HealthSim Version 4.1 · Quality assurance

Build and Understand Healthcare Systems · Question-driven systems thinking

Scientific transparency: All scenarios, shock effects and regional profiles are fictional. Capacity, access, and equity scores are simplified teaching indicators, not validated estimates of health outcomes. No real maternal mortality reduction is calculated.

1 · Define the country

Annual health budget: . You allocate the portion reserved for new investments; existing services are represented in the starting regional capacity.

2 · Ask Before You Act

Select the questions you would investigate before planning a maternal health system reform.

3 · Build the regional health system

Select a region, then invest in its service levels and workforce

Costs: Level 1 PHC centre $2M/year · Level 2 hospital $12M/year · Level 3 hospital $30M/year · midwife team $0.5M/year · referral network $3M/year. All are illustrative annual operating-equivalent costs. The model does not yet verify specialty workforce, case mix, catchment populations or real tertiary referral flows. Investments persist through the selected simulation horizon. Removing an existing service is assumed to release its illustrative annual operating cost, but may reduce access and resilience; real-world closure costs, staff redeployment, and political constraints are not modeled.

Annual investment ceiling (8% of health budget): Committed: · Remaining:

4 · Scenario Comparison Lab

Same country, different decisions. Configure facilities, NCD policies and governance; choose a time horizon; then save a scenario. Change your strategy and save another. Compare up to three strategies side by side.

No scenarios saved yet. Set up a strategy in Sections 3 and 6, then save it here.

Saved strategyHorizonAnnual investmentAccessEquity gapActions

Comparison indicators are illustrative teaching outputs, not epidemiological forecasts. All scenarios are compared using the same country baseline and time horizon; the simulation will warn if baseline inputs have changed.

5 · Results Dashboard

All simulation outputs appear here and in Section 6. Change the time horizon using the persistent Simulation Control Center above, then press Run ALL simulations.

Illustrative additional annual programme costs: immunization outreach $3M, screening expansion $4M. They are constrained by the same investment ceiling. Coverage gains are hypothetical, not empirically calibrated.

Press Run Integrated Simulation to calculate the annual pathway.

YearAnnual costWeighted accessEquity gapImmunization coverageScreening coverageLagged prevention signal*

*Lagged prevention signal is an illustrative implementation/benefit-readiness index (0–100), not avoided cases, mortality reduction or cost savings. Screening and immunization have different disease-specific lag structures; these must be calibrated separately.

Regional results

RegionBaselinePlannedNeed-adjusted access

What changed — and why?

6 · NCD prevention, governance & pandemic resilience

Step 1: Select risk-factor interventions and governance policies below. Step 2: Set the years in the top toolbar. Step 3: Click Run ALL simulations at the top; the page will take you to the results. Individual simulation buttons remain available for focused experiments.
6A · Four major NCD groups & five shared risk factors

Select multiple interventions. The four disease-group pathways respond to shared risk factors, dedicated care programmes, and tobacco policy governance. Outputs are synthetic programme-readiness and exposure indices, not projected disease cases or deaths.

Shared modifiable risk factors

Four major NCD groups

6B · Integrated Policy & Governance — all five risk factors

Select specific instruments for each risk factor. Each has its own adoption, implementation and enforcement settings. Policies influence the synthetic risk pathway only when the corresponding risk-factor programme above is selected. All costs are illustrative annual USD millions.

Governance componentWhat it means in the simulation
AdoptionLegal/policy commitment; cannot deliver full impact without implementation
ImplementationOperational delivery, staff, systems and programme execution
EnforcementCompliance and regulatory follow-through
CoordinationSmall illustrative improvement to delivery; requires funding

All programme and governance costs are annual USD millions, illustrative, and count toward the same 8% investment ceiling. Interventions take effect gradually; during a pandemic, disrupted essential services slow clinical programme delivery.

Select interventions and run the simulation to see four disease-group pathways.
YearShared risk reduction indexCVD readinessCancer readinessRespiratory readinessDiabetes readinessEssential care continuity

Why did results change?

Choose a combination of risk-factor policies and disease-group programmes.


6B · Disease-specific programmes & pandemic response

Plan hypertension, diabetes, cancer screening and tobacco prevention alongside a COVID-like respiratory pandemic. This is a transparent illustrative systems-thinking exercise, not a validated epidemiological forecast.

Choose a disease or prevention programme

Select a programme, edit its starting conditions, and enable its intervention. You may enable several programmes by switching between them; selections are retained.

Hypertension — detection and control

Selected: Hypertension

Results are illustrative programme coverage trajectories, not predictions of incidence, mortality or cost-effectiveness.

Unexpected respiratory pandemic

Budget rule: Recurring NCD and preparedness costs count against the same annual investment ceiling. Emergency response costs are funded from a separate temporary emergency appropriation and are reported transparently; they are not assumed to be free.

Run the simulation to reveal the emergency year and consequences.

YearEventHTN screeningHTN controlEssential care continuityHospital pressure indexAnnual emergency cost

Selected disease: annual results

Choose a disease and click Run selected disease simulation.

YearProgramme indicatorEssential care continuityEvent

Multi-disease NCD programme results

YearDiabetes screeningCervical screeningBreast screeningTobacco policy implementation*Continuity

*Tobacco policy implementation is a synthetic 0–100 index, not smoking prevalence. Cancer screening coverage is not cancer incidence or mortality. Programmes may experience disruption during the pandemic.

Explain the trade-offs

Hospital pressure is a synthetic index, not hospital occupancy. Hypertension control is a hypothetical programme indicator, not an estimate of avoided strokes, deaths, QALYs or cost savings. Recovery may extend beyond the shock year.

Scenario interpretation & policy reflection

Scenario interpretation: Run ALL simulations to interpret your decisions and results.

Levels of care — your investment strategy

Run ALL simulations to assess the balance of primary, secondary and tertiary care, workforce and referrals.

Health equity — your regional trade-offs

Run ALL simulations to assess population-weighted access and the gap between highest- and lowest-scoring regions.

Policy reflection

Run ALL simulations to receive a question about your investment choices.

Scientific note: HealthSim is an educational simulation using illustrative assumptions and synthetic indicators. Results are not validated clinical, epidemiological or economic forecasts and should not be used for policy decisions without empirical calibration and validation.