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Uzochukwu BSC, Okeke C, Ruiz F, Torres-Rueda S, Kazibwe J, Uzochukwu A, Vassall A. Future support on evidence-informed priority setting and situational analysis of the potential role of Health Technology Assessment in Africa to support future pandemic preparedness and response: protocol for a scoping review. Syst Rev 2024; 13:198. [PMID: 39061088 PMCID: PMC11282749 DOI: 10.1186/s13643-024-02610-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/13/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has highlighted the importance of evidence-informed priority setting and situational analysis in pandemic preparedness and response. Health Technology Assessment (HTA) has been identified as an essential tool for evidence-informed decision-making in healthcare. However, the potential role of HTA in pandemic preparedness and response in Africa has yet to be explored. The objective of this scoping review is to ascertain the current understanding of the possible role of HTA in Africa to support future pandemic preparedness and response. METHODS We will conduct a scoping review of literature published between 2010 and 2024. Electronic databases like Embase, PubMed, Scopus, Web of Science, and Google Scholar will be utilized to perform the search. We will also search grey literature sources such as websites of relevant organizations and government agencies. The search will only include studies that were conducted in the English language. Two reviewers will evaluate the titles and abstracts of the publications independently to determine their eligibility using Covidence. Full-text articles will be reviewed for eligibility and data extraction. The data will be extracted using a standardized form. The extracted data will include information on the study design, objectives, methods, findings, and conclusions. The thematic analysis approach will guide the data analysis. Themes and sub-themes will be identified and reported. The review will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. DISCUSSION This scoping review will identify the existing knowledge on the potential role of HTA in Africa to support future pandemic preparedness and response. The findings will aid in identifying deficiencies in knowledge and provide valuable insights for future study. Additionally, they will inform policy-makers and other stakeholders about the potential contribution of the Health Technology Assessment (HTA) in enhancing Africa's readiness and response to pandemics.
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Affiliation(s)
- Benjamin S C Uzochukwu
- Department of Compreparedness and Responsemunity Medicine, University of Nigeria Nsukka, Enugu Campus, Enugu, Nigeria
| | - Chinyere Okeke
- Department of Compreparedness and Responsemunity Medicine, University of Nigeria Nsukka, Enugu Campus, Enugu, Nigeria.
| | - Francis Ruiz
- Department of Global Health & Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Sergio Torres-Rueda
- Department of Global Health & Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Joseph Kazibwe
- Department of Global Health & Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Adaora Uzochukwu
- Department of Management, Faculty of Business Administration, University of Nigeria Nsukka, Enugu Campus, Enugu, Nigeria
| | - Anna Vassall
- Department of Global Health & Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
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Sharma D, Chauhan AS, Guinness L, Mehndiratta A, Dhiman A, Singh M, Prinja S. Understanding the extent of economic evidence usage for informing policy decisions in the context of India's national health insurance scheme: Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (PM-JAY). BMJ Glob Health 2024; 9:e015079. [PMID: 38857943 PMCID: PMC11168173 DOI: 10.1136/bmjgh-2024-015079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/29/2024] [Indexed: 06/12/2024] Open
Abstract
INTRODUCTION Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (PM-JAY) is one of the world's largest tax-funded insurance schemes. The present study was conducted to understand the decision-making process around the evolution (and revision) of health benefit packages (HBPs) and reimbursement rates within PM-JAY, with a specific focus on assessing the extent of use of economic evidence and role of various stakeholders in shaping these policy decisions. METHODS A mixed-methods study was adopted involving in-depth interviews with seven key stakeholders involved in HBP design and reimbursement rates decisions, and a survey of 80 government staff and other relevant stakeholders engaged in the implementation of PM-JAY. The data gathered were thematically analysed, and a coding framework was developed to explore specific themes. Additionally, publicly available documents were reviewed to ensure a comprehensive understanding of the decision-making processes. RESULTS Findings reveal a progressive transition towards evidence-based practices for policy decisions within PM-JAY. The initial version of HBP relied heavily on key criteria like disease burden, utilisation rates, and out-of-pocket expenditures, along with clinical opinion in shaping decisions around the inclusion of services in the HBP and setting reimbursement rates. Revised HBPs were informed based on evidence from a national-level costing study and broader stakeholder consultations. The use of health economic evidence increased with each additional revision with consideration of health technology assessment (HTA) evidence for some packages and reimbursement rates based on empirical cost evidence in the most recent update. The establishment of the Health Financing and Technology Assessment unit further signifies the use of evidence-based policymaking within PM-JAY. However, challenges persist, notably with regard to staff capacity and understanding of HTA principles, necessitating ongoing education and training initiatives. CONCLUSION While substantial progress has been made in transitioning towards evidence-based practices within PM-JAY, sustained efforts and political commitment are required for the ongoing systematisation of processes.
