Abstract This paper reviews the worldwide use of utility values in healthcare systems and highlights their relevance for strengthening evidence-based decision-making in Africa. Utility values, commonly measured through preference-based instruments such as the EQ-5D, quantify health-related quality of life and support the calculation of quality-adjusted life years (QALYs), which are essential for economic evaluation, health technology assessment, reimbursement decisions, and resource allocation. Following the PRISMA methodology, this systematic review examined studies published between 1990 and December 2023 in PubMed, Scopus, and Web of Science. A total of 69 studies involving 151,633 participants from 46 countries were included. The review shows that EQ-5D utility values are widely available in Europe, Asia, the Americas, and Oceania, while their use remains limited in Africa. Findings also reveal important cross-country variations in the prioritization of health dimensions, particularly mobility, pain/discomfort, and anxiety/depression. These variations reflect cultural, socioeconomic, and healthcare system differences. The paper argues that promoting the use of utility values in African healthcare systems can improve cost-effectiveness analysis, patient-centered care, priority-setting, and equitable resource allocation. It concludes that expanding local utility data is essential for designing interventions adapted to African health priorities and constraints.
Marfak et al. (Thu,) studied this question.
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