Browsing by Author "Aviva Tugendhaft"
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Item CHAT SA: Modification of a Public Engagement Tool for Priority Setting for a South African Rural Context(2022-02-01) Aviva Tugendhaft; Marion Danis; Nicola Christofides; Kathleen Kahn; Agnes Erzse; Marthe Gold; Rhian Twine; Audrey Khosa; Karen Hofman1Background: Globally, as countries move towards universal health coverage (UHC), public participation in decision making is particularly valuable to inform difficult decisions about priority setting and resource allocation. In South Africa (SA), which is moving towards UHC, public participation in decision-making is entrenched in policy documents yet practical applications are lacking. Engagement methods that are deliberative could be useful in ensuring the public participates in the priority setting process that is evidence-based, ethical, legitimate, sustainable and inclusive. Methods modified for the country context may be more relevant and effective. To prepare for such a deliberative process in SA, we aimed to modify a specific deliberative engagement tool - the CHAT (Choosing All Together) tool for use in a rural setting. Methods: Desktop review of published literature and policy documents, as well as 3 focus groups and modified Delphi method were conducted to identify health topics/issues and related interventions appropriate for a rural setting in SA. Our approach involved a high degree of community and policy-maker/expert participation. Qualitative data were analysed thematically. Cost information was drawn from various national sources and an existing actuarial model used in previous CHAT exercises was employed to create the board. Results: Based on the outcomes, 7 health topics/issues and related interventions specific for a rural context were identified and costed for inclusion. These include maternal, new-born and reproductive health; child health; woman and child abuse; HIV/AIDS and tuberculosis (TB); lifestyle diseases; access; and malaria. There were variations in priorities between the 3 stakeholder groups, with community-based groups emphasizing issues of access. Violence against women and children and malaria were considered important in the rural context. Conclusion: The CHAT SA board reflects health topics/issues specific for a rural setting in SA and demonstrates some of the context-specific coverage decisions that will need to be made. Methodologies that include participatory principles are useful for the modification of engagement tools like CHAT and can be applied in different country contexts in order to ensure these tools are relevant and acceptable. This could in turn impact the success of the implementation, ultimately ensuring more effective priority setting approaches.Item Deliberative engagement methods on health care prioritysetting in a rural South African communityAviva Tugendhaft; Karen Hofman; Marion Danis; Kathleen Kahn; Agnes Erzse; Rhian Twine; Marthe Gold; Nicola ChristofidesItem Developing and piloting a contextspecified ethics framework for health technology assessment the South African Values and Ethics for Universal Health Coverage approachC B Krubiner; N W Barsdorf; Susan Goldstein; Atiya Mosam; S Potgieter; M J DiStefano; Aviva Tugendhaft; E et al; Karen HofmanItem Engaging community members in setting priorities for nutrition interventions in rural northern GhanaM Dalaba; E Nonterah; S Chatio; J Adoctor; Agnes Erzse; Aviva Tugendhaft; E etalItem Moving towards social inclusion Engaging rural voices in priority setting for healthAviva Tugendhaft; Nicola Christofides; N Stacey; Kathleen Kahn; Agnes Erzse; M Danis; M Gold; Karen HofmanItem The Value of Explicit Deliberative and ContextSpecified Ethics Analysis for Health Technology Assessment Evidence From a Novel Approach Piloted in South AfricaC Krubiner; Aviva Tugendhaft; M DiStefano; N Barsdorf; Maria W Merritt; Susan Goldstein; Atiya Mosam; Karen Hofman; E et al