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Affiliation(s)
- Deepshikha Sharma
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Akashdeep Singh Chauhan
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | | | | | | | | | - Shankar Prinja
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Aryankhesal A, Behzadifar M, Bakhtiari A, Shahabi S, Azari S, Darvishi Teli B, Rezapour A, Ehsanzadeh SJ, Behzadifar M. Exploring the landscape of health technology assessment in Iran: perspectives from stakeholders on needs, demand and supply. Health Res Policy Syst 2024; 22:11. [PMID: 38225573 PMCID: PMC10789076 DOI: 10.1186/s12961-023-01097-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 12/20/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND The evaluation of health technologies plays a crucial role in the allocation of resources and the promotion of equitable healthcare access, known as health technology assessment (HTA). This study focuses on Iran's efforts to integrate HTA and aims to gain insights into stakeholder perspectives regarding capacity needs, demand and implementation. METHODS In this study, we employed the HTA introduction status analysis questionnaire developed by the International Decision Support Initiative (iDSI), which has been utilized in various countries. The questionnaire consisted of 12 questions divided into three sections: HTA need, demand and supply. To identify key informants, we conducted a literature review and consulted with the Ministry of Health and Medical Education (MOHME), as well we experts in policy-making, health service provision and HTA. We selected stakeholders who held decision-making positions in the healthcare domain. A modified Persian version of the questionnaire was administered online from September 2022 to January 2023 and was pretested for clarity. The analysis of the collected data involved quantitative methods for descriptive analysis and qualitative methods for thematic analysis. RESULTS In this study, a total of 103 questionnaires were distributed, resulting in a favourable response rate of 61% from 63 participants, of whom 68% identified as male. The participants, when assessing the needs of HTA, rated allocative efficiency as the highest priority, with a mean rating of 8.53, thereby highlighting its crucial role in optimizing resource allocation. Furthermore, healthcare quality, with a mean rating of 8.17, and transparent decision-making, with a mean rating of 7.92, were highly valued for their impact on treatment outcomes and accountability. The importance of budget control (mean rating 7.58) and equity (mean rating 7.25) were also acknowledged, as they contribute to maintaining sustainability and promoting social justice. In terms of HTA demand, safety concerns were identified as the top priority, closely followed by effectiveness and cost-effectiveness, with an expanded perspective on the economy. However, limited access to local data was reported, which arose from various factors including data collection practices, system fragmentation and privacy concerns. The priorities of HTA users encompassed coverage, payment reform, benefits design, guidelines, service delivery and technology registration. Evidence generation involved the participation of medical universities, research centres and government bodies, albeit with ongoing challenges in research quality, data access and funding. The study highlights government support and medical education as notable strengths in this context. CONCLUSIONS This study provides a comprehensive evaluation of Iran's HTA landscape, considering its capacity, demand and implementation aspects. It underlines the vital role of HTA in optimizing resources, improving healthcare quality and promoting equity. The study also sheds light on the strengths of evidence generation in the country, while simultaneously identifying challenges related to data access and system fragmentation. In terms of policy priorities, evidence-based decision-making emerges as crucial for enhancing healthcare access and integrating technology. The study stresses the need for evidence-based practices, a robust HTA infrastructure and collaboration among stakeholders to achieve better healthcare outcomes in Iran.
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Affiliation(s)
- Aidin Aryankhesal
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Meysam Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ahad Bakhtiari
- Health Equity Research Center (HERC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samad Azari
- Hospital Management Research Center, Health Management Research Institute, University of Medical Sciences, Tehran, Iran
| | - Banafshe Darvishi Teli
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Health Management Research Institute, Iran, University of Medical Sciences, Tehran, Iran
| | - Seyed Jafar Ehsanzadeh
- English Language Department, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
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Ravinetto R, Henriquez R, Srinivas PN, Bradley H, Coetzee R, Ochoa TJ, Semuto Ngabonziza JC, Mazarati JB, Van Damme W, van de Pas R, Vandaele N, Torreele E. Shaping the future of global access to safe, effective, appropriate and quality health products. BMJ Glob Health 2024; 9:e014425. [PMID: 38195155 PMCID: PMC10807033 DOI: 10.1136/bmjgh-2023-014425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 12/10/2023] [Indexed: 01/11/2024] Open
Affiliation(s)
- Raffaella Ravinetto
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
- School of Public Health, University of the Western Cape, Cape Town, Western Cape, South Africa
| | - Rodrigo Henriquez
- Maestría de Epidemiología y Salud Colectiva, Universidad Andina Simón Bolívar, Quito, Ecuador
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Hazel Bradley
- School of Public Health, University of the Western Cape, Cape Town, Western Cape, South Africa
| | - Renier Coetzee
- School of Public Health, University of the Western Cape, Cape Town, Western Cape, South Africa
| | - Theresa J Ochoa
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jean Claude Semuto Ngabonziza
- Research, Innovation and Data Science Division, Rwanda Biomedical Center, Kigali, Rwanda
- Department of Clinical Biology, University of Rwanda, Kigali, Rwanda
| | | | - Wim Van Damme
