United States Agency for International Development, Washington, District of Columbia, United States of America.
Project SOAR (Supporting Operational AIDS Research), Palladium, Washington, District of Columbia, United States of America.
PLoS One. 2019 Mar 18;14(3):e0213605. doi: 10.1371/journal.pone.0213605. eCollection 2019.
Modeling contributes to health program planning by allowing users to estimate future outcomes that are otherwise difficult to evaluate. However, modeling results are often not easily translated into practical policies. This paper examines the barriers and enabling factors that can allow models to better inform health decision-making.
The Decision Makers' Program Planning Tool (DMPPT) and its successor, DMPPT 2, are illustrative examples of modeling tools that have been used to inform health policy. Their use underpinned Voluntary Medical Male Circumcision (VMMC) scale-up for HIV prevention in southern and eastern Africa. Both examine the impact and cost-effectiveness of VMMC scale-up, with DMPPT used initially in global advocacy and DMPPT 2 then providing VMMC coverage estimates by client age and subnational region for use in country-specific program planning. Their application involved three essential steps: identifying and engaging a wide array of stakeholders from the outset, reaching consensus on key assumptions and analysis plans, and convening data validation meetings with critical stakeholders. The subsequent DMPPT 2 Online is a user-friendly tool for in-country modeling analyses and continuous program planning and monitoring.
Through three iterations of the DMPPT applied to VMMC, a comprehensive framework with six steps was identified: (1) identify a champion, (2) engage stakeholders early and often, (3) encourage consensus, (4) customize analyses, (5), build capacity, and (6) establish a plan for sustainability. This framework could be successfully adapted to other HIV prevention programs to translate modeling results to policy and programming.
Models can be used to mobilize support, strategically plan, and monitor key programmatic elements, but they can also help inform policy environments in which programs are conceptualized and implemented to achieve results. The ways in which modeling has informed VMMC programs and policy may be applicable to an array of other health interventions.
建模通过允许用户估计难以评估的未来结果，有助于健康计划规划。然而，建模结果往往不容易转化为实际政策。本文探讨了可以使模型更好地为健康决策提供信息的障碍和促成因素。
决策者规划工具（DMPPT）及其后续版本 DMPPT 2 是用于为卫生政策提供信息的建模工具的示例。它们的使用为南部和东部非洲的自愿男性割礼扩大规模以预防艾滋病毒提供了依据。两者都考察了扩大男性割礼规模的影响和成本效益，DMPPT 最初用于全球宣传，DMPPT 2 随后按客户年龄和次国家区域提供男性割礼覆盖估计数，用于国家特定的规划。它们的应用涉及三个基本步骤：从一开始就确定并吸引广泛的利益相关者，就关键假设和分析计划达成共识，以及与关键利益相关者举行数据验证会议。随后的 DMPPT 2 Online 是一个用户友好的工具，用于国内建模分析和持续的规划和监测。
通过三轮 DMPPT 在男性割礼中的应用，确定了一个包含六个步骤的综合框架：(1) 确定一个支持者，(2) 尽早并经常与利益相关者接触，(3) 鼓励达成共识，(4) 定制分析，(5) 建立能力，(6) 制定可持续性计划。这个框架可以成功地应用于其他艾滋病毒预防方案，将建模结果转化为政策和方案。
模型可以用于调动支持、战略性规划和监测关键方案要素，但也可以帮助为方案的构思和实施提供信息，以实现成果的政策环境。建模为男性割礼方案和政策提供信息的方式可能适用于一系列其他卫生干预措施。
