Global Health Priority-Setting

2019 ◽  
Keyword(s):  
Global Health ◽  
Priority Setting ◽  
Health Resources ◽  
Decision Makers ◽  
Health Priorities ◽  
Health Coverage ◽  
Household Finances ◽  
Health Gains ◽  
Global Priority ◽  
Financing Gap

Global health is at a crossroads. The 2030 Agenda for Sustainable Development has come with ambitious targets for health and health services worldwide. To reach these targets, many more billions of dollars need to be spent on health. However, development assistance for health has plateaued and domestic funding on health in most countries is growing at rates too low to close the financing gap. National and international decision-makers face tough choices about how scarce health care resources should be spent. Should additional funds be spent on primary prevention of stroke, treating childhood cancer, or expanding treatment for HIV/AIDS? Should health coverage decisions take into account the effects of illness on productivity, household finances, and children’s educational attainment, or should they just focus on health outcomes? Does age matter for priority-setting or should it be ignored? Are health gains far in the future less important than gains in the present? Should higher priority be given to people who are sicker or poorer? This book provides a framework for how to think about evidence-based priority-setting in health. Over 18 chapters, ethicists, philosophers, economists, policymakers, and clinicians from around the world assess the state of current practice in national and global priority-setting, describe new tools and methodologies to address establishing global health priorities, and tackle the most important ethical questions that decision-makers must consider in allocating health resources.

scholarly journals Scaling-Up NCD Interventions in South-East Asia (SUNI-SEA) - the cost evaluation of life-style related NCD interventions

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Koot
Keyword(s):  
Scaling Up ◽  
Decision Makers ◽  
Cost Evaluation ◽  
Health Coverage ◽  
Community Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Gains ◽  
The Cost ◽  
Universal Health

Abstract Vietnam, Myanmar, and Indonesia are trying to create innovative synergies within and between sectors to prevent and treat NCDs. Universal Health Coverage (UHC) is the objective of these countries. The challenge for decision makers in healthcare is to implement programmes and interventions that effectively contain NCDs at the lowest possible cost both in community-based and primary care facilities. The value of implementation and upscaling is assessed by estimating costs, savings and health gains. The presentation focuses on cost-effectiveness evaluation of the entire scaling-up, allowing for comparison within and among countries and generate recommendations for achieving UHC in low- and middle-income countries.

scholarly journals Setting Priorities in the Pursuit of Universal Health Coverage

2019 ◽  
pp. 299-314
Author(s):  
Trygve Ottersen ◽  
Ole F. Norheim
Keyword(s):  
Universal Health Coverage ◽  
Priority Setting ◽  
Service Selection ◽  
Decision Makers ◽  
Health Coverage ◽  
Recent Developments ◽  
Thai Government ◽  
Past Experiences ◽  
Universal Health

Priority-setting is fundamental to the fair and efficient pursuit of universal health coverage (UHC). This chapter addresses the key choices in selecting services for UHC and the alternative criteria, tools, and processes to guide these choices. The authors first describe the choices decision-makers have to make on the path to UHC and the recommendations by the WHO Consultative Group on Equity and Universal Health Coverage for how these choices can be made. Using Thailand as a case study, the authors examine how the Thai government has set priorities in its pursuit of UHC. Against this background, the authors discuss alternative criteria, tools, and processes for guiding service selection and the design of benefit packages for UHC. When doing this, the authors consider past experiences in Thailand and other countries and examine how recent developments and the insights from the preceding chapters in this volume can provide directions for the future.

scholarly journals Analysis of the Health Product Profile Directory — a new tool to inform priority-setting in global public health

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
R. F. Terry ◽  
A. Plasència ◽  
J. C. Reeder
Keyword(s):  
Global Health ◽  
Priority Setting ◽  
Communicable Disease ◽  
Safety Information ◽  
Target Population ◽  
Health Priorities ◽  
Health Product ◽  
Global Public Health ◽  
Middle Income ◽  
Product Profile

