Modelling the Cost-Effectiveness of Establishing Specialised Trauma Centres in Nigeria’s North East Zone: A Health Economic Analysis

The North East geopolitical zone of Nigeria bears a disproportionate burden of traumatic injury from conflict, road traffic accidents, and agricultural accidents, yet lacks a single dedicated specialised trauma centre. This dissertation provides a health economic analysis modelling the cost-effectiveness of establishing specialised trauma centres in the North East compared to the status quo of managing trauma at general hospitals. A decision analytic Markov model was constructed using epidemiological, clinical, and cost data derived from primary field surveys in Borno, Adamawa, and Gombe states in 2022 to 2023. Model parameters included trauma incidence rates, disability-adjusted life years (DALYs) lost, case fatality rates, treatment costs, and projected improvements in outcomes from specialised trauma care. Probabilistic sensitivity analysis was applied over a 20-year time horizon from the Nigerian public payer perspective. Establishing two specialised trauma centres in the North East was projected to avert 4,820 DALYs annually at an incremental cost-effectiveness ratio of USD 312 per DALY averted, well below the WHO threshold for Nigeria. Sensitivity analyses confirmed robustness to trauma incidence and capital cost variations. The model demonstrates strong economic justification for trauma centre investment and recommends the Federal Government of Nigeria prioritize trauma centre establishment in the North East as part of the next National Health Sector Development Plan. Keywords: trauma centre, health economics, cost-effectiveness, North East Nigeria, DALY