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Table 1 Kapiriri and Martin’s framework for assessing the quality of priority-setting

From: An analysis of how health systems integrated priority-setting in the pandemic planning in a sample of Latin America and the Caribbean countries

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
  1. DALYs disability-adjusted life-years, ICU intensive care unit
  2. 1This parameter was not assessed in the national COVID-19 plans, but the information about the political, economic, social and cultural context was obtained from different sources and provided in this study to identify similarities and differences among countries in the same region
  3. 2This parameter was added to the framework for the specific context of the COVID-19 pandemic
  4. 3This parameter was not possible to be assessed in the national COVID-19 plans