Evaluation of the use of modelling in resource allocation decisions for HIV and TB

Introduction Globally, resources for health spending, including HIV and tuberculosis (TB), are constrained, and a substantial gap exists between spending and estimated needs. Optima is an allocative efficiency modelling tool that has been used since 2010 in over 50 settings to generate evidence for...

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Main Authors: Nicole Fraser-Hurt, Nick Scott, Anna L Bowring, Debra ten Brink, Rowan Martin-Hughes, Nejma Cheikh
Format: Article
Language:English
Published: BMJ Publishing Group 2024-01-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/9/1/e012418.full
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author Nicole Fraser-Hurt
Nick Scott
Anna L Bowring
Debra ten Brink
Rowan Martin-Hughes
Nejma Cheikh
author_facet Nicole Fraser-Hurt
Nick Scott
Anna L Bowring
Debra ten Brink
Rowan Martin-Hughes
Nejma Cheikh
author_sort Nicole Fraser-Hurt
collection DOAJ
description Introduction Globally, resources for health spending, including HIV and tuberculosis (TB), are constrained, and a substantial gap exists between spending and estimated needs. Optima is an allocative efficiency modelling tool that has been used since 2010 in over 50 settings to generate evidence for country-level HIV and TB resource allocation decisions. This evaluation assessed the utilisation of modelling to inform financing priorities from the perspective of country stakeholders and their international partners.Methods In October to December 2021, the World Bank and Burnet Institute led 16 semi-structured small-group virtual interviews with 54 representatives from national governments and international health and funding organisations. Interviews probed participants’ roles and satisfaction with Optima analyses and how model findings have had been used and impacted resource allocation. Interviewed stakeholders represented nine countries and 11 different disease programme-country contexts with prior Optima modelling analyses. Interview notes were thematically analysed to assess factors influencing the utilisation of modelling evidence in health policy and outcomes.Results Common influences on utilisation of Optima findings encompassed the perceived validity of findings, health system financing mechanisms, the extent of stakeholder participation in the modelling process–including engagement of funding organisations, sociopolitical context and timeliness of the analysis. Using workshops can facilitate effective stakeholder engagement and collaboration. Model findings were often used conceptually to localise global evidence and facilitate discussion. Secondary outputs included informing strategic and financial planning, funding advocacy, grant proposals and influencing investment shifts.Conclusion Allocative efficiency modelling has supported evidence-informed decision-making in numerous contexts and enhanced the conceptual and practical understanding of allocative efficiency. Most immediately, greater involvement of country stakeholders in modelling studies and timing studies to key strategic and financial planning decisions may increase the impact on decision-making. Better consideration for integrated disease modelling, equity goals and financing constraints may improve relevance and utilisation of modelling findings.
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spelling doaj.art-44d47ddf50444cb19f959459096ab3022024-02-03T10:55:08ZengBMJ Publishing GroupBMJ Global Health2059-79082024-01-019110.1136/bmjgh-2023-012418Evaluation of the use of modelling in resource allocation decisions for HIV and TBNicole Fraser-Hurt0Nick Scott1Anna L Bowring2Debra ten Brink3Rowan Martin-Hughes4Nejma Cheikh5World Bank, Washington, DC, USABurnet Institute, Melbourne, Victoria, AustraliaBurnet Institute, Melbourne, Victoria, AustraliaBurnet Institute, Melbourne, Victoria, AustraliaBurnet Institute, Melbourne, Victoria, AustraliaWorld Bank, Washington, DC, USAIntroduction Globally, resources for health spending, including HIV and tuberculosis (TB), are constrained, and a substantial gap exists between spending and estimated needs. Optima is an allocative efficiency modelling tool that has been used since 2010 in over 50 settings to generate evidence for country-level HIV and TB resource allocation decisions. This evaluation assessed the utilisation of modelling to inform financing priorities from the perspective of country stakeholders and their international partners.Methods In October to December 2021, the World Bank and Burnet Institute led 16 semi-structured small-group virtual interviews with 54 representatives from national governments and international health and funding organisations. Interviews probed participants’ roles and satisfaction with Optima analyses and how model findings have had been used and impacted resource allocation. Interviewed stakeholders represented nine countries and 11 different disease programme-country contexts with prior Optima modelling analyses. Interview notes were thematically analysed to assess factors influencing the utilisation of modelling evidence in health policy and outcomes.Results Common influences on utilisation of Optima findings encompassed the perceived validity of findings, health system financing mechanisms, the extent of stakeholder participation in the modelling process–including engagement of funding organisations, sociopolitical context and timeliness of the analysis. Using workshops can facilitate effective stakeholder engagement and collaboration. Model findings were often used conceptually to localise global evidence and facilitate discussion. Secondary outputs included informing strategic and financial planning, funding advocacy, grant proposals and influencing investment shifts.Conclusion Allocative efficiency modelling has supported evidence-informed decision-making in numerous contexts and enhanced the conceptual and practical understanding of allocative efficiency. Most immediately, greater involvement of country stakeholders in modelling studies and timing studies to key strategic and financial planning decisions may increase the impact on decision-making. Better consideration for integrated disease modelling, equity goals and financing constraints may improve relevance and utilisation of modelling findings.https://gh.bmj.com/content/9/1/e012418.full
spellingShingle Nicole Fraser-Hurt
Nick Scott
Anna L Bowring
Debra ten Brink
Rowan Martin-Hughes
Nejma Cheikh
Evaluation of the use of modelling in resource allocation decisions for HIV and TB
BMJ Global Health
title Evaluation of the use of modelling in resource allocation decisions for HIV and TB
title_full Evaluation of the use of modelling in resource allocation decisions for HIV and TB
title_fullStr Evaluation of the use of modelling in resource allocation decisions for HIV and TB
title_full_unstemmed Evaluation of the use of modelling in resource allocation decisions for HIV and TB
title_short Evaluation of the use of modelling in resource allocation decisions for HIV and TB
title_sort evaluation of the use of modelling in resource allocation decisions for hiv and tb
url https://gh.bmj.com/content/9/1/e012418.full
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