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. 2020 Nov;5(11):e003699.
doi: 10.1136/bmjgh-2020-003699.

WICID framework version 1.0: criteria and considerations to guide evidence-informed decision-making on non-pharmacological interventions targeting COVID-19

Jan M Stratil  1 , Maike Voss  2 , Laura Arnold  3
Affiliations

WICID framework version 1.0: criteria and considerations to guide evidence-informed decision-making on non-pharmacological interventions targeting COVID-19

Jan M Stratil et al. BMJ Glob Health. 2020 Nov.

Abstract

Introduction: Public health decision-making requires the balancing of numerous, often conflicting factors. However, participatory, evidence-informed decision-making processes to identify and weigh these factors are often not possible- especially, in the context of the SARS-CoV-2 pandemic. While evidence-to-decision frameworks are not able or intended to replace stakeholder participation, they can serve as a tool to approach relevancy and comprehensiveness of the criteria considered.

Objective: To develop a decision-making framework adapted to the challenges of decision-making on non-pharmacological interventions to contain the global SARS-CoV-2 pandemic.

Methods: We employed the 'best fit' framework synthesis technique and used the WHO-INTEGRATE framework as a starting point. First, we adapted the framework through brainstorming exercises and application to case studies. Next, we conducted a content analysis of comprehensive strategy documents intended to guide policymakers on the phasing out of applied lockdown measures in Germany. Based on factors and criteria identified in this process, we developed the WICID (WHO-INTEGRATE COVID-19) framework version 1.0.

Results: Twelve comprehensive strategy documents were analysed. The revised framework consists of 11+1 criteria, supported by 48 aspects, and embraces a complex systems perspective. The criteria cover implications for the health of individuals and populations due to and beyond COVID-19, infringement on liberties and fundamental human rights, acceptability and equity considerations, societal, environmental and economic implications, as well as implementation, resource and feasibility considerations.

Discussion: The proposed framework will be expanded through a comprehensive document analysis focusing on key stakeholder groups across the society. The WICID framework can be a tool to support comprehensive evidence-informed decision-making processes.

Keywords: health policy; public health; qualitative study.

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Conflict of interest statement

Competing interests: JMS is the author of the WHO-INTEGRATE framework. JMS and MV were part of an expert group which developed strategy documents intended to inform the COVID-19 crisis task force of the German government. One (in the case of JMS) and two (in the case of MV) of which were included as comprehensive strategy documents in this analysis. We received support by the Bundeszentrale für gesundheitliche Aufklärung (BZgA; the German Federal Center for Health Education) to cover the publication fees for this manuscript. The BZgA did not have any editorial or scientific influence on the content of this publication.

Figures

Figure 1
Figure 1
WICID framework version 1.0. The colour of the 11+1 criteria of the WICID refers to their grouping and relation to the criteria of the WHO-INTEGRATE framework they are derived from. The center-most circle describes population groups onto which the criteria and aspects should be applied to. The innermost circle describes the perspective the decision-makers can take onto criteria and populations. WICID, WHO-INTEGRATE COVID-19.
Figure 2
Figure 2
Complex system perspective on the implications caused by a measure being introduced into a system. The intervention (grey circle on the left) is introduced as an ‘event’ to a system. It directly affects other components of the system (non-grey circles on the right) which again interact with other components of the system, causing a chain reaction of the system reacting and adapting to the event; leading to the societal, economic and health-related consequences of the intervention.
See this image and copyright information in PMC

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