Situation analysis of evidence-informed health decision-making in Lao PDR: the case of health technology assessment

IF 7.6 1区医学 Q1 HEALTH CARE SCIENCES & SERVICES

The Lancet Regional Health: Western Pacific Pub Date : 2025-04-01 DOI:10.1016/j.lanwpc.2025.101534

Sysavanh Phommachanh , Manit Sittimart , Aparna Ananthakrishnan , Souphaphone Vongsack , Soudavanh Soysouvanh , Elizabeth A. Ashley , Yot Teerawattananon , Saudamini Vishwanath Dabak , Mayfong Mayxay

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Abstract

Background

There is increasing interest in using evidence to inform policy in Lao PDR, which is in the process of establishing a unit for Health Technology Assessment (HTA). This situation analysis aims to explore the current landscape of evidence generation and translation into policy decisions in Lao PDR using the case of HTA.

Methods

A mixed methods approach was applied. Self-administered questionnaires and semi-structured interviews were conducted with different stakeholder groups. Data were analysed thematically and summarised in tabular form.

Findings

There were 212 responses to the survey and 38 stakeholders were interviewed between March and September 2021. The health policy decision process in Lao PDR is based on consultation meetings, influenced by external experts and/or companies, without consistent use of evidence. There remains a lack of human resource and infrastructure for health evidence to inform policy. Two-thirds of the respondents to the survey strongly agreed that HTA helps in efficient allocation of health resources and improving quality of healthcare. Half of the respondents perceived that HTA can impact the government budget and transparency, which was consistent with findings from the qualitative data. Use of economic considerations was limited in Lao PDR. HTA was seen to apply to policy areas, notably for reimbursement. Only a few organisations can supply health evidence and HTA output, and more training and multi-disciplinary collaboration is needed to conduct and produce HTA and other health evidence to inform policy in Lao PDR. Funding for HTA remains a concern.

Interpretation

Improvement of the health policy decision process is urgently needed in Lao PDR. Limited capacity to conduct HTA as well as institutional considerations need to be addressed. Recent efforts towards this end through the establishment of a unit focused on HTA, capacity building activities and international collaborations are promising to establish evidence-informed priority setting for health policy and can also benefit from regional efforts in this direction. This type of approach to assess the situation for evidence use will be beneficial for other countries embarking on this path.

Funding

Wellcome Trust, the United Kingdom Department of Health and Social Care (DHSC), and the Ministry of Public Health, Thailand.

查看原文本刊更多论文

老挝人民民主共和国循证卫生决策的情况分析：卫生技术评估案例

老挝人民民主共和国正在建立一个卫生技术评估单位，人们对利用证据为政策提供信息越来越感兴趣。这一情况分析的目的是利用HTA的案例，探讨老挝人民民主共和国证据生成和转化为政策决定的现状。方法采用混合方法。对不同的利益相关者群体进行了自我管理的问卷调查和半结构化访谈。数据按主题进行分析，并以表格形式汇总。调查结果在2021年3月至9月期间，共有212份调查回复，38名利益相关者接受了采访。老挝人民民主共和国的卫生政策决策过程以协商会议为基础，受到外部专家和（或）公司的影响，没有一贯使用证据。卫生证据为政策提供信息的人力资源和基础设施仍然不足。三分之二的受访者强烈同意，卫生保健服务有助于有效分配卫生资源和提高卫生保健质量。一半的受访者认为HTA可以影响政府预算和透明度，这与定性数据的结果一致。在老挝人民民主共和国，经济考虑的使用受到限制。卫生保健政策被认为适用于政策领域，特别是在报销方面。只有少数组织能够提供卫生证据和卫生评估产出，需要更多的培训和多学科合作，以便开展和产生卫生评估和其他卫生证据，为老挝人民民主共和国的政策提供信息。HTA的资金仍然是一个问题。老挝人民民主共和国迫切需要改进卫生政策决策过程。需要解决进行人道主义评价的能力有限以及体制方面的考虑。最近为实现这一目标所作的努力，包括设立一个侧重于卫生保健、能力建设活动和国际合作的单位，有望为卫生政策确定循证优先事项，并可从这方面的区域努力中获益。这种评估证据使用情况的方法将有利于其他走上这条道路的国家。资助：威康信托基金、联合王国卫生和社会保障部以及泰国公共卫生部。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health

CiteScore

8.80

自引率

2.80%

发文量

305

审稿时长

11 weeks

期刊介绍： The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.