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | | | - Nico Vandaele
- Access-To-Medicines Research Centre, KU Leuven, Leuven, Belgium
| | - Els Torreele
- , Institute for Innovation and Public Purpose, University College London, London, UK
- Independent Researcher and Advisor, Geneva, Switzerland
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Mundy L, Maddern G. HTA capacity building in Asia: towards one goal. Int J Technol Assess Health Care 2023; 39:e56. [PMID: 37581298 DOI: 10.1017/s0266462323000405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
OBJECTIVES The aim of the 2022 Health Technology Assessment International (HTAi) Asia Policy Forum (APF) was to discuss experiences and challenges around health technology assessment (HTA) capacity building for both HTA agencies and companies in the Asia region and to identify possible solutions as part of a capacity building roadmap. METHODS Discussions during the 2022 APF, informed by a pre-meeting survey of HTA agencies and industry attendees from the region, form the basis of this paper. RESULTS HTA is an essential element of priority-setting in healthcare; however, the scarcity of skilled technical HTA practitioners is a rate-limiting step in the conduct of HTA. The lack of investment in HTA and the political will to mandate the use of HTA in decision-making may be due to a lack of understanding of the value of the HTA process, and how HTA is interpreted and used in the healthcare decision-making process. CONCLUSIONS Increased demand for HTA is created when the value of HTA is recognized. HTA capacity-building challenges may be mitigated by educating stakeholders, particularly policymakers, on the value of, and the need to invest in, HTA as a transparent process to ensure equitable access to health care for all. Investigating a means of funding and implementing an HTA intern program between agencies, in partnership with industry, to facilitate a supportive environment to foster HTA skills and knowledge, build capacity or strengthen existing capacity should be a priority.
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Affiliation(s)
- Linda Mundy
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Guy Maddern
- Chair, HTAi Asia Policy Forum, Discipline of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Woodville South, Australia
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Behzadifar M, Behzadifar M, Saran M, Shahabi S, Bakhtiari A, Azari S, Bragazzi NL. The role of Iran's context for the development of health technology assessment: challenges and solutions. HEALTH ECONOMICS REVIEW 2023; 13:23. [PMID: 37079131 PMCID: PMC10116738 DOI: 10.1186/s13561-023-00438-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 04/14/2023] [Indexed: 05/03/2023]
Abstract
Health technology assessment (HTA) is a comprehensive and structured evaluation that aims to analyze the potential impacts of health technologies, including medical devices, diagnostic tools, pharmaceuticals, and public health interventions. Its purpose is to provide policymakers with evidence-based information to inform decisions related to the utilization and implementation of these technologies. HTA allows for the comparison of various scenarios related to a technology across a wide range of factors. This can aid in the creation of an essential drug list and health benefits package that is tailored to the actual needs of the community within a given healthcare system. In the present paper, we review the role of Iran's context for the development of HTA, in terms of challenges and solutions.
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Affiliation(s)
- Meysam Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Maryam Saran
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahad Bakhtiari
- Health Equity Research Center (HERC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Samad Azari
- Research Center for Emergency and Disaster Resilience, Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran
| | - Nicola Luigi Bragazzi
- Human Nutrition Unit Department of Food and Drugs, University of Parma Medical School, Building C, Via Volturno, 39, 43125 Parma, Italy
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Falkowski A, Ciminata G, Manca F, Bouttell J, Jaiswal N, Farhana Binti Kamaruzaman H, Hollingworth S, Al-Adwan M, Heggie R, Putri S, Rana D, Mukelabai Simangolwa W, Grieve E. How Least Developed to Lower-Middle Income Countries Use Health Technology Assessment: A Scoping Review. Pathog Glob Health 2023; 117:104-119. [PMID: 35950264 PMCID: PMC9970250 DOI: 10.1080/20477724.2022.2106108] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
Health Technology Assessment (HTA) is a multidisciplinary tool to inform healthcare decision-making. HTA has been implemented in high-income countries (HIC) for several decades but has only recently seen a growing investment in low- and middle-income countries. A scoping review was undertaken to define and compare the role of HTA in least developed and lower middle-income countries (LLMIC). MEDLINE and EMBASE databases were searched from January 2015 to August 2021. A matrix comprising categories on HTA objectives, methods, geographies, and partnerships was used for data extraction and synthesis to present our findings. The review identified 50 relevant articles. The matrix was populated and sub-divided into further categories as appropriate. We highlight topical aspects of HTA, including initiatives to overcome well-documented challenges around data and capacity development, and identify gaps in the research for consideration. Those areas we found to be under-studied or under-utilized included disinvestment, early HTA/implementation, system-level interventions, and cross-sectoral partnerships. We consider broad practical implications for decision-makers and researchers aiming to achieve greater interconnectedness between HTA and health systems and generate recommendations that LLMIC can use for HTA implementation. Whilst HIC may have led the way, LLMIC are increasingly beginning to develop HTA processes to assist in their healthcare decision-making. This review provides a forward-looking model that LLMIC can point to as a reference for their own implementation. We hope this can be seen as timely and useful contributions to optimize the impact of HTA in an era of investment and expansion and to encourage debate and implementation.
