Implementing health technology assessment in Ghana to support universal health coverage: building relationships that focus on people, policy, and process

Hollingworth, Samantha; Gyansa-Lutterodt, Martha; Dsane-Selby, Lydia; Nonvignon, Justice; Lopert, Ruth; Gad, Mohamed; Ruiz, Francis; Tunis, Sean; Chalkidou, Kalipso

doi:10.1017/s0266462319000795

Cited by 28 publications

(24 citation statements)

References 10 publications

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“…At some point countries will 'graduate' from aid -they will need mechanisms to effectively manage healthcare resources. Ghana has begun its journey to reduce reliance on donor assistance for health 7,13 .…”

Section: Discussionmentioning

confidence: 99%

“…The International Decision Support Initiative (iDSI) is a global network of health, policy and economic expertise, which seeks to support countries make better decisions about efficient spending on healthcare. iDSI has been working in SSA since 2013 to develop local capacity and support implementation of robust HTA processes 6,7 . There is growing interest across the continent but the current HTA landscape is fragmented and undocumented.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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Background: Health technology assessment (HTA) is an effective tool to support 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%) 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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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“…In this context, an HTA pilot study was initiated by the Ghanaian Ministry of Health (MoH) in 2016 to examine the costeffectiveness of antihypertensives in the NHIS [14]. This pilot catalysed a partnership between government and academia, demonstrating the importance of institutional collaboration in evidence-informed processes, and how HTA can inform NHIS spending decisions to improve allocative efficiency [15]. In the national medicines policy [16], the Government has outlined its vision to institutionalise HTA as part of its plan towards achieving UHC and has explicitly committed to using HTA evidence to inform prioritisation for the essential medicines list [17] and standard treatment guidelines [18].…”

Section: Introductionmentioning

confidence: 99%

What do we need to know? Data sources to support evidence-based decisions using health technology assessment in Ghana

Hollingworth

Downey

Ruiz

et al. 2020

Health Res Policy Sys

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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 bene ts packages, clinical guideline development, and service improvement. Public health programs, medicines and vaccines were the three main technology types that would especially bene t 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 nancing, health service provision, burden of disease and noted a need for training support in research methodology, HTA and data management Conclusion The use of HTA by policymakers and communities in Nigeria is very limited mainly due to inadequate and insu cient capacity to produce and use HTA. Developing sustainable and institutionalized HTA systems requires in-country expertise and active participation from a range of stakeholders. Stakeholder participation in identifying HTA topics and conducting relevant research will enhance the use of HTA evidence produced for decision making. Therefore, the identi ed training needs for HTA and possible research topics should be considered a priority in establishing HTA for evidenceinformed policy making for achieving UHC particularly among the most vulnerable people in Nigeria.

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“…Scienti c associations can thus provide a list of interventions with lower costs and prevent many future complications. Furthermore, improving the HTA can play an important role in this domain [32]. Even so, weaknesses in HTA process are among common problems facing the Iranian health care system [33].…”

Section: Stewardshipmentioning

confidence: 99%

Recommendations to improve insurance coverage for physiotherapy services in Iran: A multi-criteria decision making approach

Shahabi

Heydari

Lankarani

et al. 2020

Preprint

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Background: High toll of traffic-related injuries, climate change, natural disasters, population aging, as well as chronic diseases have all made considerable demands on receiving physiotherapy services in Iran. Nevertheless, there is an assortment of complications facing utilization of such services, particularly poor insurance coverage. Therefore, the present study investigated and prioritized potential policy recommendations to improve insurance coverage for physiotherapy services in Iran.Methods: This project was carried out in Iran, using a mix-methods (viz. qualitative-quantitative) approach. Within the first phase, a qualitative study was completed to find policy recommendations. Such recommendations were then prioritized through the Analytical Hierarchy Process (AHP), in the second phase, based on effectiveness, acceptability, cost, fairness, feasibility, and time. Results: Within the first phase, a total number of 30 semi-structured interviews with health policy-makers, health insurers, faculty members, rehabilitation experts, and physiotherapists were completed. Several policy recommendations were also proposed by the study participants. Following the second phase, prioritized recommendations were provided to promote stewardship (e.g. informing policy-makers about physiotherapy services), collection of funds (e.g. placing value-added taxes on luxury goods and services), pooling of funds (e.g. moving allocated resources towards insurance [viz. third-party] mechanism), purchasing (e.g. using strategic purchasing), and benefit package (e.g. considering preventive interventions) as the main components of insurance coverage. Conclusion: The study findings provided a favorable ground to improve insurance coverage for physiotherapy services in Iran. As well, decision- and policy-makers can place these recommendations on the agenda in the health sector to protect population health status, especially that of groups with disabilities.

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Implementing health technology assessment in Ghana to support universal health coverage: building relationships that focus on people, policy, and process

Cited by 28 publications

References 10 publications

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

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

What do we need to know? Data sources to support evidence-based decisions using health technology assessment in Ghana

Recommendations to improve insurance coverage for physiotherapy services in Iran: A multi-criteria decision making approach

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