Institutionalization Roadmap for Health Technology Assessments and Health Benefit Package Design

As countries develop and expand benefit packages, working towards a progressive realization of UHC, it is critical to understand the current landscape for developing the capacity to implement and sustain benefit package design processes. This includes the necessary legal and regulatory aspects as well as decision-making processes such as health technology assessment (HTA). WHO defines HTA as “the systematic evaluation of properties, effects and/or impacts of health technologies and interventions. It covers both the direct, intended consequences of technologies and interventions and their indirect, unintended consequences. The approach is used to inform policy and decision-making in health care, especially on how best to allocate limited funds to health interventions and technologies. The assessment is conducted by interdisciplinary groups using explicit analytical frameworks, drawing on clinical, epidemiological, health economic and other information and methodologies.” (Bertram, Dhaene et al. 2021)

One resource that can assist stakeholders to understand their processes and where to take action is WHO’s Institutionalization Roadmap for Health Technology Assessments and Health Benefit Package Design (forthcoming). The Roadmap is a self-assessment tool that can help countries to assess their current capacities across a range of areas. Its main purpose is to identify areas where capacity and resources can be developed and provide direction for the steps needed to progress towards institutionalization. 

The WHO HTA roadmap was specifically developed for country stakeholders interested in priority-setting for health benefit packages. The Roadmap includes four levels of progress, ranging from ‘emerging’ to ‘advanced’, covering areas such as human resource capacity, knowledge management and sharing, data availability and quality, availability and sustainability of funding, political demand and support, clarity of institutional arrangements, the existence of a legal framework, stakeholder participation, transparency and accountability, the production and quality of reports, etc. The roadmap is designed to be flexible and to applicable to all countries, ranging from those that are just starting to develop capacity to those that have functioning and well-established processes already in place. The framework below illustrates the levels of progress and the key elements against which progress is assessed.