Abstract Background The Health Product Profile Directory (HPPD) is an online database describing 8–10 key characteristics (such as target population, measures of efficacy and dosage) of product profiles for medicines, vaccines, diagnostics and other products that are intended to be accessed by populations in low- and middle-income countries. The HPPD was developed by TDR on behalf of WHO and launched on 15 May 2019. Methods The contents of the HPPD were downloaded into an Excel™ spreadsheet via the open access interface and analysed to identify the number of health product profiles by type, disease, year of publication, status, author organization and safety information. Results The HPPD contains summaries of 215 health product profiles published between 2008 and May 2019, 117 (54%) of which provide a hyperlink to the detailed publication from which the summary was extracted, and the remaining 98 provide an email contact for further information. A total of 55 target disease or health conditions are covered, with 210 profiles describing a product with an infectious disease as the target. Only 5 product profiles in the HPPD describe a product for a non-communicable disease. Four diseases account for 40% of product profiles in the HPPD; these are tuberculosis (33 profiles, 15%), malaria (31 profiles, 14%), HIV (13 profiles, 6%) and Chagas (10 profiles, 5%). Conclusion The HPPD provides a new tool to inform priority-setting in global health — it includes all product profiles authored by WHO (n = 51). There is a need to standardise nomenclature to more clearly distinguish between strategic publications (describing research and development (R&D) priorities or preferred characteristics) compared to target product profiles to guide a specific candidate product undergoing R&D. It is recommended that all profiles published in the HPPD define more clearly what affordability means in the context where the product is intended to be used and all profiles should include a statement of safety. Combining the analysis from HPPD to a mapping of funds available for R&D and those products in the R&D pipeline would create a better overview of global health priorities and how they are supported. Such analysis and increased transparency should take us a step closer to measuring and improving coordination of efforts in global health R&D.

scholarly journals Global health security and universal health coverage: from a marriage of convenience to a strategic, effective partnership

2019 ◽  
Vol 4 (1) ◽  
pp. e001145 ◽  
Author(s):  
Clare Wenham ◽  
Rebecca Katz ◽  
Charles Birungi ◽  
Lisa Boden ◽  
Mark Eccleston-Turner ◽  
...  
Keyword(s):  
Global Health ◽  
Universal Health Coverage ◽  
Individual Characteristics ◽  
Health System Strengthening ◽  
Health Priorities ◽  
Local Health ◽  
Health Coverage ◽  
Global Health Security ◽  
Health Security ◽  
Universal Health

Global health security and universal health coverage have been frequently considered as “two sides of the same coin”. Yet, greater analysis is required as to whether and where these two ideals converge, and what important differences exist. A consequence of ignoring their individual characteristics is to distort global and local health priorities in an effort to streamline policymaking and funding activities. This paper examines the areas of convergence and divergence between global health security and universal health coverage, both conceptually and empirically. We consider analytical concepts of risk and human rights as fundamental to both goals, but also identify differences in priorities between the two ideals. We support the argument that the process of health system strengthening provides the most promising mechanism of benefiting both goals.

Doctor Retention in Ireland - What it may mean for the Global Health Workforce Reform Agenda Comment on "Doctor Retention: A Cross-sectional Study of How Ireland Has Been Losing the Battle"

2020 ◽  
Author(s):  
Bernard Hope Taderera
Keyword(s):  
Global Health ◽  
Health Workforce ◽  
Cross Sectional Study ◽  
Early Career ◽  
Healthcare Personnel ◽  
Health Coverage ◽  
Cross Sectional ◽  
Middle Income ◽  
Reform Agenda ◽  
Medical Graduates

The study of healthcare personnel migration in Ireland reports that most medical graduates plan to leave the country’s health system. It may be possible to address this challenge by understanding and addressing the reasons why young doctors plan to leave. Future studies should contribute to the retention of early career doctors in highincome countries such as Ireland. This will help reduce the migration of doctors from low- and middle-income countries in order to address the global health workforce crisis and its impact on the attainment of universal health coverage in all health systems.

