Abstract
OBJECTIVE: To develop new DALY-based indices for measuring productivity loss, health system resilience, and resource allocation efficiency for liver cancer across eight MENA countries. These will be combined into the Integrated Health-Adjusted Productivity Index (IHAPI) to aid health policy development. SETTING: The final analysis utilized 289,067 data entries from a total of 394,944, including information from Egypt, Iran, Jordan, Kuwait, Turkey, Saudi Arabia, Oman, and the UAE from 2000 to 2021. DESIGN: This study adopted a cross-country approach, employing secondary data to develop six composite measures: the Health-Adjusted Productivity Loss Index (HAPLI), the Economic Vulnerability to Health Impact Index (EVHI), the Relative Resilience to Liver Cancer Loss Index (RLCL), the Resource Allocation Efficiency Index (RAEI), the Health System Response Index (HSRI), and the Sustainable Development Health Equity Index (SD-HEI). These measures were aggregated into the IHAPI score. RESULTS: The analysis revealed that the most significant factor influencing the IHAPI score was the EVHI (feature importance = 0.73). Egypt exhibited the highest growth in Disability-Adjusted Life Years (DALY), leading to substantial productivity loss (HAPLI), while Saudi Arabia and Jordan demonstrated greater resilience (as indicated by higher RLCL scores and less variability in the IHAPI). The UAE and Turkey reported strong HSRI and Productivity Performance Index (PPI) rates, suggesting better-coordinated preventive investments. Conversely, the highest variability in the indices was observed in Iran and Oman, particularly in the SD-HEI and Total Productivity Loss and Inequality Index (TPLTI), indicating unstable equity and trends. Kuwait exhibited moderate performance in burden and resource allocation indices. CONCLUSION: This paper presents an integrative model for evaluating both economic and health system impacts of liver cancer in MENA countries. The IHAPI and its related indices provide valuable insights that can be implemented to enhance equity, efficiency, and resilience in health policy.