HEALTH-TECHNOLOGY-ASSESSMENT-INSIGHTS-FROM-卫生技术评估启示课件

OBJECTIVESNeedofHTAinPakistanProcess&experienceofHTAforumLessonslearntinnongovernmentalsectorFuturedirectionsPopulation:170millionProvinces:4Districts:134Villages:50,000Poverty:32%Percapitaincome:US$1000Literacyrate:50%HDIranking:140Healthbudget:0.6%ofGDPTHE:US$18GHE:US$6OPE:US$12Privatesector:80%healthcare(mostlycurative)UnregulatedHealthinsuranceandsocialsecuritynetsPoorlyfunctioninghealthsystem

MDGindicatorBaseline1990CurrentstatusTargets2019Under5mortality1409852IMR1207840MMR550276140BirthsSBAs18%34%90%HIVprevalence<0.1<0.1<0.1TBcasesdetected&cured-55%85%Malariaprevention&treatment-45%75%MajorchallengesinhealthsectorHighinfant,childandmaternalmortalityHighburdenofcommunicablediseaseMeagerresourcesforhealthPoorlyfunctioninghealthsystemsUnregulatedprivatesectorHumanresourcecapacityandmanagementKnowledgedividePolicydilemmaDomoreforlessChangingscenariosTheneedforHTAinPakistanShrinkingresourceswithrisingcostsPush&Pullofmanufacturers&vestedinterestsRapidlyemergingtechnologiesRoleofunregulatedprivatesectorAmbiguouspolicieswithpoorcapacitytoachieveevidencebaseddecisionsGullibleconsumersOthersHTAForumPakistanVisitofPresidentISTAHCtoPakistan2019Groupofprofessionalsdedicatedtopromotionof“cultureofevidencebased”practicesClinicians,academics,managers,policymakers,nurses,publichealthspecialist,epidemiologists,othersNongovernmentalsetupObjectivesofHTAForumExchangeofexperiencePrioritizecountryneedsSensitizeanddevelopliaisonwithnationalandinternationalstakeholdersOrganizeactivitiesleadingtobetterunderstandingoftheroleofHTAforPakistanCapacitydevelopmentalongwithdeveloping&conductingsmallscaletechnologiesassessmentsActivities

RegularmeetingsPresentationsatvariousforumsResearchandpublicationofreportsIdentificationofpriorityareasCapacitybuildingEstablishmentoflinkagesIdentificationoffocalpersonsinvariousareasTrainingsandseminarsRegularmeetingsBrainstormingsessionsVariousinstitutions2-3monthintervalPresentationofstudiesContinuingeducationFuturedirectionsandplanningPresentationsatvariousforumsNationalforumsInternationalforumsLocalgatheringsIdentificationofpriorityareasConsensusbuildingexerciseDiagnosticsDrugsandmedicinesEquipmentprocurementCapacitybuildingTrainingsbyexpertsHealthServicesAcademyCollegeofphysiciansandsurgeonsPakistanInternationalmeetings/workshopsEstablishmentoflinkagesWorldHealthOrganizationHTAiNationalHealthPolicyUnitMoHAcademicinstitutionsIdentificationoffocalpersonsinvariousareasGeographicalInstitutions

MoHDoHProfessionalassociationsTeachinghospitalsDistricthospitalsGeneralpracticeUniversity(publicprivate)NursingassociationOthersResearchandpublicationofreportsNoofpublicationsinlocalmedicaljournalsSmalltechnologiesassessmentsininstitutionsandregionsRoutinepreopCXRinyoungpatients

Method:prospectivestudyConclusion:ineffectivetechnologyImpact:routineCXRabandonedresultinginannualsavingofonemillionRsCTscaninadvancedabdominaltumorsMethod:prospectivestudyConclusion:inoursettingwhereU/Shasconfirmedtheextentofdisease,CTscanisunnecessary,aslaprotomy/lprocopyhastobecarriedouttoconfirmdiagnosesordopalliativeprocedures.Impact:UnnecessaryCTscansstopped(costs100US$perpatient)Ritualcircumcision:

Timingandpre-opinvestigationsMethod:LiteraturesearchConclusion:Forroutinecircumcisionbesttimetooperateisfirst10to72hoursnopre-opscreeningforcoagulationdisordersisrequiredImpact:

resultspublishedSetofpre-opinvestigationsrequireapproxUS$10Useofmultivitaminsinroutineprescriptions

Method:prospectivedesignConclusion:Onbasisoftheevidencecollected,multivitamintabletsusewasfoundtobein-effectivetechnology,inoursettingsImpact:Rs0.5millionsavedinonehospitalannuallyDiagnosticeffectivenessstudyatmetropolitancorporationLahoreMethod:prospectivestudyResult:TheequipmentwasinappropriatelyplacedIneffectivelyusedNopositiveimpactonhealthofusersVeryhighoperatingcostsImpact:reviewofpolicybyMCLwascarriedoutRedistributionofresourcesandappropriatetrainingwasputinplacetoimproveefficiencyTrainingsandseminarsLocalmeetingsInternationalseminar/workshopFirstHTAworkshop/seminar2019MoH,WHO,PIMS,NetworkObjectives:AdvocacyCapacitybuildingFuturedirectionandrecommendationsParticipants:150seminar25workshopOutcome:WorkshopreportListofrecommendationsGroupoftrainedpeopleStrengthsofHTAinitiativeinPakistanIndependentstatusLinkagesScopeofworkMotivatedworkforceRequirementsSimpleandshortassessmentsAdaptationsEconomicanalysisDiagnostics,drugs,equipment.DistrictperspectiveChallengesandbarriersInvolvementofMoHanddonorsinamoresustainablewayBetterunderstandingofeffectofevidenceondecisionsmakinginpolicyandpracticeIncreaseandimprovepatient&professionalparticipationImprovedisseminationtools,languageandtimingAdapttolocalcircumstancesandvalues(flexibility)Lessonslearnt

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