scholarly journals Sharing power in global health research: an ethical toolkit for designing priority-setting processes that meaningfully include communities

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Bridget Pratt
Keyword(s):  
Global Health ◽  
Priority Setting ◽  
Health Research ◽  
Reflective Equilibrium ◽  
Empirical Work ◽  
The Philippines ◽  
Project Planning ◽  
Global Health Research ◽  
Research Priority ◽  
Health Research Priority Setting

AbstractTo promote social justice and equity, global health research should meaningfully engage communities throughout projects: from setting agendas onwards. But communities, especially those that are considered disadvantaged or marginalised, rarely have a say in the priorities of the research projects that aim to help them. So far, there remains limited ethical guidance and resources on how to share power with communities in health research priority-setting. This paper presents an “ethical toolkit” for academic researchers and their community partners to use to design priority-setting processes that meaningfully include the communities impacted by their projects. An empirical reflective equilibrium approach was employed to develop the toolkit. Conceptual work articulated ethical considerations related to sharing power in g0l0o0bal health research priority-setting, developed guidance on how to address them, and created an initial version of the toolkit. Empirical work (51 in-depth interviews, 1 focus group, 2 case studies in India and the Philippines) conducted in 2018 and 2019 then tested those findings against information from global health research practice. The final ethical toolkit is a reflective project planning aid. It consists of 4 worksheets (Worksheet 1- Selecting Partners; Worksheet 2- Deciding to Partner; Worksheet 3- Deciding to Engage with the Wider Community; Worksheet 4- Designing Priority-setting) and a Companion Document detailing how to use them. Reflecting on and discussing the questions in Worksheets 1 to 4 before priority-setting will help deliver priority-setting processes that share power with communities and projects with research topics and questions that more accurately reflect their healthcare and system needs.

scholarly journals Development of a checklist to guide equity considerations in health technology assessment

2021 ◽  
Vol 37 ◽  
Author(s):  
Maria Benkhalti ◽  
Manuel Espinoza ◽  
Richard Cookson ◽  
Vivian Welch ◽  
Peter Tugwell ◽  
...  
Keyword(s):  
Knowledge Translation ◽  
Health Technology Assessment ◽  
Priority Setting ◽  
Technology Assessment ◽  
Literature Search ◽  
Health Inequities ◽  
Health Technology ◽  
Decision Makers ◽  
Added Value ◽  
Pilot Test

Abstract Objectives Health technology assessment (HTA) can impact health inequities by informing healthcare priority-setting decisions. This paper presents a novel checklist to guide HTA practitioners looking to include equity considerations in their work: the equity checklist for HTA (ECHTA). The list is pragmatically organized according to the generic HTA phases and can be consulted at each step. Methods A first set of items was based on the framework for equity in HTA developed by Culyer and Bombard. After rewording and reorganizing according to five HTA phases, they were complemented by elements emerging from a literature search. Consultations with method experts, decision makers, and stakeholders further refined the items. Further feedback was sought during a presentation of the tool at an international HTA conference. Lastly, the checklist was piloted through all five stages of an HTA. Results ECHTA proposes elements to be considered at each one of the five HTA phases: Scoping, Evaluation, Recommendations and Conclusions, Knowledge Translation and Implementation, and Reassessment. More than a simple checklist, the tool provides details and examples that guide the evaluators through an analysis in each phase. A pilot test is also presented, which demonstrates the ECHTA's usability and added value. Conclusions ECHTA provides guidance for HTA evaluators wishing to ensure that their conclusions do not contribute to inequalities in health. Several points to build upon the current checklist will be addressed by a working group of experts, and further feedback is welcome from evaluators who have used the tool.

scholarly journals Analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from Ethiopia

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Amare Worku Tadesse ◽  
Kassu Ketema Gurmu ◽  
Selamawit Tesfaye Kebede ◽  
Mahlet Kifle Habtemariam
Keyword(s):  
Health Promotion ◽  
Global Health ◽  
Health System ◽  
Universal Health Coverage ◽  
World Health ◽  
Health Coverage ◽  
Health Security ◽  
Universal Health ◽  
Health Agenda

