Department of Community medicine, College of Medicine, University of Nigeria Enugu Campus Nigeria, Enugu, Nigeria.
International Decision Support Initiative (iDSI), Global Health and Development Group, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK.
Global Health. 2020 Jul 8;16(1):58. doi: 10.1186/s12992-020-00583-2.
Health technology assessment (HTA) is an effective tool to support priority setting and generate evidence for decision making especially en route to achieving universal health coverage (UHC). We assessed the capacity needs, policy areas of demand, and perspectives of key stakeholders for evidence-informed decision making in Nigeria where HTA is still new.
We surveyed 31 participants including decision makers, policy makers, academic researchers, civil society organizations, community-based organizations, development partners, health professional organizations. We revised an existing survey to qualitatively examine the need, policy areas of demand, and perspectives of stakeholders on HTA. We then analyzed responses and explored key themes.
Most respondents were associated with organizations that generated or facilitated health services research. Research institutes highlighted their ability to provide expertise and skills for HTA research but some respondents noted a lack of human capacity for HTA. HTA was considered an important and valuable priority-setting tool with a key role in the design of health benefits packages, clinical guideline development, and service improvement. Public health programs, medicines and vaccines were the three main technology types that would especially benefit from the application of HTA. The perceived availability and accessibility of suitable local data to support HTA varied widely but was mostly considered inadequate and limited. Respondents needed evidence on health system financing, health service provision, burden of disease and noted a need for training support in research methodology, HTA and data management.
The use of HTA by policymakers and communities in Nigeria is very limited mainly due to inadequate and insufficient capacity to produce and use HTA. Developing sustainable and institutionalized HTA systems requires in-country expertise and active participation from a range of stakeholders. Stakeholder participation in identifying HTA topics and conducting relevant research will enhance the use of HTA evidence produced for decision making. Therefore, the identified training needs for HTA and possible research topics should be considered a priority in establishing HTA for evidence-informed policy making for achieving UHC particularly among the most vulnerable people in Nigeria.
卫生技术评估（HTA）是一种支持优先事项设定和生成决策证据的有效工具，尤其是在实现全民健康覆盖（UHC）的过程中。我们评估了尼日利亚的决策制定者、政策制定者、学术研究人员、民间社会组织、社区组织、发展伙伴、卫生专业组织等关键利益攸关方在证据基础上进行决策的能力需求、政策需求领域和观点，因为在尼日利亚，HTA 仍然是一个新兴领域。
我们调查了 31 名参与者，包括决策者、政策制定者、学术研究人员、民间社会组织、社区组织、发展伙伴、卫生专业组织。我们修改了一份现有的调查，以定性地检查利益相关者对 HTA 的需求、政策需求领域和观点。然后，我们对答复进行了分析并探讨了关键主题。
大多数受访者与生成或促进卫生服务研究的组织有关。研究机构强调了他们提供 HTA 研究专业知识和技能的能力，但一些受访者指出 HTA 方面缺乏人力。HTA 被认为是一种重要且有价值的优先事项设定工具，在设计健康福利套餐、临床指南制定和服务改进方面具有关键作用。公共卫生计划、药品和疫苗是将特别受益于 HTA 应用的三种主要技术类型。对支持 HTA 的适宜本地数据的可获得性和可及性的看法差异很大，但大多数人认为这些数据不足和有限。受访者需要关于卫生系统融资、卫生服务提供、疾病负担的证据，并指出需要在研究方法、HTA 和数据管理方面提供培训支持。
尼日利亚的决策者和社区对 HTA 的使用非常有限，主要是因为缺乏足够的能力来生产和使用 HTA。建立可持续和制度化的 HTA 系统需要国内专家和来自各种利益攸关方的积极参与。利益攸关方参与确定 HTA 主题和进行相关研究将增强对用于决策的 HTA 证据的使用。因此，确定 HTA 培训需求和可能的研究主题应被视为在尼日利亚建立 HTA 以实现证据为基础的政策制定、实现全民健康覆盖的优先事项，尤其是对尼日利亚最弱势群体而言。
