Health screening for emerging non-communicable disease burdens among the global poor: Evidence from sub-Saharan Africa

•Evidence lacks on the effectiveness of NCD health screenings in low-income contexts.•We show sustained effects of referrals given to persons with high blood pressure.•Recipients of referral letters have a lower blood pressure, and lower probability of being hypertensive by about 22 percentage point...

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Veröffentlicht in:Journal of health economics 2021-01, Vol.75, p.102388-102388, Article 102388
Hauptverfasser: Ciancio, Alberto, Kämpfen, Fabrice, Kohler, Hans-Peter, Kohler, Iliana V.
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Sprache:eng
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Zusammenfassung:•Evidence lacks on the effectiveness of NCD health screenings in low-income contexts.•We show sustained effects of referrals given to persons with high blood pressure.•Recipients of referral letters have a lower blood pressure, and lower probability of being hypertensive by about 22 percentage points four years later.•Key findings agree across regression discontinuity and matching estimators. Evidence for the effectiveness of population health screenings to reduce the burden of non-communicable diseases in low-income countries remains very limited. We investigate the sustained effects of a health screening in Malawi where individuals received a referral letter if they had elevated blood pressure. Using a regression discontinuity design and a matching estimator, we find that receiving a referral letter reduced blood pressure and the probability of being hypertensive by about 22 percentage points four years later. These lasting effects are explained by a 20 percentage points increase in the probability of being diagnosed with hypertension. There is also evidence of an increase in the uptake of medication, while we do not identify improvements in hypertension-related knowledge or risk behaviors. On the contrary, we find an increase in sugar intake and a decrease in physical activity both of which are considered risky behaviors in Western contexts. The health screening had some positive effects on mental health. Overall, this study suggests that population-based hypertension screening interventions are an effective tool to improve health in low-income contexts.
ISSN:0167-6296
1879-1646
DOI:10.1016/j.jhealeco.2020.102388