Mapping of priority-setting in health in 17 low and middle income countries across Asia, Latin America, and Africa

By Karla Hernandez-Villafuerte, Ryan Li, Adrian Towse, Kalipso Chalkidou May. 20, 2015

A new OHE occasional paper has just been published, written in collaboration with NICE International. The document aims to assess the characteristics of a sample of low and middle income countries (LMICs), in order to select a shortlist of countries in which an iDSI practical support project could have the maximum likelihood of success and possible impact. The practical support project would assist one country in building institutional and technical capacity in priority-setting for universal health coverage (UHC).
We identified a longlist of 17 LMICs across three regions, with a broad mix of geographical representation, population size and economic performance: Brazil, Chile, Colombia, Mexico, Uruguay, Ghana, Kenya, Malawi, South Africa, Uganda, China, India, Indonesia, Myanmar, Philippines, Thailand and Vietnam. In order to assess priority-setting readiness in each country, we developed qualitative and quantitative indicators covering: political will, current position along the UHC journey, institutional and technical capacity, health system financing characteristics, and potential economies of scale in priority-setting. We gathered and synthesised data up to May 2014 on countries’ priority-setting readiness from various sources, including literature review, key opinion leader questionnaires and in-depth interviews.
In shortlisting candidate countries for iDSI practical support, we excluded: (1) countries that have already established a dedicated, centralised priority-setting institution), (2) countries that have not articulated a political commitment to priority-setting for UHC, and (3) countries where iDSI partners may be limited in their ability to gain traction.
We applied our exclusion criteria and identified a shortlist of four countries: Indonesia, Myanmar, South Africa and Ghana. All four shortlisted countries shared a common vision of increased public financing and provision of healthcare, with explicit priority-setting recognised as a crucial means of ensuring sustainable UHC. Leaders in all four countries have expressed a strong interest in working with iDSI in their effort to introduce UHC. In any of the four countries, an iDSI practical support project would likely to be feasible, and generate economies of scale within and across regions. iDSI could support institutional and technical capacity building for priority-setting and add significant value for each of these countries in different ways that are aligned with the strategic priorities of iDSI funders Bill & Melinda Gates Foundation and UK Department for International Development (DFID), and of high-level decision makers in those countries.
Download the full paper here.
Following the completion of this paper and a scoping visit in July 2014, Indonesia was selected by iDSI as the partner country for an ongoing practical support project to support HTA development.
For more information contact Karla Hernandez-Villafuerte at OHE.

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