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Chapter 13 - Decision-Making Tools for Informed Decisions by Health Policymakers and Managers

from Section 1 - Analyzing Health Systems: Concepts, Components, Performance

Published online by Cambridge University Press:  08 December 2022

By
Meesha Iqbal ,
Hiba Sameen ,
Mohammad Abu-Zaineh ,
Awad Mataria  and
Sameen Siddiqi
Edited by
Sameen Siddiqi ,
Awad Mataria ,
Katherine D. Rouleau  and
Meesha Iqbal
Sameen Siddiqi
Affiliation:
Aga Khan University
Awad Mataria
Affiliation:
World Health Organization, Egypt
Katherine D. Rouleau
Affiliation:
University of Toronto
Meesha Iqbal
Affiliation:
UTHealth School of Public Health, Houston
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Summary

The process of decision making is not linear and is affected by multiple factors, other than availability of evidence, such as political context, personal over public interests, decision makers’ accountability, relationships with stakeholders, and familiar experiences in the past. Evidence-informed decisions positively influence access, quality, efficiency, equity, and sustainability of health services, and improve transparency and accountability thereby reducing wastage, abuse, and corruption in the health system. This chapter presents six decision making tools that help policy makers and managers take evidence-informed decisions: burden of disease analysis; health technology assessment; cost-effectiveness analysis; health equity analysis; national health accounts analysis; and stakeholder analysis. The list of tools is not exhaustive, and additional tools can be explored to respond to the context and nature of the public health concern. Policymakers are not expected to know all their methodological aspects, rather they should know what tools are available, their purpose and application, strengths and limitations, and how to interpret the results in the local context.

Keywords

Decision Making ToolsEvidence Based DecisionsBurden of DiseaseHealth Technology AssessmentDALYsQALYCost-effectiveness AnalysisIncremental Cost-effectiveness RatioHealth InequalityHealth EquityNational Health AccountsStakeholder AnalysisPolicy AnalysisLorenz CurveGini CoefficientConcentration CurveL&MIC
Type
Chapter
Information
Making Health Systems Work in Low and Middle Income Countries
Textbook for Public Health Practitioners
 , pp. 186 - 207
Publisher: Cambridge University Press
Print publication year: 2022

