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Abstract：
BACKGROUND: Health technology assessment uses a multidisciplinary approach to support health benefits package design towards universal health coverage. The evidence-informed deliberative process framework has been used alongside Health technology assessment to enhance stakeholder participation and deliberations in health benefits package design. Applying the evidence-informed deliberative framework for Health assessment could support the morally diverse sexual reproductive health and rights (SRHR) benefits package design process. However, evidence on participation and deliberations for stakeholders in health technology assessment for SRHR benefits package design has not been curated in sub-Saharan Africa. This study synthesises literature to fill this gap.
METHODS: This scoping review applies the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews, and deductive analysis following the evidence-informed deliberative processes framework. The search strategy uses the Guttmacher-Lancet Commission-proposed comprehensive definition of SRHR and the World Health Organisation\'s universal health coverage compendium of SRHR interventions to generate search terms. Six databases and biographical hand searches were used to identify studies in Sub-Saharan Africa from 1994.
RESULTS: A total of 14 studies met the inclusion criteria. Evidence for yearly public budgets and explicit SRHR health technology assessment processes was not found. In 12 of the studies reviewed, new advisory committees were set up specifically for health technology assessment for SRHR priority-setting and benefits package design. In all decision-making processes reviewed, the committee member roles, participation and deliberations processes, and stakeholder veto powers were not clearly defined. Patients, the public, and producers of health technology were often excluded in the health technology assessment for the SRHR benefits package design. Most health technology assessment processes identified at least one decision-making criterion but failed to use this in their selection and appraisal stages for SRHR benefits design. The identification, selection, and scoping stages in health technology assessment for SRHR were non-existent in most studies. In 11 of the 14 processes of the included studies, stakeholders were dissatisfied with the health policy recommendation from the appraisal process in health technology assessment. Perceived benefits for evidence-informed deliberative processes included increased stakeholder engagement and fairness in decision-making.
CONCLUSIONS: To support the integration of diverse social values in health technology assessment for fairer SRHR benefits package design, evidence from this review suggests the need to institutionalise health technology assessment, establish prioritisation decision criteria, involve all relevant stakeholders, and standardise the process and assessment methodological approaches.
METHODS: This scoping review applies the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews, and deductive analysis following the evidence-informed deliberative processes framework. The search strategy uses the Guttmacher-Lancet Commission-proposed comprehensive definition of SRHR and the World Health Organisation\'s universal health coverage compendium of SRHR interventions to generate search terms. Six databases and biographical hand searches were used to identify studies in Sub-Saharan Africa from 1994.
RESULTS: A total of 14 studies met the inclusion criteria. Evidence for yearly public budgets and explicit SRHR health technology assessment processes was not found. In 12 of the studies reviewed, new advisory committees were set up specifically for health technology assessment for SRHR priority-setting and benefits package design. In all decision-making processes reviewed, the committee member roles, participation and deliberations processes, and stakeholder veto powers were not clearly defined. Patients, the public, and producers of health technology were often excluded in the health technology assessment for the SRHR benefits package design. Most health technology assessment processes identified at least one decision-making criterion but failed to use this in their selection and appraisal stages for SRHR benefits design. The identification, selection, and scoping stages in health technology assessment for SRHR were non-existent in most studies. In 11 of the 14 processes of the included studies, stakeholders were dissatisfied with the health policy recommendation from the appraisal process in health technology assessment. Perceived benefits for evidence-informed deliberative processes included increased stakeholder engagement and fairness in decision-making.
CONCLUSIONS: To support the integration of diverse social values in health technology assessment for fairer SRHR benefits package design, evidence from this review suggests the need to institutionalise health technology assessment, establish prioritisation decision criteria, involve all relevant stakeholders, and standardise the process and assessment methodological approaches.
摘要：
背景：卫生技术评估使用多学科方法来支持面向全民健康覆盖的卫生福利包设计。与卫生技术评估一起使用了以证据为依据的审议过程框架，以增强利益相关者对卫生福利一揽子计划设计的参与和审议。应用以证据为依据的审议框架进行健康评估可以支持道德上多样化的性生殖健康和权利（SRHR）福利包设计过程。然而,在撒哈拉以南非洲地区，尚未收集有关利益攸关方参与和审议SRHR福利包设计的卫生技术评估的证据。本研究综合了文献来填补这一空白。
方法：本范围审查适用于系统审查的首选报告项目和范围审查的荟萃分析扩展，遵循循证审议过程框架的演绎分析。搜索策略使用Guttmacher-Lancet委员会提出的SRHR综合定义和世界卫生组织的SRHR干预措施全民健康覆盖纲要来生成搜索术语。自1994年以来，使用了六个数据库和传记手搜索来确定撒哈拉以南非洲的研究。
结果：共有14项研究符合纳入标准。没有发现年度公共预算和明确的SRHR卫生技术评估程序的证据。在所审查的12项研究中，成立了新的咨询委员会，专门为SRHR优先事项设定和福利一揽子计划设计进行卫生技术评估。在审查的所有决策过程中，委员会成员的角色，参与和审议进程，和利益相关者的否决权没有明确定义。患者,公众,和卫生技术生产者经常被排除在SRHR福利包设计的卫生技术评估之外。大多数卫生技术评估过程至少确定了一个决策标准，但在选择和评估阶段未将其用于SRHR福利设计。身份证明,选择,在大多数研究中，SRHR卫生技术评估的范围界定阶段不存在。在纳入研究的14个过程中的11个过程中，利益相关者对卫生技术评估评估过程中的卫生政策建议不满意.以证据为依据的审议过程所带来的好处包括增加了利益相关者的参与和决策的公平性。
结论：为了支持在卫生技术评估中整合不同的社会价值，以实现更公平的SRHR福利包设计，这项审查的证据表明，有必要将卫生技术评估制度化，建立优先级决策标准，涉及所有相关利益相关者，并将过程和评估方法标准化。
方法：本范围审查适用于系统审查的首选报告项目和范围审查的荟萃分析扩展，遵循循证审议过程框架的演绎分析。搜索策略使用Guttmacher-Lancet委员会提出的SRHR综合定义和世界卫生组织的SRHR干预措施全民健康覆盖纲要来生成搜索术语。自1994年以来，使用了六个数据库和传记手搜索来确定撒哈拉以南非洲的研究。
结果：共有14项研究符合纳入标准。没有发现年度公共预算和明确的SRHR卫生技术评估程序的证据。在所审查的12项研究中，成立了新的咨询委员会，专门为SRHR优先事项设定和福利一揽子计划设计进行卫生技术评估。在审查的所有决策过程中，委员会成员的角色，参与和审议进程，和利益相关者的否决权没有明确定义。患者,公众,和卫生技术生产者经常被排除在SRHR福利包设计的卫生技术评估之外。大多数卫生技术评估过程至少确定了一个决策标准，但在选择和评估阶段未将其用于SRHR福利设计。身份证明,选择,在大多数研究中，SRHR卫生技术评估的范围界定阶段不存在。在纳入研究的14个过程中的11个过程中，利益相关者对卫生技术评估评估过程中的卫生政策建议不满意.以证据为依据的审议过程所带来的好处包括增加了利益相关者的参与和决策的公平性。
结论：为了支持在卫生技术评估中整合不同的社会价值，以实现更公平的SRHR福利包设计，这项审查的证据表明，有必要将卫生技术评估制度化，建立优先级决策标准，涉及所有相关利益相关者，并将过程和评估方法标准化。
