Setting priorities in global child health research investments: addressing values of stakeholders

Abstract

Aim: To identify main groups of stakeholders in the process of health research priority setting and propose strategies for addressing their systems of values.

Methods: In three separate exercises that took place between March and June 2006 we interviewed three different groups of stakeholders: 1) members of the global research priority setting network; 2) a diverse group of national-level stakeholders from South Africa; and 3) participants at the conference related to international child health held in Washington, DC, USA. Each of the groups was administered different version of the questionnaire in which they were asked to set weights to criteria (and also minimum required thresholds, where applicable) that were a priori defined as relevant to health research priority setting by the consultants of the Child Health and Nutrition Research initiative (CHNRI).

Results: At the global level, the wide and diverse group of respondents placed the greatest importance (weight) to the criterion of maximum potential for disease burden reduction, while the most stringent threshold was placed on the criterion of answerability in an ethical way. Among the stakeholders' representatives attending the international conference, the criterion of deliverability, answerability, and sustainability of health research results was proposed as the most important one. At the national level in South Africa, the greatest weight was placed on the criterion addressing the predicted impact on equity of the proposed health research.

Conclusions: Involving a large group of stakeholders when setting priorities in health research investments is important because the criteria of relevance to scientists and technical experts, whose knowledge and technical expertise is usually central to the process, may not be appropriate to specific contexts and in accordance with the views and values of those who invest in health research, those who benefit from it, or wider society as a whole.

Figure 1

Graphical presentation of the concept of thresholds and weights (T1-Tn and W1-Wn). A priority-setting tool below addresses n key priority setting criteria (eg, answerability, effectiveness, deliverability, maximum potential for disease burden reduction, and impact on equity); intermediate scores for this particular research options had values IS1-ISn. Input from stakeholders resulted in values W1-Wn, ie, factors by which each criterion’s value (intermediate score) is weighted, and threshold scores (T1-Tn) needed to be met within each criterion in order for the proposed research option to be considered a priority. The final “research priority score” (RPS) for each proposed research avenue is defined as their weighted average: [W1 × (Criterion 1 score) + W2 × (Criterion 2 score) + … + Wn x (Criterion n score)] / (W1+…+Wn)