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Affiliation(s)
- Anna Falkowski
- Division of Communicable Disease, Michigan Department of Health and Human Services, State of Michigan, USA
| | - Giorgio Ciminata
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow
| | - Francesco Manca
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow
| | - Janet Bouttell
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow
| | - Nishant Jaiswal
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow
| | - Hanin Farhana Binti Kamaruzaman
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow.,Malaysian Health Technology Assessment Section (MaHTAS), Ministry of Health Malaysia, Putrajaya
| | | | - Mariana Al-Adwan
- F. Hoffman-La Roche Ltd, Amman, Jordan and Jordan ISPOR Chapter, Amman, Jordan
| | - Robert Heggie
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow
| | - Septiara Putri
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow.,Health Policy and Administration Department, Faculty of Public Health, University of Indonesia, Depok, West Java, Indonesia
| | - Dikshyanta Rana
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow
| | - Warren Mukelabai Simangolwa
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu Natal, Durban, South Africa and Patient and Citizen Involvement in Health, Lusaka, Zambia
| | - Eleanor Grieve
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics and Health Technology Assessment, University of Glasgow, 1 Lilybank Gardens, Glasgow
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Mistrust of the Nigerian health system and its practical implications: Qualitative insights from professionals and non-professionals in the Nigerian health system. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-022-01814-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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Pinilla-Dominguez P, Taha S, McGuire H, Elagamy A, Sedrak A, Gamal M, Eldebeiky M, Dawoud D. Institutionalizing health technology assessment in Egypt: Situational analysis and roadmap. Front Pharmacol 2022; 13:1014658. [PMID: 36438785 PMCID: PMC9682258 DOI: 10.3389/fphar.2022.1014658] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/14/2022] [Indexed: 11/11/2022] Open
Abstract
Objective: To conduct a situational analysis with the aim to inform future health technology assessment efforts (HTA) in Egypt. Introduction: The Egyptian government has set universal health coverage as a 2030 target. Several agencies have been created in the context of the ongoing healthcare reform. The Egyptian Authority for Unified Procurement, Medical Supply and the Management of Medical Technology (UPA) is one of them and was established to support strategic procurement using HTA. Methods: Description of the development of HTA in Egypt supported by a literature search as part of a scoping exercise, and a stakeholder analysis and identification of HTA capacity survey, based on previous surveys, with relevant stakeholders conducted in 2022. This was followed by a stakeholder event where results were shared and further contextualized. Results: The UPA is expected to evaluate the cost-effectiveness of health technologies and public health programs. The HTA process is being developed, focusing on the assessment of the value of new pharmaceuticals being introduced to the Egyptian market. A total of 16 participants responded on behalf of their organizations to the stakeholder analysis and identification of HTA capacity survey. More than 80% of the respondents were familiar with current efforts conducted by UPA and strongly support the implementation of HTA in Egypt. Transparency was highlighted as an important criterion. Over 90% of the respondents mentioned economic analyses as an HTA product being developed in Egypt, and medicines were the type of technology that stakeholders ranked as first in the rank of health technologies that need the output from HTA urgently. Capability building and training were highlighted as areas in which further support is required. Conclusion: This study represents the first attempt to describe the current path for HTA in Egypt. There seems to be momentum in Egypt to proceed and advance with HTA institutionalization. It would be important that next steps are built on the skills and capabilities already in place in Egypt, ensure methods and processes are in place and up to date and involve the wider system in Egypt so stakeholders can appropriately contribute and participate in the HTA process.
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Affiliation(s)
- Pilar Pinilla-Dominguez
- NICE International—National Institute for Health and Care Excellence (NICE), London, United Kingdom
- Department of Quantitative Methods for Economics and Management, University of Las Palmas de Gran Canaria, Las Palmas, Spain
- *Correspondence: Pilar Pinilla-Dominguez, ; Shorouk Taha, ; Ahmed Elagamy, ; Dalia Dawoud,
| | - Shorouk Taha
- Central Administration of Health Technology Management (CAHTM), Egyptian Authority for Unified Procurement, Medical Supply and Technology Management (UPA), Cairo, Egypt
- *Correspondence: Pilar Pinilla-Dominguez, ; Shorouk Taha, ; Ahmed Elagamy, ; Dalia Dawoud,
| | - Hugh McGuire
- NICE International—National Institute for Health and Care Excellence (NICE), London, United Kingdom
| | - Ahmed Elagamy
- Central Administration of Health Technology Management (CAHTM), Egyptian Authority for Unified Procurement, Medical Supply and Technology Management (UPA), Cairo, Egypt
- *Correspondence: Pilar Pinilla-Dominguez, ; Shorouk Taha, ; Ahmed Elagamy, ; Dalia Dawoud,
| | - Amal Sedrak
