A Targeted Review of Available Data Sources to Support Evidence-Informed Decisions: Implications for Health Technology Assessment in South Africa
摘要
Universal health coverage (UHC) is central to the global health agenda. South Africa is in the process of developing a single financing system for UHC through a National Health Insurance (NHI). The NHI Act legislates the establishment of a health technology assessment (HTA) body to develop and, over time, add to an explicit package of health services funded by the NHI. This study aims to identify data that is publicly available for conducting HTA using the South African Values and Ethics for Universal Health Coverage (SAVE-UHC) framework.
MethodsA targeted literature review was conducted to identify data sources for conducting HTA using the SAVE-UHC framework. The SAVE-UHC lists 12 domains that can be used to conduct HTA. We searched for published literature on PubMed using the following search terms: ‘South Africa’, ‘healthcare’, ‘data sources’, ‘databases’ and ‘evidence’ in the Title/Abstract fields. We also used our experience in the field to search for existing data from local and international organisations. We then mapped the data sources to the SAVE-UHC domains.
ResultsSouth Africa has some data to conduct HTA using the SAVE-UHC domains. Data for six of the domains (burden of disease, harms and benefits, cost effectiveness, budget impact, personal financial impact and equity) is available from local and international databases. Some data for the domain ‘system factors and constraints’ is available from the Office of Health Standards Compliance and the Human Resource Strategy for Health. Data on the five remaining domains (respect and dignity, solidarity and social cohesion, impact on personal relationships, impact on safety and security and ease of suffering) is limited.
ConclusionThere are a number of data sources available to inform health technology assessment in South Africa. However, the data sources available only measure some of the value elements in the SAVE-UHC framework. Thus, South Africa needs to invest in healthcare data collection and management under the NHI to ensure healthcare decisions are made using relevant and recent evidence.