Stakeholder analysis for advancing health-technology assessment in India: A pilot

Article type
Authors
Jain B1, Hiligsmann M2, L. Mathew J3, M. Evers S2
1ACCESS Health International
2Department of Health Services Research, School for Primary Care and Public Health (CAPHRI), Maastricht University, Maastricht, Netherlands
3Advanced Pediatrics Center, PGIMER, Chandigarh, India
Abstract
Background: Health technology assessment (HTA) could potentially have an impact on the policy making in developing countries where a large population is affected by healthcare services and resources are limited to provide public healthcare services. India is characterised by low public-sector expenditure and high private out-of-pocket expenditure. There is an increasing emphasis on usage of evidence-based tools such as HTA for future investments and decision making for the Indian healthcare system. It is essential to understand the perspective of the various stakeholders especially decision makers how far as evidence building tools such as HTA are taken into account in decision making.

Objectives: This study aims to explore and understand the perspectives of several key stakeholders in the use of HTA for evidence-informed policy decision making in the context of the Indian health system

Methods: A stakeholder analysis was undertaken to understand the knowledge, position and interest in HTA of key stakeholders. Seven semi-structured interviews were conducted in April-June 2013 with policy makers, academicians, industry experts and community representatives from India. A semi-structured questionnaire was designed based on WHO framework for evidence informed health policy making.

Results: Though there is a good understanding of HTA among the national level policy makers, academicians, civil society representative and industry experts, there is lack of knowledge about the subject amongst policy makers at the lower level. There is a positive perception of on producing and using HTA for decision making among all interviewed stakeholders. Further at national level, institutions prefer to tread the use of HTA evidence with caution as there is very limited capacity in the health system to adopt evidence based tools.

Conclusions: This stakeholder analysis suggests a mixed response in implementing HTA in India. However, there are factors involved in implementing such tools, which can be dealt with using various approaches. Finally there is positive view at national level to push the HTA agenda forward for better health decision making.