- Central Administration of Health Technology Management (CAHTM), Egyptian Authority for Unified Procurement, Medical Supply and Technology Management (UPA), Cairo, Egypt
- Faculty of Medicine, Department of Public Health, Cairo University, Cairo, Egypt
| | - Mary Gamal
- Central Administration of Health Technology Management (CAHTM), Egyptian Authority for Unified Procurement, Medical Supply and Technology Management (UPA), Cairo, Egypt
| | - Mariam Eldebeiky
- Central Administration of Health Technology Management (CAHTM), Egyptian Authority for Unified Procurement, Medical Supply and Technology Management (UPA), Cairo, Egypt
| | - Dalia Dawoud
- NICE Science, Policy & Research, National Institute for Health and Care Excellence, London, United Kingdom
- Faculty of Pharmacy, Cairo University, Cairo, Egypt
- *Correspondence: Pilar Pinilla-Dominguez, ; Shorouk Taha, ; Ahmed Elagamy, ; Dalia Dawoud,
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Ananthakrishnan A, Luz ACG, KC S, Ong L, Oh C, Isaranuwatchai W, Dabak SV, Teerawattananon Y, Turner HC. How can health technology assessment support our response to public health emergencies? Health Res Policy Syst 2022; 20:124. [PMID: 36333759 PMCID: PMC9636714 DOI: 10.1186/s12961-022-00925-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
Public health emergencies (PHEs), such as the COVID-19 crisis, are threats to global health and public order. We recommend that countries bolster their PHE responses by investing in health technology assessment (HTA), defined as a systematic process of gathering pertinent information on and evaluating health technologies from a medical, economic, social and ethical standpoint. We present examples of how HTA organizations in low- and middle-income countries have adapted to supporting PHE-related decisions during COVID-19 and describe the ways HTA can help the response to a PHE. In turn, we advocate for HTA capacity to be further developed globally and for increased institutional acceptance of these methods as a building block for preparedness and response to future PHEs. Finally, the long-term potential of HTA in strengthening health systems and embedding confidence and transparency into scientific policy should be recognized.
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Affiliation(s)
- Aparna Ananthakrishnan
- grid.415836.d0000 0004 0576 2573Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand
| | - Alia Cynthia Gonzales Luz
- grid.415836.d0000 0004 0576 2573Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand
| | - Sarin KC
- grid.415836.d0000 0004 0576 2573Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand
| | - Leslie Ong
- Access and Delivery Partnership, United Nations Development Programme (UNDP), Bangkok, Thailand
| | - Cecilia Oh
- Access and Delivery Partnership, United Nations Development Programme (UNDP), Bangkok, Thailand
| | - Wanrudee Isaranuwatchai
- grid.415836.d0000 0004 0576 2573Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand ,grid.17063.330000 0001 2157 2938Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON Canada
| | - Saudamini Vishwanath Dabak
- grid.415836.d0000 0004 0576 2573Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand
| | - Yot Teerawattananon
- grid.415836.d0000 0004 0576 2573Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand ,grid.4280.e0000 0001 2180 6431Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Hugo C. Turner
- grid.7445.20000 0001 2113 8111MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
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Antihypertensive medicine use differs between Ghana and Nigeria. BMC Cardiovasc Disord 2022; 22:368. [PMID: 35948937 PMCID: PMC9364553 DOI: 10.1186/s12872-022-02799-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/19/2022] [Indexed: 11/12/2022] Open
Abstract
Background Non-communicable diseases are a growing burden in many African countries; cardiovascular disease is the main disease. Antihypertensive medicines (AHM) are a common treatment option but we know little about community use in most low- and medium-income countries (LMIC). We aimed to describe the use of antihypertensive medicines (AHM) in Ghana and Nigeria using a novel data source. Methods We used data from mPharma—a health and pharmaceutical company which distributes pharmaceuticals to hospital and retail pharmacies. We extracted data using the anatomical therapeutic chemical (ATC) classification codes and calculated use in defined daily doses and explored patterns by class, medicines, dose, and originator or generic product. Results AHM use differed between Ghana and Nigeria. The most used classes in Ghana were angiotensin receptor blockers (ARB) followed by calcium channel blockers (CCB) and angiotensin-converting-enzyme inhibitors (ACEi). The five most used products were 16 mg candesartan, 30 mg nifedipine, 10 mg lisinopril, 5 mg amlodipine and 50 mg losartan. In Nigeria ARB, CCB and diuretics were widely used; the top five products were 50 mg losartan, 10 mg lisinopril, 30 mg nifedipine, 40 mg furosemide, and 5 mg amlodipine. More originator products were used in Ghana than Nigeria. Conclusion The differences between Ghana and Nigeria may result from a combination of medical, contextual and policy evidence and reflect factors related to clinical guidance (e.g. standard treatment guidelines), accessibility to prescribers and the role of community pharmacies, and structure of the health system and universal health coverage including funding for medicines. We show the feasibility of using novel data sources to gain insights on medicines use in the community.
