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Table 10 Factors that can determine the importance of implementing health policies and programmes

From: SUPPORT Tools for evidence-informed health Policymaking (STP) 16: Using research evidence in balancing the pros and cons of policies

The following factors may sometimes be considered independently (or in combination) as criteria for setting priorities for implementing health policies and programmes:

• How serious the problem is -- the more serious a problem is, the more likely it is that a policy or programme that addresses the problem will be a priority

• The number of people that are affected by the problem -- the more people who are affected, the more likely it is that a policy or programme that addresses the problem will be a priority

• Benefits -- the larger the benefit, the more likely it is that a policy or programme will be a priority

• Adverse effects -- the greater the risk of undesirable effects, the less likely it is that a policy or programme will be a priority

• Resource use (costs) -- the greater the cost, the less likely it is that a policy or programme will be a priority

• Cost-effectiveness -- the lower the cost per unit of benefit, the more likely it is that a policy or programme will be a priority

• Impacts on equity -- policies or programmes that reduce inequities may be more of a priority than ones that do not (or ones that increase inequities)

Decisions about priorities should rest on shared criteria or reasoning such as the ideas shown above. They should also be open to inspection and they should be possible to appeal in light of considerations that stakeholders may raise. Regulation should ensure that these three conditions are met [25]. When criteria such as the above are used implicitly rather than explicitly, it is difficult to judge whether the criteria or the decisions were appropriate [26].