Abstract Background Evidence exists about synergies among universal health coverage, health security and health promotion. Uniting these three global agendas has brought success to the country’s health sector. This study aimed to document the efforts Ethiopia has made to apply nationally synergistic approaches uniting these three global health agendas. Our study is part of the Lancet Commission on synergies between these global agendas. Methods We employed a case study design to describe the synergistic process in the Ethiopian health system based on a review of national strategies and policy documents, and key informant interviews with current and former policymakers, and academics. We analyzed the “hardware” (using the World Health Organization’s building blocks) and the “software” (ideas, interests, and power relations) of the Ethiopian health system according to the aforementioned three global agendas. Results Fragmentation of health system primarily manifested as inequities in access to health services, low health workforce and limited capacity to implementation guidelines. Donor driven vertical programs, multiple modalities of health financing, and inadequate multisectoral collaborations were also found to be key features of fragmentation. Several approaches were found to be instrumental in fostering synergies within the global health agenda. These included strong political and technical leadership within the government, transparent coordination, and engagement of stakeholders in the process of priority setting and annual resource mapping. Furthermore, harmonization and alignment of the national strategic plan with international commitments, joint financial arrangements with stakeholders and standing partnership platforms facilitated efforts for synergy. Conclusions Ethiopia has implemented multiple approaches to overcome fragmentation. Such synergistic efforts of the primary global health agendas have made significant contributions to the improvement of the country’s health indicators and may promote sustained functionality of the health system.

scholarly journals Global health trials methodological research agenda: results from a priority setting exercise

Trials ◽  
2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Anna Rosala-Hallas ◽  
Aneel Bhangu ◽  
Jane Blazeby ◽  
Louise Bowman ◽  
Mike Clarke ◽  
...  
Keyword(s):  
Global Health ◽  
Priority Setting ◽  
Research Agenda ◽  
Methodological Research ◽  
A Priority ◽  
Priority Setting Exercise

scholarly journals Health Priority Setting in Iran: Evaluating Against the Social Values Framework

2016 ◽  
Vol 8 (10) ◽  
pp. 212
Author(s):  
Hakimeh Mostafavi ◽  
Arash Rashidian ◽  
Mohammad Arab ◽  
Mohammad R. V. Mahdavi ◽  
Kioomars Ashtarian
Keyword(s):  
Health Care ◽  
Health System ◽  
Priority Setting ◽  
Social Values ◽  
City Council ◽  
Decision Makers ◽  
The Public ◽  
Health Technologies ◽  
Health Priority ◽  
The Social

<p><strong>Background:</strong> Health systems, as part of the social system, consider public values. This study was conducted to examine the role of social values in the health priority setting in the Iranian health system.</p><p><strong>Methods:</strong> In this qualitative case study, three main data sources were used: literature, national documents, and key informants who were purposefully selected from health care organizations and other related institutions. Data was analyzed and interpreted using the Clark-Weale Framework.</p><p><strong>Results:</strong> According to our results, the public indirectly participates in decision-making. The public representatives participate in the meetings of the health priority setting as parliament members, representatives of some unions, members of the city council, and donors. The transparency of the decisions and the accountability of the decision makers are low. Decision makers only respond to complaints of the Audit Court and the Inspection Organization. Individual choice, although respected in hospitals and clinics, is limited in health care networks because of the referral system. Clinical effectiveness is considered in insurance companies and some hospitals. There are no technical abilities to determine the cost-effectiveness of health technologies; however, some international experiences are employed. Equity and solidarity are considered in different levels of the health system.</p><p><strong>Conclusion:</strong> Social values are considered in the health priority decisions in limited ways. It seems that the lack of an appropriate value-based framework for priority setting and also the lack of public participation are the major defects of the health system. It is recommended that health policymakers invite different groups of people and stakeholders for active involvement in health priority decisions. </p>

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