School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.
Independent Consultant in Nutrition, Tunis, Tunisia.
Int J Technol Assess Health Care. 2023 Jan 30;39(1):e9. doi: 10.1017/S0266462323000016.
This study aimed to provide a structured description of the commonalities and differences in healthcare structures across Africa to establish a reliable basis for the health technology assessment (HTA) of nutrition and nutrition interventions. A ranking of current nutrition conditions in the general population of the participating countries was included to gain a better understanding of the factors influencing hospital malnutrition (HMN), which will inform future multi-country research.
A questionnaire on the structure of the health systems was distributed among ten African countries. Subsections were included that inquired about the drivers or barriers to using principles of HTA to assess nutritional care. Analysis and ranking of malnutrition data were based on data from the Global Hunger Index report and two poverty indicators used by the World Bank.
The health system structure of each country was identified and described, whereas questions about HTA could not always be analyzed due to a lack of adequate in-depth knowledge and skills in most countries. Early experience from some countries demonstrates a conceivable route ahead for African countries in strengthening the capacity for and implementing HTA in accordance with distinct national healthcare contexts and social determinants of health.
Problems related to nutritional care represent one of the major priorities in the surveyed countries. A future HMN multi-country study will provide valuable insight into the potential of low-cost primary prevention orientations.
本研究旨在对非洲各国医疗结构的共性和差异进行系统描述,为营养和营养干预措施的卫生技术评估(HTA)建立可靠基础。本研究还对参与国家的一般人群的当前营养状况进行了排名,以更好地了解影响医院营养不良(HMN)的因素,这将为未来的多国研究提供信息。
向十个非洲国家分发了一份关于卫生系统结构的调查问卷。其中包括询问使用 HTA 原则评估营养护理的驱动因素或障碍的部分。营养不良数据的分析和排名基于全球饥饿指数报告的数据和世界银行使用的两个贫困指标。
确定并描述了每个国家的卫生系统结构,而由于大多数国家缺乏足够的深入知识和技能,HTA 相关问题无法进行分析。一些国家的早期经验展示了非洲国家根据独特的国家医疗保健背景和健康的社会决定因素,加强 HTA 能力和实施 HTA 的可行途径。
与营养护理相关的问题是调查国家的主要优先事项之一。未来的 HMN 多国研究将为低成本初级预防方向的潜力提供有价值的见解。