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12
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Bidonde J, Meneses-Echavez JF, Asare B, Chola L, Gad M, Heupink LF, Peacocke EF. Developing a tool to assess the skills to perform a health technology assessment. BMC Med Res Methodol 2022; 22:78. [PMID: 35313812 PMCID: PMC8939100 DOI: 10.1186/s12874-022-01562-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/03/2022] [Indexed: 11/29/2022] Open
Abstract
Background Health technology assessment (HTA) brings together evidence from various disciplines while using explicit methods to assess the value of health technologies. In resource-constrained settings, there is a growing demand to measure and develop specialist skills, including those for HTA, to aid the implementation of Universal Healthcare Coverage. The purpose of this study was twofold: a) to find validated tools for the assessment of the technical capacity to conduct a HTA, and if none were found, to develop a tool, and b) to describe experiences of its pilot. Methods First, a mapping review identified tools to assess the skills to conduct a HTA. A medical librarian conducted a comprehensive search in four databases (MEDLINE, Embase, Web of Science, ERIC). Then, incorporating results from the mapping and following an iterative process involving stakeholders and experts, we developed a HTA skills assessment tool. Finally, using an online platform to gather and analyse responses, in collaboration with our institutional partner, we piloted the tool in Ghana, and sought feedback on their experiences. Results The database search yielded 3871 records; fifteen those were selected based on a priori criteria. These records were published between 2003 and 2018, but none covered all technical skills to conduct a HTA. In the absence of an instrument meeting our needs, we developed a HTA skill assessment tool containing four sections (general information, core and soft skills, and future needs). The tool was designed to be administered to a broad range of individuals who would potentially contribute to the planning, delivery and evaluation of HTA. The tool was piloted with twenty-three individuals who completed the skills assessment and shared their initial impressions of the tool. Conclusions To our knowledge, this is the first comprehensive tool enabling the assessment of technical skills to conduct a HTA. This tool allows teams to understand where their individual strengths and weakness lie. The tool is in the early validation phases and further testing is needed. Trial registration Not applicable. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01562-4.
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Affiliation(s)
- Julia Bidonde
- Norwegian Institute of Public Health, P.O. Box: 222 Skøyen, 0213, Oslo, Norway. .,School of Rehabilitation Sciences, College of Medicine, University of Saskatchewan, Suite 3400, 3rd Floor, 104 Clinic Pl, Saskatoon, SK, S7N 2Z4, Canada.
| | - Jose Francisco Meneses-Echavez
- Norwegian Institute of Public Health, P.O. Box: 222 Skøyen, 0213, Oslo, Norway.,Facultad de Cultura Física, Deporte y Recreación, Universidad Santo Tomás, Bogotá, Colombia
| | - Brian Asare
- Ghana Ministry of Health, Ministries Accra, P.O.Box M 44, Accra, Ghana
| | - Lumbwe Chola
- Norwegian Institute of Public Health, P.O. Box: 222 Skøyen, 0213, Oslo, Norway
| | - Mohamed Gad
- London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Lieke Fleur Heupink
- Norwegian Institute of Public Health, P.O. Box: 222 Skøyen, 0213, Oslo, Norway
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Jaca A, Malinga T, Iwu-Jaja CJ, Nnaji CA, Okeibunor JC, Kamuya D, Wiysonge CS. Strengthening the Health System as a Strategy to Achieving a Universal Health Coverage in Underprivileged Communities in Africa: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:587. [PMID: 35010844 PMCID: PMC8744844 DOI: 10.3390/ijerph19010587] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 12/13/2022]
Abstract
Universal health coverage (UHC) is defined as people having access to quality healthcare services (e.g., treatment, rehabilitation, and palliative care) they need, irrespective of their financial status. Access to quality healthcare services continues to be a challenge for many people in low- and middle-income countries (LMICs). The aim of this study was to conduct a scoping review to map out the health system strengthening strategies that can be used to attain universal health coverage in Africa. We conducted a scoping review and qualitatively synthesized existing evidence from studies carried out in Africa. We included studies that reported interventions to strengthen the health system, e.g., financial support, increasing work force, improving leadership capacity in health facilities, and developing and upgrading infrastructure of primary healthcare facilities. Outcome measures included health facility infrastructures, access to medicines, and sources of financial support. A total of 34 studies conducted met our inclusion criteria. Health financing and developing health infrastructure were the most reported interventions toward achieving UHC. Our results suggest that strengthening the health system, namely, through health financing, developing, and improving the health infrastructure, can play an important role in reaching UHC in the African context.
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Affiliation(s)
- Anelisa Jaca
- Cochrane South Africa, South African Medical Research Council, Cape Town 8000, South Africa; (T.M.); (C.A.N.); (C.S.W.)
| | - Thobile Malinga
- Cochrane South Africa, South African Medical Research Council, Cape Town 8000, South Africa; (T.M.); (C.A.N.); (C.S.W.)
| | - Chinwe Juliana Iwu-Jaja
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa;
| | - Chukwudi Arnest Nnaji
- Cochrane South Africa, South African Medical Research Council, Cape Town 8000, South Africa; (T.M.); (C.A.N.); (C.S.W.)
