweighted quality-adjusted life-years could increase health inequalities between already disadvantaged groups. Equity weights derived using epidemiological data used burden of disease and mortality data by Socio-Economic Indexes for Areas quintiles from the Australian Institute of Health and Welfare. Two ratios were calculated comparing quintile 1 (lowest) to the total Australian population, and comparing quintile 1 to quintile 5 (highest). Preference-based weights were derived using a discrete choice experiment survey (n = 710). Respondents chose between two programs, with varying gains in life expectancy going to a low- or a high-income group. A probit model incorporating nominal values of the difference in life expectancy was estimated to calculate the equity weights. The epidemiological weights ranged from 1.2 to 1.5, with larger weights when quintile 5 was the denominator. The preference-based weights ranged from 1.3 (95% confidence interval 1.2-1.4) to 1.8 (95% confidence interval 1.6-2.0), with a tendency for increasing weights as the gains to the low-income group increased. Both methods derived plausible and consistent weights. Using weights of different magnitudes in sensitivity analysis would allow the appropriate weight to be considered by decision makers and stakeholders to reflect policy objectives.
Publisher: BMJ
Date: 2021
DOI: 10.1136/BMJOPEN-2020-042850
Abstract: Increasing urban populations have led to the growth of informal settlements, with contaminated environments linked to poor human health through a range of interlinked pathways. Here, we describe the design and methods for the Revitalising Informal Settlements and their Environments (RISE) study, a transdisciplinary randomised trial evaluating impacts of an intervention to upgrade urban informal settlements in two Asia-Pacific countries. RISE is a cluster randomised controlled trial among 12 settlements in Makassar, Indonesia, and 12 in Suva, Fiji. Six settlements in each country have been randomised to receive the intervention at the outset the remainder will serve as controls and be offered intervention delivery after trial completion. The intervention involves a water-sensitive approach, delivering site-specific, modular, decentralised infrastructure primarily aimed at improving health by decreasing exposure to environmental faecal contamination. Consenting households within each informal settlement site have been enrolled, with longitudinal assessment to involve health and well-being surveys, and human and environmental s ling. Primary outcomes will be evaluated in children under 5 years of age and include prevalence and ersity of gastrointestinal pathogens, abundance and ersity of antimicrobial resistance (AMR) genes in gastrointestinal microorganisms and markers of gastrointestinal inflammation. Diverse secondary outcomes include changes in microbial contamination abundance and ersity of pathogens and AMR genes in environmental s les impacts on ecological bio ersity and microclimates mosquito vector abundance anthropometric assessments, nutrition markers and systemic inflammation in children caregiver-reported and self-reported health symptoms and healthcare utilisation and measures of in idual and community psychological, emotional and economic well-being. The study aims to provide proof-of-concept evidence to inform policies on upgrading of informal settlements to improve environments and human health and well-being. Study protocols have been approved by ethics boards at Monash University, Fiji National University and Hasanuddin University. ACTRN12618000633280 Pre-results.
Publisher: Elsevier BV
Date: 10-2021
Publisher: Elsevier BV
Date: 08-2009
DOI: 10.1111/J.1753-6405.2009.00407.X
Abstract: We estimated the cost to the public health system of treating Injecting-Related Injuries and Diseases (IRIDs) in the three most populous states in Australia in the 12 months over 2005/06. We conducted a cost of illness analysis from the perspective of the public health system. Costs of treating IRIDs in the community were estimated from health service utilisation surveys of injecting drug users and physicians (yielding data on Government subsidised physician visits, medicines prescribed and emergency department presentations). Data on admitted hospitalisations in public hospitals due to IRIDs were extracted from State Government databases. Appropriate costs were attached to all Government-borne services and prescriptions to estimate the total cost to the public health system of treating IRIDs in 2005/06 in Queensland, NSW and Victoria. Our estimate of the cost to the public health system of treating IRIDs in Queensland, NSW and Victoria in 2005/06 was $20 million. IRIDs are an under-recognised harm resulting from injecting drug use, but the economic burden of IRIDs in Australia are non-negligible. Research is needed to identify cost effective programs to reduce the clinical and economic burden caused by IRIDs, particularly to reduce hospitalisations due to IRIDs. General practitioners, clinicians and other health workers need to be alert to IRIDs in their injecting drug user clients to prevent progression to more serious disease and consequent elevation of the associated economic costs.
Publisher: Oxford University Press (OUP)
Date: 30-11-2023
DOI: 10.1093/NTR/NTAC270
Abstract: This study estimates the extent to which in iduals’ smoking cessation and relapse patterns are associated with the smoking behavior of their household members. Longitudinal data on household members’ smoking behavior was sourced from a representative s le of 12 723 Australians who ever reported smoking between 2001 and 2019. Controlling for a rich set of confounders, multivariate regression analyses were used to predict the likelihood of smoking cessation and relapse given other household members’ smoking status and their relationship type. The models were then used to forecast smoking prevalence over 10 years across different household types. In iduals living with a smoking spouse were less likely to quit (OR 0.77 [95% CI 0.72 .83]) and more likely to relapse (OR 1.47 [95% CI 1.28 .69]) compared to those living with nonsmoking spouses. Subsequently, the proportion of smokers living with other smoking household members increased by 15% between 2011 and 2019. A 10-year forecast using the smoking cessation and relapse models predicts that, on average, smokers living with nonsmokers will reduce by 43%, while those living alone or with a smoking partner will only reduce by 26% and 28% respectively. Over time, those who are still smoking are more likely to live with other smokers. Therefore, the current cohort of smokers is increasingly less likely to quit and more likely to relapse. Smoking projection models that fail to account for this dynamic risk may overstate the downstream health benefits and health cost savings. Interventions that encourage smoking cessation at the household level, particularly for spouses, may assist in iduals to quit and abstain from smoking. The current and future paradigm shift in the smoking environment suggests that smoking cessation and relapse prevention policies should consider household structure. Policies designed to affect smoking at the household level are likely to be particularly effective. When estimating the long-term benefits of current smoking policies intrahousehold smoking behavior needs to be considered.
No related organisations have been discovered for Rohan Sweeney.
Start Date: 09-2021
End Date: 05-2025
Amount: $349,127.00
Funder: Australian Research Council
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