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尼日利亚决策者的 COVID-19 疫苗接种卫生技术评估:确定利益相关者和支持证据采用的途径。

A health technology assessment of COVID-19 vaccination for Nigerian decision-makers: Identifying stakeholders and pathways to support evidence uptake.

机构信息

Department of Community Medicine, University of Nigeria Nsukka, Enugu Campus, Nsukka, Nigeria.

Health Policy Research Group, College of Medicine, University of Nigeria Nsukka, Enugu Campus, Nsukka, Nigeria.

出版信息

Health Res Policy Syst. 2024 Jun 26;22(1):73. doi: 10.1186/s12961-024-01158-y.


DOI:10.1186/s12961-024-01158-y
PMID:38926716
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11210088/
Abstract

BACKGROUND: Nigeria commenced rollout of vaccination for coronavirus disease 2019 (COVID-19) in March 2021 as part of the national public health response to the pandemic. Findings from appropriately contextualized cost-effectiveness analyses (CEA) as part of a wider process involving health technology assessment (HTA) approaches have been important in informing decision-making in this area. In this paper we outline the processes that were followed to identify COVID-19 vaccine stakeholders involved in the selection, approval, funding, procurement and rollout of vaccines in Nigeria, and describe the process routes we identified to support uptake of HTA-related information for evidence-informed policy in Nigeria. METHODS: Our approach to engaging with policy-makers and other stakeholders as part of an HTA of COVID vaccination in Nigeria consisted of three steps, namely: (i) informal discussions with key stakeholders; (ii) stakeholder mapping, analysis and engagement; and (iii) communication and dissemination strategies for the HTA-relevant evidence produced. The analysis of the stakeholder mapping uses the power/interest grid framework. RESULTS: The informal discussion with key stakeholders generated six initial policy questions. Further discussions with policy-makers yielded three suitable policy questions for analysis: which COVID-19 vaccines should be bought; what is the optimal mode of delivery of these vaccines; and what are the cost and cost-effectiveness of vaccinating people highlighted in Nigeria's phase 2 vaccine rollout prioritized by the government, especially the inclusion of those aged between 18 and 49 years. The stakeholder mapping exercise highlighted the range of organizations and groups within Nigeria that could use the information from this HTA to guide decision-making. These stakeholders included both public/government, private and international organizations The dissemination plan developed included disseminating the full HTA results to key stakeholders; production of policy briefs; and presentation at different national and international conferences and peer-reviewed publications. CONCLUSIONS: HTA processes that involve stakeholder engagement will help ensure important policy questions are taken into account when designing any HTA including any underpinning evidence generation. Further guidance about stakeholder engagement throughout HTA is required, especially for those with low interest in vaccine procurement and use.

摘要

背景:尼日利亚于 2021 年 3 月开始推出针对 2019 年冠状病毒病(COVID-19)的疫苗接种,这是国家应对大流行的公共卫生措施的一部分。在这方面,作为卫生技术评估(HTA)方法更广泛过程的一部分,进行适当背景化的成本效益分析(CEA)的结果对于决策具有重要意义。在本文中,我们概述了确定参与尼日利亚 COVID-19 疫苗选择、批准、资金、采购和推出的疫苗的利益相关者的过程,并描述了我们确定的过程路线,以支持尼日利亚采用与 HTA 相关的信息来制定基于证据的政策。

方法:我们与决策者和其他利益相关者接触的方法是作为尼日利亚 COVID 疫苗接种 HTA 的一部分,包括三个步骤,即:(i)与主要利益相关者进行非正式讨论;(ii)利益相关者映射、分析和参与;(iii)用于传播与 HTA 相关的证据的沟通和传播策略。利益相关者映射分析使用权力/利益网格框架。

结果:与主要利益相关者的非正式讨论产生了六个初始政策问题。与决策者进一步讨论产生了三个适合分析的政策问题:应购买哪些 COVID-19 疫苗;这些疫苗的最佳交付模式是什么;以及在尼日利亚政府优先进行的第二阶段疫苗推出中强调的接种人群的成本和成本效益如何,特别是包括 18 至 49 岁的人群。利益相关者映射工作突出了尼日利亚内部可能使用该 HTA 信息来指导决策的各种组织和团体。这些利益相关者包括公共/政府、私营和国际组织。制定的传播计划包括向主要利益相关者传播完整的 HTA 结果;编写政策简报;以及在不同的国家和国际会议上介绍和发表同行评议的出版物。

结论:涉及利益相关者参与的 HTA 流程将有助于确保在设计任何 HTA 时考虑到重要的政策问题,包括任何基础证据的生成。需要进一步了解 HTA 过程中的利益相关者参与情况,特别是对于那些对疫苗采购和使用兴趣较低的利益相关者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1667/11210088/c9c9249ddd2f/12961_2024_1158_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1667/11210088/e6cf96963b70/12961_2024_1158_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1667/11210088/2a155081e18f/12961_2024_1158_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1667/11210088/c9c9249ddd2f/12961_2024_1158_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1667/11210088/e6cf96963b70/12961_2024_1158_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1667/11210088/2a155081e18f/12961_2024_1158_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1667/11210088/c9c9249ddd2f/12961_2024_1158_Fig3_HTML.jpg

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引用本文的文献

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Vaccination versus natural infection: A review of antibody differentiation techniques.

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本文引用的文献

[1]
What, how and who: Cost-effectiveness analyses of COVID-19 vaccination to inform key policies in Nigeria.

PLOS Glob Public Health. 2023-3-22

[2]
Incremental Net Benefit and Incremental Cost-Effectiveness Ratio of COVID-19 Vaccination Campaigns: Systematic Review of Cost-Effectiveness Evidence.

Vaccines (Basel). 2023-2-3

[3]
Return on Investment of the COVID-19 Vaccination Campaign in New York City.

JAMA Netw Open. 2022-11-1

[4]
COVID-19 vaccine hesitancy among staff and students in a Nigerian tertiary educational institution.

Ther Adv Infect Dis. 2021-11-1

[5]
COVID-19 vaccine hesitancy among healthcare workers and its socio-demographic determinants in Abia State, Southeastern Nigeria: a cross-sectional study.

Pan Afr Med J. 2021

[6]
Health technology assessment and priority setting for universal health coverage: a qualitative study of stakeholders' capacity, needs, policy areas of demand and perspectives in Nigeria.

Global Health. 2020-7-8

[7]
Coronavirus outbreak in Nigeria: Burden and socio-medical response during the first 100 days.

Int J Infect Dis. 2020-9

[8]
The link between health technology assessment and decision making for the allocation of health resources in Latin America.

Int J Technol Assess Health Care. 2020-4

[9]
Modelling for policy: The five principles of the Neglected Tropical Diseases Modelling Consortium.

PLoS Negl Trop Dis. 2020-4-9

[10]
Use of Evidence-Informed Deliberative Processes by Health Technology Assessment Agencies Around the Globe.

Int J Health Policy Manag. 2020-1-1

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