The two-day ‘Setting Priorities Fairly: Sustainable Policies for Effective Resource Allocation’ event, opened Ghana’s Deputy Minister for Health Mr Kingsley Aboagye-Gyedu, set out to address the difficulties LMICs face with Universal Health Coverage (UHC) attainment; and how to navigate inconsistent and dwindling healthcare funding.

Health Technology Assessment (HTA) was a key focus, with presentations including global experiences of HTA from eminent researchers, health economists and medical doctors from the University of Ghana, Ghana’s National Health Insurance Authority, The Global Fund to Fight AIDS, Tuberculosis and Malaria, World Health Organization, HTAi, iDSI and more.

During his keynote speech Mr Aboagye-Gyedu described how Ghana had incorporated HTA recommendations in its Standard Treatment Guidelines and Essential Medicines List because of its usefulness as tool to assuring value-for-money – from the design and management of benefit packages to the determination of reimbursement list of medicines.

Ghana’s Deputy Minister for Health Mr Kingsley Aboagye-Gyedu who opened the event

Under the leadership of Ghana’s Ministry of Health, iDSI has been working with a variety of Ghanaian entities for several years now, providing technical assistance and facilitating capacity building for evidence informed priority-setting, to support the tough decisions and trade-offs government is faced with.

Mr Aboagye-Gyedu also acknowledged iDSI’s support on Ghana’s pilot study on cost-effective management of hypertension, describing the project as “gearing the country into a real policy momentum to entrench HTA into the selection and pricing processes.”

Day one of the event consisted of pre-conference workshops aimed at stakeholders with relevant interest in HTA development in sub-Saharan Africa, intended to provide an overview of HTA, covering core technical components and how HTA could be integrated within a broader decision-making process.

The second day aimed to extend global experiences in HTA to the SSA region and increase the understanding of the use of HTA for resource allocation decisions while coordinating policy priorities of SSA nations. A mix of expert speakers provided international perspectives and thought-provoking presentations in plenary and parallel sessions covering a wide array issues pertinent to HTA in SSA.

iDSI‘s newly released Health Technology Assessment Toolkit was launched at the event, with each delegate receiving the resource pre-loaded onto a USB stick. The HTA Toolkit is a free, accessible resource for technical staff working in health policy keen to build HTA processes in their own countries and was developed in consultation with staff working in health policy around the world.

Iñaki Gutierrez Ibarluzea, HTAi Vice President, said: “HTAi was proud to join forces with iDSI as well as HTA colleagues from around the world on this ground-breaking initiative. The healthcare challenges sub-Sahara Africa faces are complex and multi-faceted – by leveraging the collective inputs and suggestions from global leaders we hope the ideas and recommendations stemming from this workshop will further spur development and innovation within the region. The collection of knowledge from the delegates that attended the conference was truly remarkable and we are excited to see what some the brightest HTA minds can achieve as a result of this collaboration.” 

Professor Kalipso Chalkidou, iDSI Director, said: “iDSI was delighted to collaborate with HTAi and Ghana’s Ministry of Health to host the event. Bringing together almost 100 policy representatives from across Africa and Europe, our aim was to support countries’ vision to reach Universal Health Coverage in an equitable and sustainable fashion. It was wonderful to be back in Accra, further strengthening our partnership with the Ministry of Health in Ghana, at this event. I would like to extend my thanks to Mr Aboagye-Gyedu for his endorsement and for formally opening and supporting the event.”

Visit the iDSI Knowlege Gateway to read our round up of the event, including key messages and details of external media coverage.

We have made all presentations from the event available on iDSI’s website.

Press coverage:

Ghana News Agency: Ghana hosts conference on sustainable resource allocation
policies (27 September 2018)
Modern Ghana: Conference On Sustainable Resource Allocation Policies (28 September
2018)
Business Ghana: Ghana hosts conference on sustainable resource allocation policies (1
October 2018)

The ‘setting priorities fairly’ event is the first of its kind for Sub Saharan Africa (SSA), with the main event opened by Ghana’s Minister for Health, Kwaku Agyemang-Manu. How important is it for representatives from SSA to share knowledge to optimise the impact of health spending?

The prospect of HTA in SSA is promising, with an increasing number of countries planning to use HTA as a priority-setting tool to promote Universal Health Coverage (UHC). In the light of this, it is crucial that SSA countries share experiences (however little) to learn from each other.

What can attendees to your workshop session on case studies of how Health Technology Assessment can inform decisions on cost-effectiveness expect?

Attendees can expect to learn what has been done already, especially in the case of Ghana and how that applies to their specific country context.

Ghana was the first Sub Saharan African country to introduce a National Health Insurance Scheme (NHIS) and has long standing commitment towards achieving UHC, of course, there is no “one-size-fits-all” approach to UHC, but what is on Ghana’s agenda?

