Table 1.

Kapiriri and Martin’s framework for assessing the quality of priority-setting

Domain	Parameter	Short definition
Contextual factors	Conducive political, economic, social and cultural context	1Relevant contextual factors that may impact priority-setting
Prerequisites	Political will	Degree to which the politicians manifested the support to tackle the pandemic
	Resources	Availability of a budget in the COVID-19 plan, and clear description of resources available or required (including human resources, ICU beds and equipment, PPE and other resources)
	Legitimate and credible institutions	Degree to which the priority-setting institutions can set priorities, public confidence in the institution
	Incentives for compliance	Explicit description of material and financial incentives to comply with the pandemic plan
The priority-setting process	Planning for continuity of care across the health systems	2Explicit mentions of the continuity of healthcare services during the pandemic
	Stakeholder participation	Description of stakeholders participating in the development and implementation of the COVID-19 plan
	Use of clear priority-setting processes/tools/methods	Documented priority-setting process and/or use of priority-setting framework
	Use of explicit relevant priority-setting criteria	Documented/articulated criteria for priority-setting in the COVID-19 plan
	Use of evidence	Explicit mention of the use of evidence to understand the context, the epidemiological situation, or to identify and assess possible interventions to be implemented
	Reflection of public values	Explicit mention that the public is represented or that public values have been considered for the development or implementation of the plan
	Publicity of priorities and criteria	Evidence that the plan and criteria for priority-setting have been publicized and documents are openly accessible
	Functional mechanisms for appealing the decision	Description of mechanisms for appealing decisions related to the COVID-19 plan, or evidence that the plan has been revised
	Functional mechanisms for enforcement the decision	Description of mechanisms for enforcing decisions related to the COVID-19 plan
	Efficiency of the priority-setting process	3Proportion of meeting time spent on priority-setting; number of decisions made on time
	Decreased dissensions	3Number of complaints from stakeholders
Implementation	Allocation of resources according to priorities	Degree of alignment of resource allocation and agreed upon priorities
	Decreased resource wastage/misallocation	3Proportion of budget unused, drug stock-outs
	Improved internal accountability/reduced corruption	Description of mechanisms for improving the internal accountability or reduce corruption
	Increased stakeholder understanding, satisfaction and compliance with the priority-setting process	3Number of stakeholders attending meetings, number of complaints from stakeholders, % stakeholders that can articulate the concepts used in priority-setting and appreciate the need for priority-setting
	Strengthening of the priority-setting institution	3Indicators relating to increased efficiency, use of data, quality of decisions, and appropriate resource allocation, % stakeholders with the capacity to set priorities
	Impact on institutional goals and objectives	3% of institutional objectives met that are attributed to the priority-setting process
Outcome/impact	Impact on health policy and practice	Changes in health policy to reflect identified priorities and swiftness of the pandemic response
	Impact on population health	Description of the expected impact of the COVID-19 plan on the population health
	Impact on reducing inequalities	Description of the expected impact of the COVID-19 plan on reducing inequalities
	Fair financial contribution	Description of the expected impact of the COVID-19 plan on fair financial contributions
	Increased public confidence in the health sector	Description of the expected impact of the COVID-19 plan for increasing public confidence in the response to the COVID-19 pandemic
	-Responsive healthcare system	3% reduction in DALYs, % reduction of the gap between the lower and upper quintiles, % of poor populations spending more than 50% of their income on healthcare, % users who report satisfaction with the healthcare system
	Improved financial and political accountability	3Number of publicized financial resource allocation decisions, number of corruption instances reported, % of the public reporting satisfaction with the process
	Increased investment in the health sector and strengthening of the healthcare system	3Proportion increase in the health budget, proportion increase in the retention of health workers, % of the public reporting satisfaction with the healthcare system

DALYs disability-adjusted life-years, ICU intensive care unit

¹This parameter was not assessed in the national COVID-19 plans, but the information about the political, economic, social and cultural context was obtained from different sources and provided in this study to identify similarities and differences among countries in the same region

²This parameter was added to the framework for the specific context of the COVID-19 pandemic

³This parameter was not possible to be assessed in the national COVID-19 plans