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The Use of Evidence-Informed Deliberative Processes for Designing the Essential Package of Health Services in Pakistan.
Baltussen, Rob; Jansen, Maarten; Akhtar, Syeda Shehirbano; Bijlmakers, Leon; Torres-Rueda, Sergio; Khalid, Muhammad; Raza, Wajeeha; Huda, Maryam; Surgey, Gavin; Zulfiqar, Wahaj; Vassall, Anna; Zaidi, Raza; Siddiqi, Sameen; Alwan, Ala.
Affiliation
  • Baltussen R; Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Jansen M; Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Akhtar SS; Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
  • Bijlmakers L; Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Torres-Rueda S; Department of Global Health & Development, London School of Hygiene and Tropical Medicine, London, UK.
  • Khalid M; Ministry of National Health Services, Regulations and Coordination, Islamabad, Pakistan.
  • Raza W; Centre for Health Economics, University of York, York, UK.
  • Huda M; Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
  • Surgey G; Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Zulfiqar W; Ministry of National Health Services, Regulations and Coordination, Islamabad, Pakistan.
  • Vassall A; Department of Global Health & Development, London School of Hygiene and Tropical Medicine, London, UK.
  • Zaidi R; Ministry of National Health Services, Regulations and Coordination, Islamabad, Pakistan.
  • Siddiqi S; Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
  • Alwan A; DCP3 Country Translation Project, London School of Hygiene and Tropical Medicine, London, UK.
Int J Health Policy Manag ; 13: 8004, 2024.
Article in En | MEDLINE | ID: mdl-39099516
ABSTRACT

BACKGROUND:

The Disease Control Priorities 3 (DCP3) project provides long-term support to Pakistan in the development and implementation of its universal health coverage essential package of health services (UHC-EPHS). This paper reports on the priority setting process used in the design of the EPHS during the period 2019-2020, employing the framework of evidence-informed deliberative processes (EDPs), a tool for priority setting with the explicit aim of optimising the legitimacy of decision-making in the development of health benefit packages.

METHODS:

We planned the six steps of the framework during two workshops in the Netherlands with participants from all DCP3 Pakistan partners (October 2019 and February 2020), who implemented these at the country level in Pakistan in 2019 and 2020. Following implementation, we conducted a semi-structured online survey to collect the views of participants in the UHC benefit package design about the prioritisation process.

RESULTS:

The key steps in the EDP framework were the installation of advisory committees (involving more than 150 members in several Technical Working Groups [TWGs] and a National Advisory Committee [NAC]), definition of decision criteria (effectiveness, cost-effectiveness, avoidable burden of disease, equity, financial risk protection, budget impact, socio-economic impact and feasibility), selection of interventions for evaluation (a total of 170), and assessment and appraisal (across the three dimensions of the UHC cube) of these interventions. Survey respondents were generally positive across several aspects of the priority setting process.

CONCLUSION:

Despite several challenges, including a partial disruption because of the COVID-19 pandemic, implementation of the priority setting process may have improved the legitimacy of decision-making by involving stakeholders through participation with deliberation, and being evidence-informed and transparent. Important lessons were learned that can be beneficial for other countries designing their own health benefit package such as on the options and limitations of broad stakeholder involvement.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Universal Health Insurance / Health Priorities Limits: Humans Country/Region as subject: Asia Language: En Journal: Int J Health Policy Manag Year: 2024 Document type: Article Affiliation country: Netherlands Country of publication: Iran

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Universal Health Insurance / Health Priorities Limits: Humans Country/Region as subject: Asia Language: En Journal: Int J Health Policy Manag Year: 2024 Document type: Article Affiliation country: Netherlands Country of publication: Iran