Health Technology Assessment (HTA) readiness in Uganda: Stakeholder’s perceptions on the potential application of HTA to support National Universal Health Coverage efforts

Mayora, Chrispus; Kazibwe, Joseph; Ssempala, Richard; Nakimuli, Brenda; Ssennyonjo, Aloysius; Ekirapa, Elizabeth; Byakika, Sarah; Aliti, Tom; Musila, Timothy; Gad, Mohamed; Vassall, Anna; Ruiz, Francis; Ssengooba, Freddie

doi:10.1101/2023.05.16.23290024

Cited by 2 publications

(1 citation statement)

References 30 publications

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“…In addition to transparency, allocative efficiency and improving the quality of healthcare were also identified as important attributes of HTA. This was consistent with results from similar studies in Nigeria (23) and Uganda (22). A potential explanation is that allocative efficiency and quality are key aspects of UHC (42) and with the country focusing on achieving UHC, participants may be aware of these aspects.…”

Section: Discussionsupporting

confidence: 89%

A situational and stakeholder analysis of health technology assessment in Zimbabwe

Dzingirai,

Dambiko,

Matyanga

et al. 2024

Int J Technol Assess Health Care

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Objectives: Systematic priority setting is necessary for achieving high-quality healthcare using limited resources in low-and middle-income countries. Health technology assessment (HTA) is a tool that can be used for systematic priority setting. The objective of this study was to conduct a stakeholder and situational analysis of HTA in Zimbabwe. Methods: We identified and analyzed stakeholders using the International Decision Support Initiative checklist. The identified stakeholders were invited to an HTA workshop convened at the University of Zimbabwe. We used an existing HTA situational analysis questionnaire to ask for participants' views on the need, demand, and supply of HTA. A follow-up survey was done among representatives of stakeholder organizations that failed to attend the workshop. We reviewed two health policy documents relevant to the HTA. Qualitative data from the survey and document review were analyzed using thematic analysis. Results: Forty-eight organizations were identified as stakeholders for HTA in Zimbabwe. A total of 41 respondents from these stakeholder organizations participated in the survey. Respondents highlighted that the HTA was needed for transparent decision making. The demand for HTArelated evidence was high except for the health economic and ethics dimensions, perhaps reflecting a lack of awareness. Ministry of Health was listed as a major supplier of HTA data. Conclusions: There is no formal HTA agency in the Zimbabwe healthcare system. Various institutions make decisions on prioritization, procurement, and coverage of health services. The activities undertaken by these organizations provide context for the institutionalization of HTA in Zimbabwe.

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Section: Discussionsupporting

confidence: 89%

A situational and stakeholder analysis of health technology assessment in Zimbabwe

Dzingirai,

Dambiko,

Matyanga

et al. 2024

Int J Technol Assess Health Care

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Exploring the landscape of health technology assessment in Iran: perspectives from stakeholders on needs, demand and supply

Aryankhesal,

Behzadifar,

Bakhtiari

et al. 2024

Health Res Policy Sys

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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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Health Technology Assessment (HTA) readiness in Uganda: Stakeholder’s perceptions on the potential application of HTA to support National Universal Health Coverage efforts

Cited by 2 publications

References 30 publications

A situational and stakeholder analysis of health technology assessment in Zimbabwe

A situational and stakeholder analysis of health technology assessment in Zimbabwe

Exploring the landscape of health technology assessment in Iran: perspectives from stakeholders on needs, demand and supply

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