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. 2024 Apr 29;40(1):e27.
doi: 10.1017/S0266462324000266.

A situational and stakeholder analysis of health technology assessment in Zimbabwe

Blessing Dzingirai  1   2 , Prudence Dambiko  1 , Celia Matyanga  1 , Pinky Manyau  1 , Dexter Tagwireyi  1 , Maarten J Postma  3   2 , Nyashadzaishe Mafirakureva  4 , Marinus van Hulst  3   5
Affiliations

A situational and stakeholder analysis of health technology assessment in Zimbabwe

Blessing Dzingirai et al. Int J Technol Assess Health Care. .

Abstract

Objectives: Systematic priority setting is necessary for achieving high-quality healthcare using limited resources in low- and middle-income countries. Health technology assessment (HTA) is a tool that can be used for systematic priority setting. The objective of this study was to conduct a stakeholder and situational analysis of HTA in Zimbabwe.

Methods: We identified and analyzed stakeholders using the International Decision Support Initiative checklist. The identified stakeholders were invited to an HTA workshop convened at the University of Zimbabwe. We used an existing HTA situational analysis questionnaire to ask for participants' views on the need, demand, and supply of HTA. A follow-up survey was done among representatives of stakeholder organizations that failed to attend the workshop. We reviewed two health policy documents relevant to the HTA. Qualitative data from the survey and document review were analyzed using thematic analysis.

Results: Forty-eight organizations were identified as stakeholders for HTA in Zimbabwe. A total of 41 respondents from these stakeholder organizations participated in the survey. Respondents highlighted that the HTA was needed for transparent decision making. The demand for HTA-related evidence was high except for the health economic and ethics dimensions, perhaps reflecting a lack of awareness. Ministry of Health was listed as a major supplier of HTA data.

Conclusions: There is no formal HTA agency in the Zimbabwe healthcare system. Various institutions make decisions on prioritization, procurement, and coverage of health services. The activities undertaken by these organizations provide context for the institutionalization of HTA in Zimbabwe.

Keywords: Universal Health Coverage; Zimbabwe; health technology assessment; low and middle income countries; priority setting; stakeholder participation.

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Conflict of interest statement

The authors declare none.

Figures

Figure 1.
Figure 1.
Attributes of health technology assessment that were perceived as important for Zimbabwe.
Figure 2.
Figure 2.
The policy areas where health technology assessment is needed in Zimbabwe. EDLIZ, Essential Medicines List and Standard Treatment Guidelines for Zimbabwe.
Figure 3.
Figure 3.
The potential users of health technology assessment output and the perceived levels of demand for evidence. AFHOZ, Association of Healthcare Funders of Zimbabwe; MCAZ, Medicines Control Authority of Zimbabwe; MOHCC, Ministry of Health and Child Care; NMTPAC, National Medicine and Therapeutics Policy Advisory Committee.
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