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References

Glazer, S., Karpati, T.. The role of culture in decision making. Cut IT J 2014; 27(9): 23–29.Google Scholar
Gaitonde, R., Oxman, A. D., Okebukola, P. O., et al. Interventions to reduce corruption in the health sector (Review). Cochrane Database Syst Rev 2016; 8: CD008856.Google Scholar
Murray, C. J., Lopez, A. D.; World Health Organization. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020: summary. 1996. https://apps.who.int/iris/handle/10665/41864 (accessed November 11, 2020).Google Scholar
World Health Organization. Disability-adjusted life years (DALYs). 2022. www.who.int/data/gho/indicator-metadata-registry/imr-details/158 (accessed January 9, 2022).Google Scholar
Global Burden of Disease Collaborative Network. Global burden of disease study 2019 (GBD 2019): life expectancy and healthy life expectancy 1990–2019. 2020. https://doi.org/10.6069/5R23-RQ49 (accessed June 17, 2021).Google Scholar
Public Health England. The burden of disease and what it means in England. https://publichealthmatters.blog.gov.uk/2015/09/15/the-burden-of-disease-and-what-it-means-in-england/ (accessed March 19, 2021).Google Scholar
World Health Organization. Burden of disease concepts, introduction and methods: assessing the environmental burden of disease at national and local levels. 2003. www.who.int/quantifying_ehimpacts/publications/9241546204/en/ (accessed December 11, 2020).Google Scholar
IHME. Measuring what matters: global burden of disease (GBD). 2020. www.healthdata.org/gbd/2019 (accessed October 25, 2021).Google Scholar
International Network of Agencies for Health Technology Assessment (INAHTA). Homepage. www.inahta.org/HTA (accessed March 19, 2021).Google Scholar
Drummond, M. F., Schwartz, J. S., Jönsson, B., et al. Key principles for the improved conduct of health technology assessments for resource allocation decisions. Int J Technol Assess Health Care 2008; 24(3): 244.Google Scholar
Prieto, L., Sacristán, J. A.. Problems and solutions in calculating quality-adjusted life years (QALYs). Health Qual Life Outcomes 2003; 1: 80.Google Scholar
NICE Clinical Guidelines. Cost-effectiveness of IVT versus ORT for children with dehydration. 2009. www.ncbi.nlm.nih.gov/books/NBK63840/ (accessed March 19, 2021).Google Scholar
Fleurbaey, M., Schokkaert, E.. Equity in health and health care. In Culyer, A. J., Newhouse, J., eds., Handbook of Health Economics. Amsterdam, Elsevier, 2011, vol. 2, pp. 1003–1092.Google Scholar
Braveman, P., Gruskin, S.. Defining equity in health. J Epidemiol Community Health 2003; 57(4): 254–258.Google Scholar
Fleurbaey, M., Schokkaert, E.. Unfair inequalities in health and health care. J Health Econ 2009; 28(1): 73–90.Google Scholar
Daisy. Equality and equity. 2019. https://social-change.co.uk/blog/2019-03-29-equality-and-equity#:~:text=Although%20both%20promote%20fairness%2C%20equality,people%20differently%20dependent%20on%20need.&text=Referring%20back%20to%20the%20student,the%20same%20level%20of%20support (accessed March 19, 2021).Google Scholar
Interaction Institute for Social Change. Illustrating equality vs. equity. 2016. https://interactioninstitute.org/illustrating-equality-vs-equity/ (accessed March 19, 2021).Google Scholar
CAWI. Advancing equity and inclusion a guide for municipalities. 2015. www.cawi-ivtf.org/sites/default/files/publications/advancing-equity-inclusion-web_0.pdf (accessed October 25, 2021).Google Scholar
Regidor, E.. Measures of health inequalities: part 1. J Epidemiol Community Health 2004; 58(10): 858.Google Scholar
Scottish Public Health Observatory. Measuring health inequalities. 2021. www.scotpho.org.uk/comparative-health/measuring-inequalities (accessed October 25, 2021).Google Scholar
Tao, Y., Henry, K., Zou, Q., et al. Methods for measuring horizontal equity in health resource allocation: a comparative study. Health Econ Rev 2014; 4(1): 10.Google Scholar
Alonge, O., Peters, D. H.. Utility and limitations of measures of health inequities: a theoretical perspective. Glob Health Action 2015; 8(1): 27591.CrossRefGoogle ScholarPubMed
Abu-Zaineh, M., Abul Naga, R. H.. Bread and social justice: measurement of social welfare and inequality using anthropometrics. Rev Income Wealth 2021. doi-org.lama.univ-amu.fr/10.1111/roiw.12545.Google Scholar
Abu-Zaineh, M., Naga, R. H.. Wealth, health, and the measurement of multidimensional inequality: evidence from the Middle East and North Africa. In Health and Inequality. Bingley, Emerald Group Publishing, pp. 421–439.Google Scholar
World Bank. Concentration curves. 2007. www.worldbank.org/content/dam/Worldbank/document/HDN/Health/HealthEquityCh7.pdf (accessed June 18, 2021).Google Scholar
World Health Organization. Health accounts. www.who.int/health-topics/health-accounts/#tab=tab_1 (accessed July 11, 2021).Google Scholar
OECD. A system of health accounts 2011. 2011. www.oecd.org/publications/a-system-of-health-accounts-2011-9789264270985-en.htm (accessed July 15, 2021).Google Scholar
Ministry of Health, Nutrition and Indigenous Medicine. Sri Lanka national health accounts 2013. 2016. www.health.gov.lk/moh_final/english/public/elfinder/files/publications/NHA/Sri%20Lanka%20National%20Health%20Accounts%202013.pdf (accessed June 17, 2021).Google Scholar
OECD. A system of health accounts 2011. 2017. www.oecd.org/publications/a-system-of-health-accounts-2011-9789264270985-en.htm (accessed October 25, 2021).Google Scholar
OECD, Eurostat, WHO. A system of health accounts 2011 edition. 2011. www.who.int/health-accounts/methodology/sha2011.pdf (accessed July 13, 2021).Google Scholar
World Health Organization. NHA production tool. User Guide, Version 1.0. www.who.int/health-accounts/tools/NHAPT_User_Guide_2.5.12.pdf (accessed July 14, 2021).Google Scholar
Varvasovszky, Z., Brugha, R.. A stakeholder analysis. Health Policy Plan 2000; 15(3): 338–345.Google Scholar
Blair, J. D., Fottler, M. D., Whitehead, C. J.. Diagnosing the stakeholder bottom line for medical group practices: key stakeholders’ potential to threaten and/or cooperate. Med Group Manage J 1996; 43(2): 40–42.Google Scholar
Schmeer, K.. Stakeholder analysis guidelines: policy toolkit for strengthening health sector reform. 2000. www.paho.org/hq/dmdocuments/2010/47-Policy_Toolkit_Strengthening_HSR.pdf (accessed December 11, 2020).Google Scholar
Reich, M.. Political Mapping of Health Policy: A Guide for Managing the Political Dimension of Health Policy. Boston, MA, Harvard School of Public Health, 1994.Google Scholar
Mendelow, A. L.. Environmental scanning: the impact of the stakeholder concept. 1981. http://aisel.aisnet.org/icis1981/20 (accessed February 7, 2022).Google Scholar
Cherry, K.. The Hawthorne effect and behavioral studies. 2020. www.verywellmind.com/what-is-the-hawthorne-effect-2795234 (accessed October 23, 2021).Google Scholar

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