Table 1 Kapiriri and Martin’s framework for assessing the quality of priority-setting
Domain | Parameter | Short definition |
|---|---|---|
Contextual factors | Conducive political, economic, social and cultural context | 1Relevant contextual factors that may impact priority-setting |
Prerequisites | Political will | Degree to which the politicians manifested the support to tackle the pandemic |
Resources | Availability of a budget in the COVID-19 plan, and clear description of resources available or required (including human resources, ICU beds and equipment, PPE and other resources) | |
Legitimate and credible institutions | Degree to which the priority-setting institutions can set priorities, public confidence in the institution | |
Incentives for compliance | Explicit description of material and financial incentives to comply with the pandemic plan | |
The priority-setting process | Planning for continuity of care across the health systems | 2Explicit mentions of the continuity of healthcare services during the pandemic |
Stakeholder participation | Description of stakeholders participating in the development and implementation of the COVID-19 plan | |
Use of clear priority-setting processes/tools/methods | Documented priority-setting process and/or use of priority-setting framework | |
Use of explicit relevant priority-setting criteria | Documented/articulated criteria for priority-setting in the COVID-19 plan | |
Use of evidence | Explicit mention of the use of evidence to understand the context, the epidemiological situation, or to identify and assess possible interventions to be implemented | |
Reflection of public values | Explicit mention that the public is represented or that public values have been considered for the development or implementation of the plan | |
Publicity of priorities and criteria | Evidence that the plan and criteria for priority-setting have been publicized and documents are openly accessible | |
Functional mechanisms for appealing the decision | Description of mechanisms for appealing decisions related to the COVID-19 plan, or evidence that the plan has been revised | |
Functional mechanisms for enforcement the decision | Description of mechanisms for enforcing decisions related to the COVID-19 plan | |
Efficiency of the priority-setting process | 3Proportion of meeting time spent on priority-setting; number of decisions made on time | |
Decreased dissensions | 3Number of complaints from stakeholders | |
Implementation | Allocation of resources according to priorities | Degree of alignment of resource allocation and agreed upon priorities |
Decreased resource wastage/misallocation | 3Proportion of budget unused, drug stock-outs | |
Improved internal accountability/reduced corruption | Description of mechanisms for improving the internal accountability or reduce corruption | |
Increased stakeholder understanding, satisfaction and compliance with the priority-setting process | 3Number of stakeholders attending meetings, number of complaints from stakeholders, % stakeholders that can articulate the concepts used in priority-setting and appreciate the need for priority-setting | |
Strengthening of the priority-setting institution | 3Indicators relating to increased efficiency, use of data, quality of decisions, and appropriate resource allocation, % stakeholders with the capacity to set priorities | |
Impact on institutional goals and objectives | 3% of institutional objectives met that are attributed to the priority-setting process | |
Outcome/impact | Impact on health policy and practice | Changes in health policy to reflect identified priorities and swiftness of the pandemic response |
Impact on population health | Description of the expected impact of the COVID-19 plan on the population health | |
Impact on reducing inequalities | Description of the expected impact of the COVID-19 plan on reducing inequalities | |
Fair financial contribution | Description of the expected impact of the COVID-19 plan on fair financial contributions | |
Increased public confidence in the health sector | Description of the expected impact of the COVID-19 plan for increasing public confidence in the response to the COVID-19 pandemic | |
-Responsive healthcare system | 3% reduction in DALYs, % reduction of the gap between the lower and upper quintiles, % of poor populations spending more than 50% of their income on healthcare, % users who report satisfaction with the healthcare system | |
Improved financial and political accountability | 3Number of publicized financial resource allocation decisions, number of corruption instances reported, % of the public reporting satisfaction with the process | |
Increased investment in the health sector and strengthening of the healthcare system | 3Proportion increase in the health budget, proportion increase in the retention of health workers, % of the public reporting satisfaction with the healthcare system |