- School of Public Health and Family Medicine, University of Cape Town, Cape Town 8000, South Africa
| | | | - Dorcas Kamuya
- Department of Health Systems and Research Ethics, KEMRI-Wellcome Trust Research Programme, Nairobi 43640-00100, Kenya;
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town 8000, South Africa; (T.M.); (C.A.N.); (C.S.W.)
- School of Public Health and Family Medicine, University of Cape Town, Cape Town 8000, South Africa
- Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa
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Hollingworth SA, Ruiz F, Gad M, Chalkidou K. Health technology assessment capacity at national level in sub-Saharan Africa: an initial survey of stakeholders. F1000Res 2021; 9:364. [PMID: 32595957 PMCID: PMC7309411 DOI: 10.12688/f1000research.23263.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Health technology assessment (HTA) is an effective tool for supporting priority setting (PS) in health. Stakeholder groups need to understand HTA appropriate to their role and to interpret and critique the evidence produced. We aimed to rapidly assess current health system priorities and policy areas of demand for HTA in Sub-Saharan Africa, and identify key gaps in data and skills to inform targeted capacity building. Methods: We revised an existing survey, delivered it to 357 participants, then analysed responses and explored key themes. Results: There were 51 respondents (14%, 30 full completions) across 14 countries. HTA was considered an important and valuable PS tool with a key role in the design of health benefits packages, clinical guideline development, and service improvement. Medicines were identified as a technology type that would especially benefit from the application of HTA. Using HTA to address safety issues (e.g. low-quality medicines) and value for money concerns was particularly highlighted. The perceived availability and accessibility of suitable local data to support HTA varied widely but was mostly considered inadequate and limited. Respondents also noted a need for training support in research methodology and data gathering. Conclusions: While important in raising awareness of HTA as a tool for PS, this study had a low response rate, and that respondents were self-selected. A more refined survey will be developed to support engagement strategies and capacity building.
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Affiliation(s)
| | - Francis Ruiz
- School of Public Health, Imperial College London, London, UK
- London School of Hygeine and Tropical Medicine, London, UK
| | - Mohamed Gad
- School of Public Health, Imperial College London, London, UK
- London School of Hygeine and Tropical Medicine, London, UK
| | - Kalipso Chalkidou
- School of Public Health, Imperial College London, London, UK
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
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15
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Decouttere C, De Boeck K, Vandaele N. Advancing sustainable development goals through immunization: a literature review. Global Health 2021; 17:95. [PMID: 34446050 PMCID: PMC8390056 DOI: 10.1186/s12992-021-00745-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 07/23/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Immunization directly impacts health (SDG3) and brings a contribution to 14 out of the 17 Sustainable Development Goals (SDGs), such as ending poverty, reducing hunger, and reducing inequalities. Therefore, immunization is recognized to play a central role in reaching the SDGs, especially in low- and middle-income countries (LMICs). Despite continuous interventions to strengthen immunization systems and to adequately respond to emergency immunization during epidemics, the immunization-related indicators for SDG3 lag behind in sub-Saharan Africa. Especially taking into account the current Covid19 pandemic, the current performance on the connected SDGs is both a cause and a result of this. METHODS We conduct a literature review through a keyword search strategy complemented with handpicking and snowballing from earlier reviews. After title and abstract screening, we conducted a qualitative analysis of key insights and categorized them according to showing the impact of immunization on SDGs, sustainability challenges, and model-based solutions to these challenges. RESULTS We reveal the leveraging mechanisms triggered by immunization and position them vis-à-vis the SDGs, within the framework of Public Health and Planetary Health. Several challenges for sustainable control of vaccine-preventable diseases are identified: access to immunization services, global vaccine availability to LMICs, context-dependent vaccine effectiveness, safe and affordable vaccines, local/regional vaccine production, public-private partnerships, and immunization capacity/capability building. Model-based approaches that support SDG-promoting interventions concerning immunization systems are analyzed in light of the strategic priorities of the Immunization Agenda 2030. CONCLUSIONS In general terms, it can be concluded that relevant future research requires (i) design for system resilience, (ii) transdisciplinary modeling, (iii) connecting interventions in immunization with SDG outcomes, (iv) designing interventions and their implementation simultaneously, (v) offering tailored solutions, and (vi) model coordination and integration of services and partnerships. The research and health community is called upon to join forces to activate existing knowledge, generate new insights and develop decision-supporting tools for Low-and Middle-Income Countries' health authorities and communities to leverage immunization in its transformational role toward successfully meeting the SDGs in 2030.