Ghana’s road to UHC through the NHIS has been brave and bumpy, with key challenges relating to financial sustainability. However, given the political support – from all sides of the political divide – the future of the NHIS is bright. A key approach is expanding enrolment through innovative strategies including group enrolment, enrolment of prison inmates etc. In addition, there are efforts to boost the financial status of the NHIS while removing other bottlenecks to promote UHC. A key way forward is re-visiting the Primary Health Care agenda to strengthen close-to-client services and implement provider payment mechanisms that reduce overall service costs and enhance sustainability of the scheme. The overall improvements in the economy could boost fiscal space for health and fast-track attainment of UHC.

You have led on a number of research projects on health economics and policy in Ghana, Botwsana, Kenya, Malawi and Nigeria – what has been your biggest achievement?

My joyous moments (which I see as achievements) are when I see that recommendations from a previous study I was involved in are evaluated and implemented. A typical example was when the Ministry of Health and World Health Organization in Botswana accepted the findings and recommendations of our study on efficiency and begun planning to implement.

What do you enjoy most about your role?

I enjoy seeing my former students in decision-making roles, applying some of the things they learnt. I also enjoy being involved in discussions and networking (with networks such as the platform that iDSI provides) that are directly relevant for evidence-informed policy making in low- and middle-income countries, particularly efforts that benefit Ministries of Health.

If you weren’t a health economist, what would you be doing instead?

I would have been a geomorphologist, studying earth formations.

Registered delegates can attend the workshop Justice will feature in, ‘Introduction to Health Technology Assessment’, from 1pm on 26 September 2018, as part of Setting priorities fairly: sustainable policies for effective resource allocation in Africa.

Read the blog here.

Seminar resources can be found here.

The book What’s In, What’s Out: Designing Benefits for Universal Health Coverage is due out in the summer.

Please click here to download the Job description.

To apply, please forward your CV and a covering letter to llazarus@icon.co.za 

Closing date for applications is Thursday 30 June 2016

NICE International supported Dr Miqdad Asaria, Research Fellow at the Centre for Health Economics, University of York to travel to Addis Ababa, Ethiopia from 21-27 November 2015.

Dr Asaria conducted a series of meetings with colleagues in Ethiopia, including from the Ethiopian Public Health Institute (EPHI), Overseas Development Institute, the Clinton Health Access Initiative, and other senior academics. In addition, Dr Asaria presented two 90-minute sessions on universal health care and the roles of economic evaluation and health inequality analysis at a workshop hosted by EPHI and the EVIDENT network, which involved policy makers from Ethiopia and the region. The visit was part of a long-term engagement strategy with academics and policy makers in Ethiopia involving NICE International partners and will contribute to on-going work in the country.

NICE International were involved in an initiative to develop ‘learning health systems’ in Sub-Saharan Africa.

At the beginning of August 2015, Kalipso Chalkidou represented NICE International at a 3-day meeting at the Rockefeller Foundation Center in Bellagio, Italy.

The meeting was convened to explore the potential for developing a new initiative, with the aim of and building capacity for pragmatic research and developing more ‘learning health systems’ in Sub Saharan Africa (SSA).

21 participants attended from SSA and across the world, including clinical, academic and policy representatives from Zambia, South Africa, Malawi and Kenya, as well as representatives from the BMJ, the Bill and Melinda Gates Foundation, WHO and other global health partners.

Participants discussed the current needs of SSA countries. The types of initiative and components required to build capacity for high quality, pragmatic research, conducted within clinical settings were explored. The ultimate goal of these initiatives is to improve health outcomes and to support the development of ‘learning health systems’ in Sub Saharan Africa.

A steering group, including NICE International, was formed to move forward with the agreed next steps for such an initiative to get off the ground, including exploring opportunities for funding.

The initiative has since been named Better Outcomes through Learning Data and Engaging in Research (BOLDER) and members of the steering group are currently working on the funding proposal.

The meeting was co-organised by NICE International, Center for Medical Technology and Policy, KEMRI-Welcome, Western University, Ontario and Stellenbosch University, South Africa.

During the meetings, Laura identified the articulated needs of the Ministry of Health in relation to planning and costing policy, coordination of the health sector across numerous funding and delivery partners, and the government’s ability to commission and use local research. Discussions explored potential areas for involvement by NICE International and other iDSI partners over the next 12 months. Contacts in Malawi continue to be engaged in wider iDSI activities in Sub-Saharan Africa, including participation in a Rockefeller Foundation-funded meeting on pragmatic research.

Associate director of NICE International Francoise Cluzeau undertook a scoping visit to Ethiopia in conjunction with the Institute of Tropical Medicine (Antwerp) and EVIDENT, an extensive network of North-South partners that aims to enhance evidence-informed decision-making and policy driven research in both health and nutrition in response to local priority concerns.

The visit included meetings with the State Minister of Health and Ministry of Health Senior Adviser, colleagues from the Ethiopian Public Health Institute (EPHI), Addis Ababa university and the Ethiopian Health Insurance Agency.

Discussions highlighted outlined areas of potential involvement for NICE International/iDSI to help Ethiopia in its efforts on achieving Universal Health Coverage through priority setting activities with a focus on health economics training to help strengthen technical capacity at the Ministry of health and its agencies.