21 research outputs found
Introducing health technology assessment in Tanzania
No full textObjectives
Health technology assessment (HTA) is a cost-effective resource allocation tool in healthcare decision-making processes; however, its use is limited in low-income settings where countries fall short on both absorptive and technical capacity. This paper describes the journey of the introduction of HTA into decision-making processes through a case study revising the National Essential Medicines List (NEMLIT) in Tanzania. It draws lessons on establishing and strengthening transparent priority-setting processes, particularly in sub-Saharan Africa.
Methods
The concept of HTA was introduced in Tanzania through revision of the NEMLIT by identifying a process for using HTA criteria and evidence-informed decision making. Training was given on using economic evidence for decision making, which was then put into practice for medicine selection for the NEMLIT. During the revision process, capacity-building workshops were held with reinforcing messages on HTA.
Results
Between the period 2014 and 2018, HTA was introduced in Tanzania with a formal HTA committee being established and inaugurated followed by the successful completion and adoption of HTA into the NEMLIT revision process by the end of 2017. Consequently, the country is in the process of institutionalizing HTA for decision making and priority setting.
Conclusion
While the introduction of HTA process is country-specific, key lessons emerge that can provide an example to stakeholders in other low- and middle-income countries (LMICs) wishing to introduce priority-setting processes into health decision making
Health Technology Assessment in Tanzania: Capacity and Experience of HTA Committee Members
No full textHealth Technology Assessment in Tanzania: Capacity and Experience of HTA Committee Member
Health Technology Assessment in Tanzania: Capacity and Experience of HTA Committee Members
No full textHealth Technology Assessment in Tanzania: Capacity and Experience of HTA Committee Member
Health Technology Assessment in Tanzania: Capacity and Experience of HTA Committee Members
No full textHealth Technology Assessment in Tanzania: Capacity and Experience of HTA Committee Member
P6.09 Identifying the barriers sex workers experience to participate in policy making decisions in johannesburg, south africa
No full textAn investigation on the expenditure and number trained by big companies in South Africa
No full textThis paper investigates the nature of company investment in training. A survey was
undertaken in 2007 of 106 large companies operating in South Africa to examine the size
of expenditure on training by these firms, the beneficiaries of the training; and investigate
firms’ attitudes towards such programmes. Both the level of firm spending, and the
proportion of payroll it amounts to are significant. The study reveals that businesses are
acutely aware of the risks of skills shortages and their role in mitigating the risks to
themselves. It also finds that investment into training and development is directly and
largely driven by a need to increase productivity, profitability, and sustainability as
companies try to proactively address a lack of skilled labour
South Africa’s private sector investment in training and its erosion as a result of HIV and AIDS
No full textSouth Africa’s economic prospects depend on the productivity of its labour, and productivity can only be maximised when the labour force possess the appropriate skills. Business is playing its part by offering training opportunities to employees. Collectively, they are spending more than the government’s mandated level on training. However, the HIV and AIDS epidemic is eroding this investment in southern Africa where the HIV epidemic is at its worst. While there has been empirical work that provides estimates on the cost of HIV and AIDS to business, there is very little data on the actual amounts large companies spend on training, and how much of this investment is eroded as a result of HIV and AIDS deaths. Using an estimate of the HIV and AIDS death rate in the private sector and survey data which identifies training expenditure by sector, the authors estimate the extent to which HIV and AIDS has potentially eroded this investment. The loss for all sectors was estimated at almost R10 million (R9,871,732) during the study year, which equates to USD1,183,661 per annum. This amount represented on average 0.73 per cent of the actual investment in training. The real costs of HIV and AIDS on business, which includes absenteeism, declining productivity and other costs are difficult to quantify, but they are likely to significantly exceed this lost training investment as a result of increasing morbidity and mortality rates due to HIV. It is therefore in a company’s best interest to: (1) ensure that a sound HIV and AIDS policy is in place; (2) invest in effective prevention programmes; and (3) provide the appropriate ARV treatment to infected employees if this treatment is not easily accessible through the public health sector
South Africa's private sector investment in training and its erosion as a result of HIV and AIDS