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Affiliation(s)
- Catherine Decouttere
- KU Leuven, Access-To-Medicines research Center, Naamsestraat 69, Leuven, Belgium
| | - Kim De Boeck
- KU Leuven, Access-To-Medicines research Center, Naamsestraat 69, Leuven, Belgium
| | - Nico Vandaele
- KU Leuven, Access-To-Medicines research Center, Naamsestraat 69, Leuven, Belgium
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Hollingworth S, Fenny AP, Yu SY, Ruiz F, Chalkidou K. Health technology assessment in sub-Saharan Africa: a descriptive analysis and narrative synthesis. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2021; 19:39. [PMID: 34233710 PMCID: PMC8261797 DOI: 10.1186/s12962-021-00293-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background Countries in Sub-Saharan Africa (SSA) are moving towards universal health coverage. The process of Health Technology Assessment (HTA) can support decisions relating to benefit package design and service coverage. HTA involves institutional cooperation with agreed methods and procedural standards. We systematically reviewed the literature on policies and capacity building to support HTA institutionalisation in SSA. Methods We systematically reviewed the literature by searching major databases (PubMed, Embase, etc.) until June 2019 using terms considering three aspects: HTA; health policy, decision making; and SSA. We quantitatively extracted and descriptively analysed content and conducted a narrative synthesis eliciting themes from the selected literature, which varied in study type and apporach. Results Half of the 49 papers identified were primary research studies and mostly qualitative. Five countries were represented in six of ten studies; South Africa, Ghana, Uganda, Cameroon, and Ethiopia. Half of first authors were from SSA. Most informants were policy makers. Five themes emerged: (1) use of HTA; (2) decision-making in HTA; (3) values and criteria for setting priority areas in HTA; (4) involving stakeholders in HTA; and (5) specific examples of progress in HTA in SSA. The first one was the main theme where there was little use of evidence and research in making policy. The awareness of HTA and economic evaluation was low, with inadequate expertise and a lack of local data and tools. Conclusions Despite growing interest in HTA in SSA countries, awareness remains low and HTA-related activities are uncoordinated and often disconnected from policy. Further training and skills development are needed, firmly linked to a strategy focusing on strengthening within-country partnerships, particularly among researchers and policy makers. The international community has an important role here by supporting policy- relevant technical assistance, highlighting that sustainable financing demands evidence-based processes for effective resource allocation, and catalysing knowledge-sharing opportunities among countries facing similar challenges. Supplementary Information The online version contains supplementary material available at 10.1186/s12962-021-00293-5.
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Affiliation(s)
- Samantha Hollingworth
- School of Pharmacy, University of Queensland, 20 Cornwall St, Woolloongabba, Brisbane, QLD, 4102, Australia. .,Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Ama Pokuaa Fenny
- Institute of Statistical, Social and Economics Research, University of Ghana, Accra, Ghana
| | - Su-Yeon Yu
- National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea
| | - Francis Ruiz
- iDSI, London School of Hygiene and Tropical Medicine, London, UK
| | - Kalipso Chalkidou
- The Global Fund To Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
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Alkhaldi M, Al Basuoni A, Matos M, Tanner M, Ahmed S. Health Technology Assessment in High, Middle, and Low-income Countries: New Systematic and Interdisciplinary Approach For Sound Informed-policy Making: Research Protocole. Risk Manag Healthc Policy 2021; 14:2757-2770. [PMID: 34234591 PMCID: PMC8254407 DOI: 10.2147/rmhp.s310215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/26/2021] [Indexed: 11/23/2022] Open
Abstract
Technological innovation has a significant role in improving health systems (HSs) and achieving universal health coverage (UHC). The World Health Organization (WHO) has declared resolutions on Health Technology Assessment (HTA) and other global organizations emphasized on HTA systems to achieve the Sustainable Development Goals (SDGs). HTA is a modern multidisciplinary decision-making framework linking knowledge and policymaking by assessing the medical, social, economic, organizational, and ethical effects, and/or impacts within health and social systems. The research significance lies in the growing need for HTA at these moments than ever as it is seen as an essential development approach to tackle the current global challenges and pandemics, particularly in developing countries. The research aims to comprehensively evaluate and understand HTA systems concerning the level of knowledge about HTA, current HTA structure, practices, application, capacity, gaps, and solutions. The project starts in January 2021 and ends in January 2022 and will be carried out in seven countries: Canada, Switzerland, Brazil, Lebanon, Jordan, Palestine, and Tanzania. A mixed-methods, quantitative and qualitative, along with a literature review will be applied. In each country, ten HTA-associated institutions will complete an adapted electronic survey, developed by the WHO, and ten key-informants selected purposively from the government, academia, NGOs, and private sectors to participate in ten individual in-depth interviews. One government representative from each country will participate in one expanded inter-country workshop. Excel, IBM Statistical Package for the Social Sciences (SPSS), and MAXQDA software programs will be used for data management and analysis. The research will form cutting-edge evidence not only for the seven countries, but also for the global, regional, and national endeavors with regards to opening a room for HTA best application and optimization. It will reveal lessons learned, determine gaps, and build a well-enabled and institutionalized HTA for better UHC, health systems, and multi-sectoral development.
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Affiliation(s)
- Mohammed Alkhaldi
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Canada.,Department of Public Health, University of Basel, Basel, Switzerland.,The Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Aisha Al Basuoni
- Projects Unit, Gaza Community Mental Health Programme, Gaza, Palestine
| | - Márcia Matos
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Canada
| | - Marcel Tanner
- Department of Public Health, University of Basel, Basel, Switzerland.,The Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Sara Ahmed
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Canada
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