What is the best set of indices/indicators for evaluating “health promotion governance” in health systems? A proposed methodology for health promotion decision-making

ABSTRACT

We aimed to identify the indices/indicators needed for assessing health promotion governance in health systems. Data were obtained from a literature review, a modified Delphi process, and an Analytic Hierarchy Process (AHP). The study was conducted from May 2021 to January 2022 using a multi-method design comprised of four sequential stages: (1) a comprehensive literature review for identifying the health promotion indices/indicators originating from the Ottawa Charter’s action areas; (2) a 3-round Delphi survey to identify, by consensus, which of those indices/indicators would be relevant to the health promotion governance in the health system;(3) Analytic Hierarchy Process technique (AHP) to prioritize the selected indices/indicators; (4) presenting the results of AHP to a group of the health promotion specialists of the selected experts to selecting other indices/indicators if necessary. Health literacy was considered the most important index to assess health promotion governance from experts’ perspectives. The per capita public health expenditure was supposed to be the second most important indicator. The indices ranked third and fourth in priority were the health equality and urban health indexes, respectively. The health promotion specialists selected three other indices: the number of policies changed due to advocacy, social capital, and positive health. Based on the results, a series of essential indices/indicators have been proposed depending on the study’s purpose, which can help health system policymakers and managers to assess the health promotion governance in the health system.

KEYWORDS:

• Health promotion
• health system governance- index- indicator

Acknowledgement

The authors thank the Research Deputy of Tabriz University of Medical Sciences.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

Conception or design of the work: F.S. and H.N.

Data Collect ion: F.S., H.N.

Data analysis and interpretation: F.S., H.N and N.G.

Drafting the article: F.S.

Critical revision of the article: All authors

Final approval of the version to be submitted: All authors.

Ethical approval

Ethical approval for this research was waived by the Tabriz University of Medical Sciences. (Ethics Code:IR.TBZMED.REC.1399.839).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Tabriz University of Medical Sciences (grant number 65561).