Publication:
Deliberative engagement methods on health care priority-setting in a rural South African community

Show simplified metadata
dc.contributor.authorTugendhaft, A.
dc.contributor.authorHofman, K.
dc.contributor.authorDanis, M.
dc.contributor.authorKahn, K.
dc.contributor.authorErzse, A.
dc.contributor.authorTwine, R.
dc.contributor.authorGold, M.
dc.contributor.authorChristofides, N.
dc.contributor.departmentAviva Tugendhaft, Karen Hofman, Agnes Erzse: SAMRC/Wits Centre for Health Economics and Decision Science- PRICELESS, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.en_US
dc.date.accessioned2024-05-05T18:04:10Z
dc.date.available2024-05-05T18:04:10Z
dc.date.epub2021
dc.date.issued2021-05-29
dc.description.abstractPublic engagement in priority-setting for health is increasingly recognized as a means to ensure more ethical, inclusive and legitimate decision-making processes, especially in the context of Universal Health Coverage where demands outweigh the available resources and difficult decisions need to be made. Deliberative approaches are often viewed as especially useful in considering social values and balancing trade-offs, however, implementation of deliberative engagement tools for priority-setting is scant, especially in low- and middle-income settings. In order to address this gap, we implemented a context-specific public deliberation tool in a rural community in South Africa to determine priorities for a health services package. Qualitative data were analysed from seven group deliberations using the engagement tool. The analysis focused on understanding the deliberative process, what the participants prioritized, the reasons for these selections and how negotiations took place within the groups. The deliberations demonstrated that the groups often considered curative services to be more important than primary prevention which related to the perceived lack of efficacy of existing health education and prevention programmes in leading to behaviour change. The groups engaged deeply with trade-offs between costly treatment options for HIV/AIDS and those for non-communicable disease. Barriers to healthcare access were considered especially important by all groups and some priorities included investing in more mobile clinics. This study demonstrates that deliberative engagement methods can be successful in helping communities balance trade-offs and in eliciting social values around health priorities. The findings from such deliberations, alongside other evidence and broader ethical considerations, have the potential to inform decision-making with regard to health policy design and implementation.en_US
dc.description.sponsorshipThis work was supported by The South African Medical Research Council [SAMRC-RFA-EMU-02-2018].Ethical approval: Ethical approval for the study was obtained from the Human Research Ethics Committee (Medical) of the University of the Witwatersrand, Johannesburg, South Africa [Clearance certificate number M161009].en_US
dc.identifier.citationTugendhaft A, Hofman K, Danis M, Kahn K, Erzse A, Twine R, Gold M, Christofides N. Deliberative engagement methods on health care priority-setting in a rural South African community. Health Policy and Planning. 2021;36(8):1279-91. doi: 10.1093/heapol/czab005.en_US
dc.identifier.doi10.1093/heapol/czab005
dc.identifier.journalHealth Policy and Planningen_US
dc.identifier.urihttps://academic.oup.com/heapol/article/36/8/1279/6288525
dc.identifier.urihttps://hdl.handle.net/11288/596110
dc.language.isoenen_US
dc.publisherOxford Academicen_US
dc.research.unitCentre for Health Economic and Priority Settingen_US
dc.rightsAttribution 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/us/*
dc.subjectPriority-setting
dc.subjecthealth care
dc.subjectresource allocation
dc.subjectCommunity participation
dc.subjectDecision-making
dc.subjectHealth care
dc.subjectSDG-03 Good health and well-being
dc.subjectSDG-05 Gender equality
dc.titleDeliberative engagement methods on health care priority-setting in a rural South African communityen_US
dc.typeArticleen_US
dspace.entity.typePublication
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Tugendhaft A_2021_Deliberative.pdf
Size:
403.29 KB
Format:
Adobe Portable Document Format
Description:
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Extramural: Journal Articles