128 research outputs found
What are health policy and systems research priorities for universal health coverage in South Africa?
We report here on the process and findings of a research prioritisation exercise for universal health coverage (UHC) in South Africa,
conducted during the course of 2019. As plans to roll out National Health Insurance (NHI) gather momentum and we transition into a
pandemic recovery phase, we believe that it is now time to revisit these priorities, while recognising that experiences with the COVIDâ19
pandemic have revealed new system challenges and strengths and introduced new priorities. The UHC research priority-setting
methodology followed a stepwise process of collation of evidence, expert brainstorming and the development of a survey completed by
68 members of the Public Health Association of South Africa. Themes related to leadership and governance were ranked most highly, and
with other priorities generated, provide an initial road map of knowledge needs that could guide individual institutions and commissioning
by funding bodies. We further reflect on the importance of researcher-decision-maker dialogue and strengthening the contribution of
health policy and systems research to policy and practice, especially as new reforms are implemented
The use of anticoagulants in patients hospitalised with COVID-19
In this Cochrane Corner, we highlight the main findings of a Cochrane Review by Flumignan et al. entitled âAnticoagulants for people hospitalised with COVIDâ19â and discuss the implications of these findings for research and practice in South Africa. In particular, we underscore the need for additional, highâquality, randomised controlled trials comparing different intensities of anticoagulation in patients with COVIDâ19 illness. Individuals in the intensive care unit and those hospitalised with another illness who are incidentally found to be infected with SARSâCoVâ2 should still only be treated with prophylacticâdose lowâmolecularâweight heparin
Decision criteria for selecting essential medicines and their connection to guidelines:an interpretive descriptive qualitative interview study
Background and Objectives: The World Health Organization Model List of Essential Medicines has led to at least 137 national lists. Essential medicines should be grounded in evidence-based guideline recommendations and explicit decision criteria. Essential medicines should be available, accessible, affordable, and the supporting evidence should be accompanied by a rating of the certainty one can place in it. Our objectives were to identify criteria and considerations that should be addressed in moving from a guideline recommendation regarding a medicine to the decision of whether to add, maintain, or remove a medicine from an essential medicines list. We also seek to explore opportunities to improve organizational processes to support evidence-based health decision-making more broadly. Methods: We conducted a qualitative study with semistructured interviews of key informant stakeholders in the development and use of guidelines and essential medicine lists (EMLs). We used an interpretive descriptive analysis approach and thematic analysis of interview transcripts in NVIVO v12. Results: We interviewed 16 key informants working at national and global levels across all WHO regions. We identified five themes: three descriptive/explanatory themes 1) EMLs and guidelines, the same, but different; 2) EMLs can drive price reductions and improve affordability and access; 3) Time lag and disconnect between guidelines and EMLs; and two prescriptive themes 4) An âevidence pipelineâ could improve coordination between guidelines and EMLs; 5) Facilitating the link between the WHO Model List of Essential Medicines (WHO EML) and national EMLs could increase alignment. Conclusion: We found significant overlap and opportunities for alignment between guideline and essential medicine decision processes. This finding presents opportunities for guideline and EML developers to enhance strategies for collaboration. Future research should assess and evaluate these strategies in practice to support the shared goal of guidelines and EMLs: improvements in health.</p
Decision criteria for selecting essential medicines and their connection to guidelines:an interpretive descriptive qualitative interview study
Background and Objectives: The World Health Organization Model List of Essential Medicines has led to at least 137 national lists. Essential medicines should be grounded in evidence-based guideline recommendations and explicit decision criteria. Essential medicines should be available, accessible, affordable, and the supporting evidence should be accompanied by a rating of the certainty one can place in it. Our objectives were to identify criteria and considerations that should be addressed in moving from a guideline recommendation regarding a medicine to the decision of whether to add, maintain, or remove a medicine from an essential medicines list. We also seek to explore opportunities to improve organizational processes to support evidence-based health decision-making more broadly. Methods: We conducted a qualitative study with semistructured interviews of key informant stakeholders in the development and use of guidelines and essential medicine lists (EMLs). We used an interpretive descriptive analysis approach and thematic analysis of interview transcripts in NVIVO v12. Results: We interviewed 16 key informants working at national and global levels across all WHO regions. We identified five themes: three descriptive/explanatory themes 1) EMLs and guidelines, the same, but different; 2) EMLs can drive price reductions and improve affordability and access; 3) Time lag and disconnect between guidelines and EMLs; and two prescriptive themes 4) An âevidence pipelineâ could improve coordination between guidelines and EMLs; 5) Facilitating the link between the WHO Model List of Essential Medicines (WHO EML) and national EMLs could increase alignment. Conclusion: We found significant overlap and opportunities for alignment between guideline and essential medicine decision processes. This finding presents opportunities for guideline and EML developers to enhance strategies for collaboration. Future research should assess and evaluate these strategies in practice to support the shared goal of guidelines and EMLs: improvements in health.</p
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