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Williams I, Kapiriri L, Vélez CM, Aguilera B, Danis M, Essue B, Goold S, Noorulhuda M, Nouvet E, Razavi D, Sandman L. How did European countries set health priorities in response to the COVID-19 threat? A comparative document analysis of 24 pandemic preparedness plans across the EURO region. Health Policy 2024; 141:104998. [PMID: 38295675 DOI: 10.1016/j.healthpol.2024.104998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 12/21/2023] [Accepted: 01/15/2024] [Indexed: 02/26/2024]
Abstract
The COVID-19 pandemic has forced governments across the world to consider how to prioritise the allocation of scarce resources. There are many tools and frameworks that have been designed to assist with the challenges of priority setting in health care. The purpose of this study was to examine the extent to which formal priority setting was evident in the pandemic plans produced by countries in the World Health Organisation's EURO region, during the first wave of the COVID-19 pandemic. This compliments analysis of similar plans produced in other regions of the world. Twenty four pandemic preparedness plans were obtained that had been published between March and September 2020. For data extraction, we applied a framework for identifying and assessing the elements of good priority setting to each plan, before conducting comparative analysis across the sample. Our findings suggest that while some pre-requisites for effective priority setting were present in many cases - including political commitment and a recognition of the need for allocation decisions - many other hallmarks were less evident, such as explicit ethical criteria, decision making frameworks, and engagement processes. This study provides a unique insight into the role of priority setting in the European response to the onset of the COVID-19 pandemic.
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Affiliation(s)
- Iestyn Williams
- Health Services Management Centre, University of Birmingham Park house, 40 Edgbaston Park Rd Birmingham, B15 2RT, UK.
| | - Lydia Kapiriri
- Department of Health, Aging & Society, McMaster University, 1280 Main Street West, Kenneth Taylor Hall Room 226, Hamilton, ON, L8S 4M4, Canada
| | - Claudia-Marcela Vélez
- Department of Health, Aging & Society, McMaster University, 1280 Main Street West, Kenneth Taylor Hall Room 226, Hamilton, ON, L8S 4M4, Canada
| | - Bernardo Aguilera
- Faculty of Medicine and Science at the Universidad San Sebastian, Providencia, Santiago de Chile, Región Metropolitana, Chile
| | - Marion Danis
- Department of Bioethics, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20812, USA
| | - Beverley Essue
- Centre for Global Health Research, St. Michael's Hospital, 30 Bond St, Toronto, ON, M5B 1W8, Canada
| | - Susan Goold
- Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, 2800 Plymouth Road Building 14, G016, Ann Arbor, MI 48109, USA
| | - Mariam Noorulhuda
- Department of Health, Aging & Society, McMaster University, 1280 Main Street West, Kenneth Taylor Hall Room 226, Hamilton, ON, L8S 4M4, Canada
| | - Elysee Nouvet
- School of Health Studies, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada
| | - Donya Razavi
- Department of Health, Aging & Society, McMaster University, 1280 Main Street West, Kenneth Taylor Hall Room 226, Hamilton, ON, L8S 4M4, Canada
| | - Lars Sandman
- National Centre for Priorities in Health, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden
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Kapilashrami A, Razavi D, Majdzadeh R. Enhancing Priority-Setting Decision-Making Process Through Use of Intersectionality for Public Participation. Int J Health Policy Manag 2023; 12:8095. [PMID: 37579396 PMCID: PMC10425643 DOI: 10.34172/ijhpm.2023.8095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 05/03/2023] [Indexed: 08/16/2023] Open
Affiliation(s)
- Anuj Kapilashrami
- School of Health and Social Care, University of Essex, Colchester, UK
| | - Donya Razavi
- Department of Health, Aging and Society, McMaster University, Hamilton, ON, Canada
| | - Reza Majdzadeh
- School of Health and Social Care, University of Essex, Colchester, UK
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Razavi S, Noorulhuda M, Marcela Velez C, Kapiriri L, Dreyse BA, Danis M, Essue B, Goold SD, Nouvet E, Williams I. Priority setting for pandemic preparedness and response: A comparative analysis of COVID-19 pandemic plans in 12 countries in the Eastern Mediterranean Region. HEALTH POLICY OPEN 2022; 3:100084. [PMID: 36415539 PMCID: PMC9673227 DOI: 10.1016/j.hpopen.2022.100084] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/28/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022] Open
Abstract
Background The COVID-19 pandemic has significantly disrupted health systems and exacerbated pre-existing resource gaps in the Eastern Mediterranean Region (WHO-EMRO). Active humanitarian and refugee crises have led to mass population displacement and increased health system fragility, which has implication for equitable priority setting (PS). We examine whether and how PS was included in national COVID-19 pandemic plans within EMRO. Methods An analysis of COVID-19 pandemic response and preparedness planning documents from a sample of 12/22 countries in WHO-EMRO. We assessed the degree to which documented PS processes adhere to twenty established quality parameters of effective PS. Results While all reviewed plans addressed some aspect of PS, none included all quality parameters. Yemen's plan included the highest number (9) of quality parameters, while Egypt's addressed the lowest (3). Most plans used evidence in their planning processes. While no plans explicitly identify equity as a criterion to guide PS; many identified vulnerable populations - a key component of equitable PS. Despite high concentrations of refugees, migrants, and IDPs in EMRO, only a quarter of the plans identified them as vulnerable. Conclusion PS setting challenges are exacerbated by conflict and the resulting health system fragmentation. Systematic and quality PS is essential to tackle long-term health implications of COVID-19 for vulnerable populations in this region, and to support effective PS and equitable resource allocation.
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Affiliation(s)
- S.Donya Razavi
- Department of Health, Aging & Society, McMaster University, 1280 Main Street West, Kenneth Taylor Hall Room 226, Hamilton, Ontario L8S 4M4, Canada
| | - Mariam Noorulhuda
- Department of Bioethics, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20812, USA
| | - C. Marcela Velez
- Department of Health, Aging & Society, McMaster University, 1280 Main Street West, Kenneth Taylor Hall Room 226, Hamilton, Ontario L8S 4M4, Canada
| | - Lydia Kapiriri
- Department of Health, Aging & Society, McMaster University, 1280 Main Street West, Kenneth Taylor Hall Room 226, Hamilton, Ontario L8S 4M4, Canada
| | | | - Marion Danis
- Department of Bioethics, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20812, USA
| | - Beverly Essue
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, The University of Toronto, Toronto, ON, Canada
| | - Susan D. Goold
- Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, 2800 Plymouth Road Building 14, G016, Ann Arbor, MI 48109, USA
| | - Elysée Nouvet
- School of Health Studies, Western University, 1151 Richmond Street, London, Ontario N6A 3K7, Canada
| | - Iestyn Williams
- Health Services Management Centre, University of Birmingham, 40 Edgbaston Park Road, Birmingham B15 2RT, UK
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