Table 1.
Framework for effective priority setting (adapted for the review of the pandemic plans).
| Domain | Parameters | Short definition |
|---|---|---|
| Contextual Factors | 1Conducive Political, Economic, Social, cultural and health system context | Relevant contextual factors that may impact COVID-19 priority setting |
| Pre-requisites | Political will | Documented or implied politicians’ support for PS within the COVID-19 plans |
| Resources | Availability of a budget in the COVID plan, and clear description of resources available or required (including human resources, ICU beds and equipment, PPE, and other resources) | |
| Legitimate and credible institutions | Documented priority setting institutions, the degree to which they can set priorities, public confidence in the institution | |
| Incentives for compliance | Explicit description of material and financial incentives to comply with the PS mechanisms in the pandemic plan | |
| The Priority setting process | 2Planning for continuity of care across the health systems | Explicit identification of strategies for the continuity of healthcare services during the pandemic |
| Stakeholder participation | Description of stakeholders participating in the development and implementation of the COVID plan (and PS activities within the plans) | |
| Use of clear priority setting process/tool/methods | Documented explicit priority setting process and/or use of priority setting framework | |
| Use of explicit relevant priority setting criteria | Documented explicit criteria for the priority setting in the COVID 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 | Documented strategies for communicating PS criteria and decisions, 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 PS within the COVID plan, or evidence that the PS plans has been revised | |
| Functional mechanisms for enforcement the decision | Description of mechanisms for enforcing decisions related to PS within the COVID plan | |
| 3Efficiency of the priority-setting process | Documented proportion of meeting time spent on priority setting; number of decisions made on time | |
| 3Decreased dissentions | Documented number of complaints from Stakeholder | |
| Implementation | 3Allocation of resources according to priorities | Documented degree of alignment of resource allocation and agreed upon priorities |
| 3Decreased resource wastage / misallocation | 3 Reported proportion of budget unused, drug stock-outs | |
| 3Improved internal accountability/reduced corruption | Description of mechanisms for improving the internal accountability or reduce corruption | |
| 3Increased stakeholder understanding, satisfaction and compliance with the Priority setting process | Reported number of SH attending meetings, number of complaints from stakeholder, % stakeholder that can articulate the concepts used in priority setting and appreciate the need for priority setting | |
| 3Strengthening of the PS institution | Documented indicators relating to increased efficiency, use of data, quality of decisions and appropriate resource allocation, % stakeholders with the capacity to set priorities | |
| 3Impact on institutional goals and objectives | % of institutional objectives met that are attributed to the priority setting process | |
| 3Impact on health policy and practice | Changes in health policy to reflect identified priorities, and swiftness of the pandemic response | |
| 3Fair financial contribution | Description of the expected impact of the COVID plan on fair financial contributions | |
| 3Increased public confidence in the health sector | Description of the expected impact of the COVID plan for increasing public confidence in the response to the COVID-19 pandemic | |
| 3Impact on population health | Description of the expected impact of the COVID plan on the population health | |
| 3Impact on reducing inequalities | Description of the expected impact of the COVID plan on reducing inequalities |
1
This parameter was not assessed in the national COVID 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.
2
This parameter was added to the framework for the specific context of the COVID-19 pandemic.
3
These parameters could not be assessed based on the review of COVID-19 plans.