Noor Tromp1,2, Rozar Prawiranegara1,3, Adiatma Siregar4, Rudi Wisaksana3, Lucas Pinxten5,6, Juul Pinxten7, Arry Lesmana Putra8,9, Deni Kurnia Sunjaya3, Maarten Jansen1, Jan Hontelez1,10,11, Scott Maurits1, Febrina Maharani3, Leon Bijlmakers1, Rob Baltussen1. 1. Department of Health Evidence, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands. 2. KIT (Royal Tropical Institute), Amsterdam, The Netherlands. 3. Faculty of Medicine, Padjadjaran University, Bandung, Indonesia. 4. Faculty Economics and Business, Padjadjaran University, Bandung, Indonesia. 5. Nijmegen Institute for Scientist-Practitioners in Addiction, Radboud University, Nijmegen, The Netherlands. 6. Faculty of Psychology and Neuroscience, Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands. 7. Social Protection and Jobs Global Practice, World Bank, Jarkarta, Indonesia. 8. United Nations Development Programme Indonesia, Jakarta, Indonesia. 9. West Java Provincial AIDS commission, Bandung, Indonesia. 10. Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. 11. Heidelberg Institute of Public Health, Faculty of Medicine, Heidelberg University, Heidelberg, Germany.
Abstract
OBJECTIVE: International guidelines recommend countries to expand antiretroviral therapy (ART) to all HIV-infected individuals and establish local-level priorities in relation to other treatment, prevention and mitigation interventions through fair processes. However, no practical guidance is provided for such priority-setting processes. Evidence-informed deliberative processes (EDPs) fill this gap and combine stakeholder deliberation to incorporate relevant social values with rational decision-making informed by evidence on these values. This study reports on the first-time implementation and evaluation of an EDP in HIV control, organised to support the AIDS Commission in West Java province, Indonesia, in the development of its strategic plan for 2014-2018. METHODS: Under the responsibility of the provincial AIDS Commission, an EDP was implemented to select priority interventions using six steps: (i) situational analysis; (ii) formation of a multistakeholder Consultation Panel; (iii) selection of criteria; (iv) identification and assessment of interventions' performance; (v) deliberation; and (vi) selection of funding and implementing institutions. An independent researcher conducted in-depth interviews (n = 21) with panel members to evaluate the process. RESULTS: The Consultation Panel included 23 stakeholders. They identified 50 interventions and these were evaluated against four criteria: impact on the epidemic, stigma reduction, cost-effectiveness and universal coverage. After a deliberative discussion, the Consultation Panel prioritised a combination of several treatment, prevention and mitigation interventions. CONCLUSION: The EDP improved both stakeholder involvement and the evidence base for the strategic planning process. EDPs fill an important gap which international guidelines and current tools for strategic planning in HIV control leave unaddressed.
OBJECTIVE: International guidelines recommend countries to expand antiretroviral therapy (ART) to all HIV-infected individuals and establish local-level priorities in relation to other treatment, prevention and mitigation interventions through fair processes. However, no practical guidance is provided for such priority-setting processes. Evidence-informed deliberative processes (EDPs) fill this gap and combine stakeholder deliberation to incorporate relevant social values with rational decision-making informed by evidence on these values. This study reports on the first-time implementation and evaluation of an EDP in HIV control, organised to support the AIDS Commission in West Java province, Indonesia, in the development of its strategic plan for 2014-2018. METHODS: Under the responsibility of the provincial AIDS Commission, an EDP was implemented to select priority interventions using six steps: (i) situational analysis; (ii) formation of a multistakeholder Consultation Panel; (iii) selection of criteria; (iv) identification and assessment of interventions' performance; (v) deliberation; and (vi) selection of funding and implementing institutions. An independent researcher conducted in-depth interviews (n = 21) with panel members to evaluate the process. RESULTS: The Consultation Panel included 23 stakeholders. They identified 50 interventions and these were evaluated against four criteria: impact on the epidemic, stigma reduction, cost-effectiveness and universal coverage. After a deliberative discussion, the Consultation Panel prioritised a combination of several treatment, prevention and mitigation interventions. CONCLUSION: The EDP improved both stakeholder involvement and the evidence base for the strategic planning process. EDPs fill an important gap which international guidelines and current tools for strategic planning in HIV control leave unaddressed.
Authors: Jan M Stratil; Deepak Paudel; Karen E Setty; Carlos E Menezes de Rezende; Aline A Monroe; Jimmy Osuret; Inger B Scheel; Manfred Wildner; Eva A Rehfuess Journal: Int J Health Policy Manag Date: 2022-05-01