No full textSouth Africa’s economic prospects depend on the productivity of its labour, and productivity can only be maximised when the labour force possess the appropriate skills. Business is playing its part by offering training opportunities to employees. Collectively, they are spending more than the government’s mandated level on training. However, the HIV and AIDS epidemic is eroding this investment in southern Africa where the HIV epidemic is at its worst. While there has been empirical work that provides estimates on the cost of HIV and AIDS to business, there is very little data on the actual amounts large companies spend on training, and how much of this investment is eroded as a result of HIV and AIDS deaths. Using an estimate of the HIV and AIDS death rate in the private sector and survey data which identifies training expenditure by sector, the authors estimate the extent to which HIV and AIDS has potentially eroded this investment. The loss for all sectors was estimated at almost R10 million (R9,871,732) during the study year, which equates to USD1,183,661 per annum. This amount represented on average 0.73 per cent of the actual investment in training. The real costs of HIV and AIDS on business, which includes absenteeism, declining productivity and other costs are difficult to quantify, but they are likely to significantly exceed this lost training investment as a result of increasing morbidity and mortality rates due to HIV. It is therefore in a company’s best interest to: (1) ensure that a sound HIV and AIDS policy is in place; (2) invest in effective prevention programmes; and (3) provide the appropriate ARV treatment to infected employees if this treatment is not easily accessible through the public health sector
Good Practices for Health Technology Assessment Guideline Development: A Report of the Health Technology Assessment International, HTAsiaLink, and ISPOR Special Task Force
No full textThe article has been co-published with permission in Value in Health and in International Journal of Technology Assessment in Health CareOBJECTIVES: Health technology assessment (HTA) guidelines are intended to support successful implementation of HTA by enhancing consistency and transparency in concepts, methods, process, and use, thereby enhancing the legitimacy of the decision-making process. This report lays out good practices and practical recommendations for developing or updating HTA guidelines to ensure successful implementation. METHODS: The task force was established in 2022 and comprised experts and academics from various geographical regions, each with substantial experience in developing HTA guidelines for national health policymaking. Literature reviews and key-informant interviews were conducted to inform these good practices. Stakeholder consultations, open peer reviews, and expert opinions validated the recommendations. A series of teleconferences among task force members was held to iteratively refine the report. RESULTS: The recommendations cover 6 key aspects throughout the guideline development cycle: (1) setting objectives, scope, and principles of the guideline, (2) building a team for a quality guideline, (3) defining a stakeholder engagement plan, (iv) developing content and utilizing available resources, (v) putting in place appropriate institutional arrangements, and (vi) monitoring and evaluating guideline success. CONCLUSION: This report presents a set of resources and context-appropriate practices for developing or updating HTA guidelines. Across all contexts, the recommendations emphasize transparency, building trust among stakeholders, and fostering a culture of ongoing learning and improvement. The report recommends timing development and revision of guidelines according to the HTA landscape and pace of HTA institutionalization. Because HTA is increasingly used to inform different kinds of decision making in a variety of country contexts, it will be important to continue to monitor lessons learned to ensure the recommendations remain relevant and effective.Siobhan Botwright, Manit Sittimart, Kinanti Khansa Chavarina, Diana Beatriz Samson Bayani, Tracy Merlin, Gavin Surgey, Christian Suharlim, Manuel A. Espinoza, Anthony J. Culyer, Wija Oortwijn, Yot Teerawattanano
The potential health and revenue effects of a tax on sugar sweetened beverages in Zambia
No full textThe global burden of non- communicable diseases (NCDs) has been rising. A key risk factor for NCDs is obesity, which has been partly linked to consumption of sugar sweetened beverages (SSBs). A tax on SSBs is an attractive control measure to curb the rising trend in NCDs, as it has the potential to reduce consumption of SSBs. However, studies on the potential effects of SSB taxes have been concentrated in high- income countries with limited studies in low- income and middle- income countries. Using data from the 2015 Zambia Living Conditions Monitoring Survey (LCMS) data, the 2017 Zambia NCD STEPS Survey, and key parameters from the literature, we simulated the effect of a 25% SSB tax in Zambia on energy intake and the corresponding change in body mass index (BMI), obesity prevalence, deaths averted, life years gained and revenues generated using a mathematical model developed using Microsoft Excel. We conducted Monte Carlo simulations to construct 95% confidence bands and sensitivity analyses to account for uncertainties in key parameters. We found that a 25% SSB would avert 2526 deaths, though these results were not statistically significant overall. However, when broken down by gender, the tax was found to significantly avert 1133 deaths in women (95% CI 353 to 1970). The tax was found to potentially generate an additional US$5.46 million (95% CI 4.66 to 6.14) in revenue annually. We conclude that an SSB tax in Zambia has the potential to significantly decrease the amount of disability- adjusted life years lost to lifestyle- related diseases in women, highlighting important health equity outcomes. Women have higher baseline BMI and therefore are at higher risk for NCDs. In addition, an SSB tax will provide government with additional revenue which if earmarked for health could contribute to healthcare financing in Zambia
