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A qualitative study on the feasibility and acceptability of institutionalizing health technology assessment in Malawi

Mfutso-Bengo, Joseph; Jeremiah, Faless; Kasende-Chinguwo, Florence; Ng'ambi, Wingston; Nkungula, Nthanda; Kazanga-Chiumia, Isabel; Juma, Mercy; ... Sculpher, Mark; + view all (2023) A qualitative study on the feasibility and acceptability of institutionalizing health technology assessment in Malawi. BMC Health Services Research , 23 (1) , Article 353. 10.1186/s12913-023-09276-z. Green open access

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Abstract

OBJECTIVE: The objective of this study was to assess the feasibility and acceptability of institutionalizing Health Technology Assessment (HTA) in Malawi. METHODS: This study employed a document review and qualitative research methods, to understand the status of HTA in Malawi. This was complemented by a review of the status and nature of HTA institutionalization in selected countries.Qualitative research employed a Focus Group Discussion (FGD ) with 7 participants, and Key Informant Interviews (KIIs) with12 informants selected based on their knowledge and expertise in policy processes related to HTA in Malawi.Data extracted from the literature was organized in Microsoft Excel, categorized according to thematic areas and analyzed using a literature review framework. Qualitative data from KIIs and the FGD was analyzed using a thematic content analysis approach. RESULTS: Some HTA processes exist and are executed through three structures namely: Ministry of Health Senior Management Team, Technical Working Groups, and Pharmacy and Medicines Regulatory Authority (PMRA) with varyingdegrees of effectiveness.The main limitations of current HTA mechanisms include limited evidence use, lack of a standardized framework for technology adoption, donor pressure, lack of resources for the HTA process and technology acquisition, laws and practices that undermine cost-effectiveness considerations. KII and FGD results showed overwhelming demand for strengthening HTA in Malawi, with a stronger preference for strengthening coordination and capacity of existing entities and structures. CONCLUSION: The study has shown that HTA institutionalization is acceptable and feasible in Malawi. However, the current committee based processes are suboptimal to improve efficiency due to lack of a structured framework. A structured HTA framework has the potential to improve processes in pharmaceuticals and medical technologies decision-making.In the short to medium term, HTA capacity building should focus on generating demand and increasing capacity in cost-effectiveness assessments. Country-specific assessments should precede HTA institutionalization as well as recommendations for new technology adoptions.

Type: Article
Title: A qualitative study on the feasibility and acceptability of institutionalizing health technology assessment in Malawi
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/s12913-023-09276-z
Publisher version: https://doi.org/10.1186/s12913-023-09276-z
Language: English
Additional information: © 2023 BioMed Central Ltd. This article is licensed under a Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).
Keywords: Decision making, Health technology, Health technology assessment, Institutionalization, Malawi, Sub-Saharan Africa, Humans, Technology Assessment, Biomedical, Malawi, Feasibility Studies, Qualitative Research, Focus Groups
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/10168811
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