Safarnejad Ali, Pavlova Milena, Son Vo Hai, Phuong Huynh Lan, Groot Wim
Maastricht Graduate School of Governance, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, Netherlands.
Department of Health Services Research; CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.
BMC Health Serv Res. 2017 Nov 13;17(1):719. doi: 10.1186/s12913-017-2679-0.
With the decline in funding for Viet Nam's response to the HIV epidemic, there is a need for evidence on the criteria to guide the prioritization of HIV programs. There is a gap in the research on the relative importance of multiple criteria for prioritizing a package of interventions. This study elicits preferences and the trade-offs made between different HIV programs by relevant stakeholders and decision-makers in Viet Nam. It also pays attention to how differences in social and professional characteristics of stakeholders and their agency affiliations shape preferences for HIV program criteria in Viet Nam.
This study uses self-explicated ranking and discrete choice experiments to determine the relative importance of five criteria - effectiveness, feasibility, cost-effectiveness, rate of investment and prevention/treatment investment ratio - to stakeholders when they evaluate and select hypothetical HIV programs. The study includes 69 participants from government, civil society, and international development partners.
Results of the discrete choice experiment show that overall the feasibility criterion is ranked highest in importance to the participants when choosing a hypothetical HIV program, followed by sustainability, treatment to prevention spending ratio, and effectiveness. The participant's work in management, programming, or decision-making has a significant effect on the importance of some criteria to the participant. In the self-explicated ranking effectiveness is the most important criterion and the cost-effectiveness criterion ranks low in importance across all groups.
This study has shown that the preferred HIV program in Viet Nam is feasible, front-loaded for sustainability, has a higher proportion of investment on prevention, saves more lives and prevents more infections. Similarities in government and civil society rankings of criteria can create common grounds for future policy dialogues between stakeholders. Innovative models of planning should be utilized to allow inputs of informed stakeholders at relevant stages of the HIV program planning process.
随着越南应对艾滋病疫情的资金减少，需要有证据来指导艾滋病项目的优先排序标准。在确定一系列干预措施优先顺序的多个标准的相对重要性方面，研究存在空白。本研究探讨了越南相关利益攸关方和决策者在不同艾滋病项目之间的偏好及权衡取舍。同时也关注利益攸关方的社会和职业特征差异及其机构归属如何影响对越南艾滋病项目标准的偏好。
本研究采用自我阐释排序法和离散选择实验法，以确定在评估和选择假设的艾滋病项目时，有效性、可行性、成本效益、投资回报率和预防/治疗投资比这五个标准对利益攸关方的相对重要性。该研究包括来自政府、民间社会和国际发展伙伴的69名参与者。
离散选择实验结果表明，总体而言，在选择假设的艾滋病项目时，可行性标准对参与者来说重要性最高，其次是可持续性、治疗与预防支出比以及有效性。参与者在管理、项目规划或决策方面的工作对某些标准对其的重要性有显著影响。在自我阐释排序中，有效性是最重要的标准，而成本效益标准在所有群体中的重要性排名较低。
本研究表明，越南优先选择的艾滋病项目应是可行的，注重可持续性，预防投资比例更高，挽救更多生命并预防更多感染。政府和民间社会在标准排序上的相似之处可为利益攸关方未来的政策对话创造共同基础。应采用创新的规划模式，以便在艾滋病项目规划过程的相关阶段纳入明智的利益攸关方的意见。
