Evidence map›Paper›PMID 37041590›Full record

ReviewBMC health services research2023

A qualitative study on the feasibility and acceptability of institutionalizing health technology assessment in Malawi.

Joseph Mfutso-Bengo, Faless Jeremiah, Florence Kasende-Chinguwo, Wingston Ng'ambi, Nthanda Nkungula, Isabel Kazanga-Chiumia, Mercy Juma, Marlen Chawani, Jobiba Chinkhumba, Pakwanja Twea and 8 more

Abstract readReview
In one paragraph

Review in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Health technology assessment capacity to support Zambia's health benefits package reform policy.International journal of technology assessment in health care · 2025
    Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Joseph Mfutso-BengoHealth Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences (KuHes), Private Bag 360, BLANTYRE 3, Lilongwe, Malawi. mfutsobengo@medcol.mw.
Faless JeremiahHealth Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences (KuHes), Private Bag 360, BLANTYRE 3, Lilongwe, Malawi.
Florence Kasende-ChinguwoHealth Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences (KuHes), Private Bag 360, BLANTYRE 3, Lilongwe, Malawi.
Wingston Ng'ambiHealth Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences (KuHes), Private Bag 360, BLANTYRE 3, Lilongwe, Malawi.
Nthanda NkungulaHealth Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences (KuHes), Private Bag 360, BLANTYRE 3, Lilongwe, Malawi.
Isabel Kazanga-ChiumiaHealth Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences (KuHes), Private Bag 360, BLANTYRE 3, Lilongwe, Malawi.
Mercy JumaHealth Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences (KuHes), Private Bag 360, BLANTYRE 3, Lilongwe, Malawi.
Marlen ChawaniHealth Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences (KuHes), Private Bag 360, BLANTYRE 3, Lilongwe, Malawi.
Jobiba ChinkhumbaHealth Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences (KuHes), Private Bag 360, BLANTYRE 3, Lilongwe, Malawi.
Pakwanja TweaMinistry of Health, Malawi Government, Lilongwe, Malawi.
Emily ChirwaMinistry of Health, Malawi Government, Lilongwe, Malawi.
Kate LangweMinistry of Health, Malawi Government, Lilongwe, Malawi.
Gerald ManthaluMinistry of Health, Malawi Government, Lilongwe, Malawi.
Lucky Gift NgwiraHealth Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences (KuHes), Private Bag 360, BLANTYRE 3, Lilongwe, Malawi.
Dominic NkhomaHealth Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences (KuHes), Private Bag 360, BLANTYRE 3, Lilongwe, Malawi.
Tim ColbournUniversity College London, London, United Kingdom.
Paul RevillCentre for Health Economics, University of York, York, UK.
Mark SculpherCentre for Health Economics, University of York, York, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe objective of this study was to assess the feasibility and acceptability of institutionalizing Health Technology Assessment (HTA) in Malawi.

methodsThis study employed a document review and qualitative research methods, to understand the status of HTA in Malawi. This was complemented by a review of the status and nature of HTA institutionalization in selected countries.Qualitative research employed a Focus Group Discussion (FGD ) with 7 participants, and Key Informant Interviews (KIIs) with12 informants selected based on their knowledge and expertise in policy processes related to HTA in Malawi.Data extracted from the literature was organized in Microsoft Excel, categorized according to thematic areas and analyzed using a literature review framework. Qualitative data from KIIs and the FGD was analyzed using a thematic content analysis approach.

resultsSome HTA processes exist and are executed through three structures namely: Ministry of Health Senior Management Team, Technical Working Groups, and Pharmacy and Medicines Regulatory Authority (PMRA) with varyingdegrees of effectiveness.The main limitations of current HTA mechanisms include limited evidence use, lack of a standardized framework for technology adoption, donor pressure, lack of resources for the HTA process and technology acquisition, laws and practices that undermine cost-effectiveness considerations. KII and FGD results showed overwhelming demand for strengthening HTA in Malawi, with a stronger preference for strengthening coordination and capacity of existing entities and structures.

conclusionThe study has shown that HTA institutionalization is acceptable and feasible in Malawi. However, the current committee based processes are suboptimal to improve efficiency due to lack of a structured framework. A structured HTA framework has the potential to improve processes in pharmaceuticals and medical technologies decision-making.In the short to medium term, HTA capacity building should focus on generating demand and increasing capacity in cost-effectiveness assessments. Country-specific assessments should precede HTA institutionalization as well as recommendations for new technology adoptions.

Indexed as

Technology Assessment, BiomedicalFeasibility StudiesFocus GroupsHumansMalawiQualitative ResearchDecision makingHealth technologyHealth technology assessmentInstitutionalizationMalawiSub-Saharan Africa

Identifiers

PMID37041590
PMCPMC10088659

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.