Strengthening health technology assessment systems in the global south: a comparative analysis of the HTA journeys of China, India and South Africa

Figures & data

Table 1. Amended data extraction framework derived from the WHO global health survey on health technology assessment by national authorities [8].

Category	Sub-Category
1. Utilization of HTA in public sector decision-making	Formal ‘information-gathering process’ for decision making; Legislative requirements for considering HTA findings; Purposes of undertaking HTA; Types of technologies or interventions assessed
2. Scope of HTA and availability of guidelines	Aspects considered in HTA; Guidelines for developing HTA
3. Institutional capacity and human resources supporting HTA	National HTA organization; Number of staff members in HTA organizations; Requests for HTAs; Professionals involved in HTA preparation and decision making
4. Governance of HTA process	Conflict of interest declaration; Communicating the outcomes of HTA; HTA entity impact on policy and decision making; Stakeholder engagement
5. Requirements for strengthening HTA capacity	Main barrier for producing HTA and using HTA findings in decision making; *Enablers in the progress towards institutionalisation of HTA Academic or training programmes to support capacity building for HTA
*6. Barriers to Institutionalising HTA	No sub-categories
*7. Future goals for HTA system development	No sub-categories

* Additional categories (6 & 7) and sub-category (within category 5) added to WHO framework during framework amendment – see Framework above.

[8] World Health Organization. Global Survey on Health Technology Assessment by National Authorities. [Internet]. Geneva: World Health Organization; 2015. Available from: http://www.who.int/health-technology-assessment/MD_HTA_oct2015_final_web2.pdf.

Table 2. Common problems, conducive factors and recommendations for HTA development in Asia [10].

Problems	Conducive Factors	Recommendations
Silo-based decision-making Low-quality decision-making criteria Strict control on research dissemination Respect for expert (senior) opinions or authorities is held in higher than evidence-based research	A high proportion of public investment and strategic purchasing mechanism Political will, leadership, and legislation A good health information infrastructure Local training on HTA-related disciplines Effective collaboration between HTA agencies/programs and local stakeholders Settings’ independence from external support or international aid	Human resource development Core team or HTA institutes Linking HTA to policy decision-making mechanisms HTA legislation International collaboration

Figure 1. Systematic search process.

Table A1. Inclusion and exclusion criteria utilised for screening articles.

Inclusion Criteria	Exclusion Criteria
Full text article access	Abstract only available
Articles on China, India or South Africa	Articles on any other country
Articles on healthcare	Articles on another field other than healthcare
	Articles on: Drug prescribing patterns; Medical education not directly related to priority-setting, HTA or evidence-based decision making for heath; A particular disease area or intervention
	Clinical trials
	Systematic reviews
	Cost effectiveness studies or HTAs

Two hundred and twelve records were screened for China and 51 records excluded. The screening of the 272 records for India resulted in 111 records being excluded. Finally, 239 records for South Africa were screened and 122 records excluded.

Table

Inclusion Criteria	Exclusion Criteria
Topic of the article relates to the practice of the following in the public health care system:(1) Priority setting(2) Evidence-based decision making;(3) Health Technology Assessment	Articles about: Priority setting for research Methodology only; Healthcare financing only; Financial protection only; Healthcare access or utilization only.

World Health Organization (WHO). 2015 Global Survey on Health Technology Assessment by National Authorities Main findings [Internet]. Geneva, Switzerland: World Health Organization (WHO); Available from: http://www.who.int/health-technology-assessment/MD_HTA_oct2015_final_web2.pdf.

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Chootipongchaivat S, Tritasavit N, Luz A, et al. Condusive Factors to the Development of Health Technology Assessment in Asia. [Internet]. Muang, Thailand: Health Intervention and Technology Assessment Program (HITAP); 2016. Available from: https://f1000research.com/documents/6-486.

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