Dataset Information

Factors influencing institutionalization of health technology assessment in Kenya.

ABSTRACT:

Background

There is a global interest in institutionalizing health technology assessment (HTA) as an approach for explicit healthcare priority-setting. Institutionalization of HTA refers to the process of conducting and utilizing HTA as a normative practice for guiding resource allocation decisions within the health system. In this study, we aimed to examine the factors that were influencing institutionalization of HTA in Kenya.

Methods

We conducted a qualitative case study using document reviews and in-depth interviews with 30 participants involved in the HTA institutionalization process in Kenya. We used a thematic approach to analyze the data.

Results

We found that institutionalization of HTA in Kenya was being supported by factors such as establishment of organizational structures for HTA; availability of legal frameworks and policies on HTA; increasing availability of awareness creation and capacity-building initiatives for HTA; policymakers' interests in universal health coverage and optimal allocation of resources; technocrats' interests in evidence-based processes; presence of international collaboration for HTA; and lastly, involvement of bilateral agencies. On the other hand, institutionalization of HTA was being undermined by limited availability of skilled human resources, financial resources, and information resources for HTA; lack of HTA guidelines and decision-making frameworks; limited HTA awareness among subnational stakeholders; and industries' interests in safeguarding their revenue.

Conclusions

Kenya's Ministry of Health can facilitate institutionalization of HTA by adopting a systemic approach that involves: - (a) introducing long-term capacity-building initiatives to strengthen human and technical capacity for HTA; (b) earmarking national health budgets to ensure adequate financial resources for HTA; (c) introducing a cost database and promoting timely data collection to ensure availability of data for HTA; (d) developing context specific HTA guidelines and decision-making frameworks to facilitate HTA processes; (e) conducting deeper advocacy to strengthen HTA awareness among subnational stakeholders; and (f) managing stakeholders' interests to minimize opposition to institutionalization of HTA.

SUBMITTER: Mbau R

PROVIDER: S-EPMC10288787 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Publications

Factors influencing institutionalization of health technology assessment in Kenya.

Mbau Rahab R Vassall Anna A Gilson Lucy L Barasa Edwine E

BMC health services research 20230622 1

<h4>Background</h4>There is a global interest in institutionalizing health technology assessment (HTA) as an approach for explicit healthcare priority-setting. Institutionalization of HTA refers to the process of conducting and utilizing HTA as a normative practice for guiding resource allocation decisions within the health system. In this study, we aimed to examine the factors that were influencing institutionalization of HTA in Kenya.<h4>Methods</h4>We conducted a qualitative case study using ...[more]

PMID: 37349812

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Project description:BackgroundFollowing approximately 10 years from the beginning of Iran's national Health Technology Assessment (HTA) programme, the present study aims to evaluate its success by examining the impact of HTA and identifying the determinant factors leading to the implementation of HTA report results.MethodsThe triangulation method was employed herein. HTA reports were initially identified and their impact and determinant factors were then examined from the perspectives of both researchers (by preparing a questionnaire according to the Payback model and sending it to HTA principle investigators) and stakeholders (semi-structured interviews held with each HTA stakeholder). Simultaneously, the quality of the HTA reports was examined with relevant critical appraisal checklists.ResultsThe impact of 19 equipment technologies and four pharmaceutical technologies were assessed in this study. Twenty researchers replied (response rate, 86.96%) to the questionnaire on the impact of HTA reports from the researcher's perspective. To assess the impact of HTA reports from the stakeholder's perspective, seven policy-makers were chosen and interviewed as the main target audience. The most common step taken to disseminate the results of the HTA projects was publication. Conducting the HTA had taught researchers and their colleagues' new skills and had facilitated the securing of research grants from other organisations. Most reports had used the systematic review method but the relevant details had been scarcely presented regarding outcomes, costs and analysis. The greatest impact of HTA reports on decision-making had been on policy-makers providing and allocating finances. Barriers in stewardship, identification and prioritisation of topics, performance and dissemination of HTA results were the main barriers of implementing HTAs.ConclusionsIn most aspects, the status of HTA impact reports need improvement. Thus far, the barriers and facilitators of the HTA programme in Iran have been investigated in other studies. These findings should be pooled to reach a solution that can be actively applied to the health system to improve the status quo of HTA in Iran.

Project description:Use of loss reduction practices are critical to ensuring losses are reduced significantly along the value chain. This necessitates for the need to assess the factors that influence adoption of the loss reductio practices to have better targeting and development. Therefore, the current study assessed the factors that influence adoption, and multistage sampling technique was employed. The counties and the sub-counties were purposively selected, and the mapping began from Nairobi which is the main market for mangoes. Wholesalers, and retailers were interviewed making use of snowballing, while farmers were randomly selected. A total of 70 farmers were selected, 74 wholesalers, and 98 retailers were sampled. From the study, at the farm level results revealed that about 38.7 % of the farmer respondents prefer use of stick and bag. On the other hand, about 37.1 % of farmers in Machakos had preference of hand picking as the main method of harvesting. Wholesaler preferred the use of cartons in Nairobi, while those in Embu and Machakos had higher preference of use of shades. Result from the empirical model showed that credit was a critical factor to use of the practices at the farm with a 40 % influence on use of multiple practices. Experiencing higher losses influenced adoption of the practices by 4.3 %, and would influence use of multiple practices by 19.2 %. Organized selling was the critical factor for wholesalers and influenced adoption by 43.4 %. Retailers in Embu and Machakos on the other hand, were 19.9 % less likely to take up the practices. The results further showed that higher PHL influence retailer to take up loss reduction practices by 30.2 %, and those that were more experience were 20 % more likely to take up the practices. From the result it was thus concluded that cost effectiveness, ability to reduce losses, and increase of incomes were some of the things actors were interested with before they could take up any loss reduction practice. Through the study it was evident that high PHL less to higher use of the practices, and also positively influence the intensity of use of the practices. It was thus recommended that there is need for upgrading the current low-cost technologies to make them more user friendly so that they are not time-wasting during harvest, and for the traders they are able to carry optimal quantities that lead to profit maximization.

Dataset Information

Factors influencing institutionalization of health technology assessment in Kenya.

Background

Methods

Results

Conclusions

Publications

Factors influencing institutionalization of health technology assessment in Kenya.

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