Community social valuation: use of nominal group technique in ranking of health conditions from two communities in Temeke and Moshi Districts in Tanzania

This study used the nominal group technique to explore societal value preferences in the ranking of health conditions from two communities in Temeke and Moshi districts in Tanzania. The nominal group technique was applied to a community of lay people including patients and community leaders. In this study we found a relatively high stability of ranking values across sites and informant groups. The nominal group technique was easy for lay people to understand and less time consuming compared to other methods used in health state valuation. The findings indicate that the nominal group technique can be used in the valuation process with a population of lay people to obtain societal preferences as a basis for priority setting in health. This study was limited to using criteria as a guide in the voting exercise, which may have framed respondent's final voting judgement. Further studies are needed to assess informant's responses and test validity and reliability of this method with larger sample size in different sites and informant groups. In conclusion, the nominal group technique may be considered to obtain societal preferences to compliment the current burden of disease data for priority setting. Tanzania Health Research Bulletin Vol.6(2) 2004: 42-5

When is a randomised controlled trial health equity relevant? Development and validation of a conceptual framework

Background Randomised controlled trials can provide evidence relevant to assessing the equity impact of an intervention, but such information is often poorly reported. We describe a conceptual framework to identify health equity-relevant randomised trials with the aim of improving the design and reporting of such trials.Methods An interdisciplinary and international research team engaged in an iterative consensus building process to develop and refine the conceptual framework via face-to-face meetings, teleconferences and email correspondence, including findings from a validation exercise whereby two independent reviewers used the emerging framework to classify a sample of randomised trials.Results A randomised trial can usefully be classified as 'health equity relevant' if it assesses the effects of an intervention on the health or its determinants of either individuals or a population who experience ill health due to disadvantage defined across one or more social determinants of health. Health equity-relevant randomised trials can either exclusively focus on a single population or collect data potentially useful for assessing differential effects of the intervention across multiple populations experiencing different levels or types of social disadvantage. Trials that are not classified as 'health equity relevant' may nevertheless provide information that is indirectly relevant to assessing equity impact, including information about individual level variation unrelated to social disadvantage and potentially useful in secondary modelling studies.Conclusion The conceptual framework may be used to design and report randomised trials. The framework could also be used for other study designs to contribute to the evidence base for improved health equity