Health technology assessment and priority setting for universal health coverage: a qualitative study of stakeholders’ capacity, needs, policy areas of demand and perspectives in Nigeria

Abstract

Introduction: Health technology assessment (HTA) is an effective tool to support priority setting and generate evidence for decision making especially en route to achieving universal health coverage (UHC). We assessed the capacity needs, policy areas of demand, and perspectives of key stakeholders for evidence-informed decision making in Nigeria where HTA is still new. Methods: We surveyed 31 participants including decision makers, policy makers, academic researchers, civil society organizations, community-based organizations, development partners, health professional organizations. We revised an existing survey to qualitatively examine the need, policy areas of demand, and perspectives of stakeholders on HTA. We then analyzed responses and explored key themes. Results: Most respondents were associated with organizations that generated or facilitated health services research. Research institutes highlighted their ability to provide expertise and skills for HTA research but some respondents noted a lack of human capacity for HTA. HTA was considered an important and valuable priority-setting tool with a key role in the design of health benefits packages, clinical guideline development, and service improvement. Public health programs, medicines and vaccines were the three main technology types that would especially benefit from the application of HTA. The perceived availability and accessibility of suitable local data to support HTA varied widely but was mostly considered inadequate and limited. Respondents needed evidence on health system financing, health service provision, burden of disease and noted a need for training support in research methodology, HTA and data management.

Health technology assessment in sub-Saharan Africa: a descriptive analysis and narrative synthesis

“…The authors pointed to the lack of suitable data to inform HTA in Ghana; current data were inadequate, fragmented, inaccessible, and not available in a usable form for any HTA exercise. A more recent article explored the views of Nigerian stakeholders about HTA; use was limited due to low capacity to produce and use HTA [ 67 ]. Efforts to institutionalise HTA in South Africa noted the importance of political support, local capacity and awareness of HTA [ 68 ].…”

Health Technology Assessment in High, Middle, and Low-income Countries: New Systematic and Interdisciplinary Approach For Sound Informed-policy Making: Research Protocole

“…HTA is an effective tool to support priority setting and generate evidence for decision making especially en route to achieving UHC. 24 HTA has been hypothesized to play a significant role in improving healthcare delivery and UHC through developing reliable evidence, insights, and comparisons to be added to the current knowledge advancement and for innovating further global and regional best practices of HTA.…”

“…Therefore, priority-setting processes are necessary to maximize the HS’s ability to work towards UHC due to limited healthcare resources and insufficient health revenue to satisfy increasing and competing demands. 24 This study will provide a comprehensive understanding of the HTA systems in different income levels of the countries. While there are notable LMIC exceptions of introducing and institutionalizing HTA, others may be constrained by limited technical and administrative capacity, scarcity of data, time and governance structures to carry out HTA.…”

Health technology assessment capacity at national level in sub-Saharan Africa: an initial survey of stakeholders

“…This is, as far as the authors are aware, the first systematic survey of the HTA landscape in SSA. Our survey was extended in a subsequent study in Nigeria with a more detailed understanding of the local context 11 . It is a preliminary survey; we will refine in future iterations with piloting.…”