scholarly journals Public Engagement in Health Priority Setting in Low- and Middle-Income Countries: Current Trends and Considerations for Policy

PLoS Medicine ◽  
2013 ◽  
Vol 10 (8) ◽  
pp. e1001495 ◽  
Author(s):  
Katarzyna Bolsewicz Alderman ◽  
David Hipgrave ◽  
Eliana Jimenez-Soto
Author(s):  
Matthew S. McCoy ◽  
Harald Schmidt ◽  
Jennifer Prah Ruger ◽  
Marion Danis

Recent years have seen growing enthusiasm for public engagement in priority-setting. But despite this widespread support, there remains uncertainty both about the precise benefits of public engagement in priority-setting and about how public engagement activities should be structured in order to realize those benefits. The authors aim to move beyond generalizations about the value of public engagement by presenting several distinct rationales for engaging the public in priority-setting. The authors illustrate how these rationales can be achieved in practice using the case study of directly observed therapy for tuberculosis. They then highlight a number of practical challenges involved in implementing engagement activities and offer advice for addressing them. The chapter pays particular attention to challenges that arise in low- and middle-income countries, where efforts to engage the public face unique structural barriers.


2021 ◽  
Vol 6 (4) ◽  
pp. e004549
Author(s):  
Cassandra Nemzoff ◽  
Francis Ruiz ◽  
Kalipso Chalkidou ◽  
Abha Mehndiratta ◽  
Lorna Guinness ◽  
...  

2020 ◽  
Vol 5 (2) ◽  
pp. e001850
Author(s):  
Ashley A Leech ◽  
David D Kim ◽  
Joshua T Cohen ◽  
Peter J Neumann

IntroductionSince resources are finite, investing in services that produce the highest health gain ‘return on investment’ is critical. We assessed the extent to which low and middle-income countries (LMIC) have included cost-saving interventions in their national strategic health plans.MethodsWe used the Tufts Medical Center Global Health Cost-Effectiveness Analysis Registry, an open-source database of English-language cost-per-disability-adjusted life year (DALY) studies, to identify analyses published in the last 10 years (2008–2017) of cost-saving health interventions in LMICs. To assess whether countries prioritised cost-saving interventions within their latest national health strategic plans, we identified 10 countries, all in sub-Saharan Africa, with the highest measures on the global burden of disease scale and reviewed their national health priority plans.ResultsWe identified 392 studies (63%) targeting LMICs that reported 3315 cost-per-DALY ratios, of which 207 ratios (6%) represented interventions reported to be cost saving. Over half (53%) of these targeted sub-Saharan Africa. For the 10 countries we investigated in sub-Saharan Africa, 58% (79/137) of cost-saving interventions correspond with priorities identified in country plans. Alignment ranged from 95% (21/22 prioritised cost-saving ratios) in South Africa to 17% (2/12 prioritised cost-saving ratios) in Cameroon. Human papillomavirus vaccination was a noted priority in 70% (7/10) of national health prioritisation plans, while 40% (4/10) of countries explicitly included prenatal serological screening for syphilis. HIV prevention and treatment were stated priorities in most country health plans, whereas 40% (2/5) of countries principally outlined efforts for lymphatic filariasis. From our sample of 45 unique interventions, 36% of interventions (16/45) included costs associated directly with the implementation of the intervention.ConclusionOur findings indicate substantial variation across country and disease area in incorporating economic evidence into national health priority plans in a sample of sub-Saharan African countries. To make health economic data more salient, the authors of cost-effectiveness analyses must do more to reflect implementation costs and other factors that could limit healthcare delivery.


2013 ◽  
Vol 39 (2-3) ◽  
pp. 308-331 ◽  
Author(s):  
Matthew Allen

It has been estimated that the use of tobacco kills nearly 6 million people each year, with most deaths occurring in low- and middle-income countries. This disparity is expected to increase over the next few decades. On the basis of current trends, tobacco use will kill more than 8 million people worldwide per annum by 2030, with eighty percent of those premature deaths occurring in low- and middle-income countries. The significant burden of morbidity and mortality associated with tobacco use is well documented and proven and will not be repeated here.The evidence base for addressing the tobacco epidemic domestically, regionally, and globally has developed in a systematic fashion over the past five decades. Effective measures for tobacco control are now well known and have been canvassed widely in the published literature.


2016 ◽  
Vol 25 ◽  
pp. 1-5 ◽  
Author(s):  
Catherine Pitt ◽  
Anna Vassall ◽  
Yot Teerawattananon ◽  
Ulla K. Griffiths ◽  
Lorna Guinness ◽  
...  

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 2119 ◽  
Author(s):  
Sripen Tantivess ◽  
Kalipso Chalkidou ◽  
Nattha Tritasavit ◽  
Yot Teerawattananon

Health Technology Assessment (HTA) is policy research that aims to inform priority setting and resource allocation. HTA is increasingly recognized as a useful policy tool in low- and middle-income countries (LMICs), where there is a substantial need for evidence to guide Universal Health Coverage policies, such as benefit coverage, quality improvement interventions and quality standards, all of which aim at improving the efficiency and equity of the healthcare system. The Health Intervention and Technology Assessment Program (HITAP), Thailand, and the National Institute for Health and Care Excellence (NICE), UK, are national HTA organizations providing technical support to governments in LMICs to build up their priority setting capacity. This paper draws lessons from their capacity building programs in India, Colombia, Myanmar, the Philippines, and Vietnam. Such experiences suggest that it is not only technical capacity, for example analytical techniques for conducting economic evaluation, but also management, coordination and communication capacity that support the generation and use of HTA evidence in the respective settings. The learned lessons may help guide the development of HTA capacity in other LMICs.


2017 ◽  
Vol 21 (S2) ◽  
pp. 262-273 ◽  
Author(s):  
Sara Gordon ◽  
Mary Jane Rotheram-Borus ◽  
Sarah Skeen ◽  
Charles Perry ◽  
Kendall Bryant ◽  
...  

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 157 ◽  
Author(s):  
John Q. Wong ◽  
Nel Jason Haw ◽  
Jhanna Uy ◽  
Diana Beatriz Bayani

The World Health Organization (WHO) launched the OneHealth Tool (OHT) to help low and middle income countries to develop their capacities for sector-wide priority setting. In 2016, we sought to use the OHT to aid the Philippine Health Insurance Corporation (PHIC), the national health insurer of the Philippines, in decisions to expand benefit packages using cost-effectiveness analyses. With technical support from the WHO, we convened health planning officers from the Philippine Department of Health (DOH) and the Philippine Health Insurance Corporation (PHIC) conduct generalized cost-effective analyses (GCEA) of selected un-financed noncommunicable disease interventions using OHT. We collected epidemiological and cost data through health facility surveys, review of literature such as cost libraries and clinical practice guidelines, and expert consultations. Although we were unable to use GCEA results directly to set policy, we learnt important policy lessons which we outline here that might help inform other countries looking to inform service coverage decisions. Additionally, the entire process and GCEA visualizations helped high-level policymakers in the health sector, who have traditionally relied on ad hoc decision making, to realize the need for a systematic and transparent priority-setting process that can continuously provide the evidence needed to inform service coverage decisions.


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