This paper reports on the development of an analytical framework on the decision-making process of EPHS revision, and the review of practices of six countries (Afghanistan, Ethiopia, Pakistan, Somalia, Sudan and Zanzibar-Tanzania).
The analytical framework distinguishes the practical organisation, fairness and institutionalisation of decision-making processes. The review shows that countries: (1) largely follow a similar practical stepwise process but differ in their implementation of some steps, such as the choice of decision criteria; (2) promote fairness in their EPHS process by involving a range of stakeholders, which in the case of Zanzibar included patients and community members; (3) are transparent in terms of at least some of the steps of their decision-making process and (4) in terms of institutionalisation, express a high degree of political will for ongoing EPHS revision with almost all countries having a designated governing institute for EPHS revision.
We advise countries to organise meaningful stakeholder involvement and foster the transparency of the decision-making process, as these are key to fairness in decision-making. We also recommend countries to take steps towards the institutionalisation of their EPHS revision process.
Baltussen R, Mwalim O, Blanchet K, Carballo M, Eregata GT, Hailu A, Huda M, Jama M, Johansson KA, Reynolds T, Raza W, Mallender J, Majdzadeh R. Decision-making processes for essential packages of health services: experience from six countries. BMJ Glob Health. 2023 Jan;8(Suppl 1):e010704. doi: 10.1136/bmjgh-2022-010704