Doherty Jane E, Wilkinson Thomas, Edoka Ijeoma, Hofman Karen
a School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Parktown , Johannesburg , South Africa.
b PRICELESS SA (Priority Cost-Effective Lessons for Systems Strengthening South Africa), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Parktown , Johannesburg , South Africa.
Glob Health Action. 2017;10(1):1370194. doi: 10.1080/16549716.2017.1370194.
Achieving sustainable universal health coverage depends partly on fair priority-setting processes that ensure countries spend scarce resources wisely. While general health economics capacity-strengthening initiatives exist in Africa, less attention has been paid to developing the capacity of individuals, institutions and networks to apply economic evaluation in support of health technology assessment and effective priority-setting.
On the basis of international lessons, to identify how research organisations and partnerships could contribute to capacity strengthening for health technology assessment and priority-setting in Africa.
A rapid scan was conducted of international formal and grey literature and lessons extracted from the deliberations of two international and regional workshops relating to capacity-building for health technology assessment. 'Capacity' was defined in broad terms, including a conducive political environment, strong public institutional capacity to drive priority-setting, effective networking between experts, strong research organisations and skilled researchers.
Effective priority-setting requires more than high quality economic research. Researchers have to engage with an array of stakeholders, network closely other research organisations, build partnerships with different levels of government and train the future generation of researchers and policy-makers. In low- and middle-income countries where there are seldom government units or agencies dedicated to health technology assessment, they also have to support the development of an effective priority-setting process that is sensitive to societal and government needs and priorities.
Research organisations have an important role to play in contributing to the development of health technology assessment and priority-setting capacity. In Africa, where there are resource and capacity challenges, effective partnerships between local and international researchers, and with key government stakeholders, can leverage existing skills and knowledge to generate a critical mass of individuals and institutions. These would help to meet the priority-setting needs of African countries and contribute to sustainable universal health coverage.
实现可持续的全民健康覆盖在一定程度上取决于公平的优先事项设定过程,该过程可确保各国明智地使用稀缺资源。虽然非洲存在一般的卫生经济能力建设举措,但对培养个人、机构和网络运用经济评估来支持卫生技术评估和有效优先事项设定的能力关注较少。
基于国际经验,确定研究组织和伙伴关系如何能够促进非洲卫生技术评估和优先事项设定方面的能力建设。
对国际正式和灰色文献进行了快速检索,并从两个与卫生技术评估能力建设相关的国际和区域研讨会的审议中提取经验教训。“能力”的定义较为宽泛,包括有利的政治环境、推动优先事项设定的强大公共机构能力、专家之间有效的网络联系、强大的研究组织和熟练的研究人员。
有效的优先事项设定需要的不仅仅是高质量的经济研究。研究人员必须与一系列利益相关者互动,与其他研究组织紧密建立网络联系,与不同层级的政府建立伙伴关系,并培训下一代研究人员和政策制定者。在很少有政府单位或机构专门负责卫生技术评估的低收入和中等收入国家,他们还必须支持制定一个对社会和政府需求及优先事项敏感的有效优先事项设定过程。
研究组织在促进卫生技术评估和优先事项设定能力的发展方面可发挥重要作用。在面临资源和能力挑战的非洲,当地和国际研究人员之间以及与关键政府利益相关者之间的有效伙伴关系,可以利用现有技能和知识,培养足够数量的个人和机构。这些将有助于满足非洲国家的优先事项设定需求,并为可持续的全民健康覆盖做出贡献。