Spillover effects on health outcomes in low- and middle-income countries: a systematic review

Jade Benjamin-Chung, Jaynal Abedin, David Berger, Ashley Clark, Veronica Jimenez, Eugene Konagaya, Diana Tran, Benjamin F Arnold, Alan E Hubbard, Stephen P Luby, Edward Miguel and John M Colford

Department of Economics, Working Paper Series from Department of Economics, Institute for Business and Economic Research, UC Berkeley

Abstract: Background Many interventions delivered to improve health may benefit not only direct recipients but also people in close physical or social proximity. Our objective was to review all published literature about the spillover effects of interventions on health outcomes in low-middle income countries and to identify methods used in estimating these effects. Methods We searched 19 electronic databases for articles published before 2014 and hand-searched titles from 2010 to 2013 in five relevant journals. We adapted the Cochrane Collaboration's quality grading tool for spillover estimation and rated the quality of evidence. Results A total of 54 studies met inclusion criteria. We found a wide range of terminology used to describe spillovers, a lack of standardization among spillover methods and poor reporting of spillovers in many studies. We identified three primary mechanisms of spillovers: reduced disease transmission, social proximity and substitution of resources within households. We found the strongest evidence for spillovers through reduced disease transmission, particularly vaccines and mass drug administration. In general, the proportion of a population receiving an intervention was associated with improved health. Most studies were of moderate or low quality. We found evidence of publication bias for certain spillover estimates but not for total or direct effects. To facilitate improved reporting and standardization in future studies, we developed a reporting checklist adapted from the CONSORT framework specific to reporting spillover effects. Conclusions We found the strongest evidence for spillovers from vaccines and mass drug administration to control infectious disease. There was little high quality evidence of spillovers for other interventions.

Keywords: Prevention, Good Health and Well Being, Developing Countries, Disease Transmission, Infectious, Health Promotion, Humans, Social Support, Socioeconomic Factors, Vaccination, Spillover effects, indirect effects, herd effects, herd immunity, diffusion, externalities, interference, Spillover effects; indirect effects; herd effects; herd immunity; diffusion; externalities; interference, Statistics, Public Health and Health Services, Epidemiology (search for similar items in EconPapers)
Date: 2017-08-01
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Citations: View citations in EconPapers (7)

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Related works:
Working Paper: Spillover effects on health outcomes in low- and middle-income countries: a systematic review (2019)
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