The need for global application of the accountability for reasonableness approach to support sustainable outcomes: Comment on “expanded HTA: Enhancing fairness and legitimacy”

Research output: Contribution to journalComment/debateResearchpeer-review

Standard

The need for global application of the accountability for reasonableness approach to support sustainable outcomes : Comment on “expanded HTA: Enhancing fairness and legitimacy”. / Byskov, Jens; Maluka, Stephen Oswald; Marchal, Bruno; Shayo, Elizabeth H.; Bukachi, Salome; Zulu, Joseph M.; Blas, Erik; Michelo, Charles; Ndawi, Benedict; Hurtig, Anna Karin.

In: International Journal of Health Policy and Management, Vol. 6, No. 2, 2017, p. 115-118.

Research output: Contribution to journalComment/debateResearchpeer-review

Harvard

Byskov, J, Maluka, SO, Marchal, B, Shayo, EH, Bukachi, S, Zulu, JM, Blas, E, Michelo, C, Ndawi, B & Hurtig, AK 2017, 'The need for global application of the accountability for reasonableness approach to support sustainable outcomes: Comment on “expanded HTA: Enhancing fairness and legitimacy”', International Journal of Health Policy and Management, vol. 6, no. 2, pp. 115-118. https://doi.org/10.15171/ijhpm.2016.106

APA

Byskov, J., Maluka, S. O., Marchal, B., Shayo, E. H., Bukachi, S., Zulu, J. M., Blas, E., Michelo, C., Ndawi, B., & Hurtig, A. K. (2017). The need for global application of the accountability for reasonableness approach to support sustainable outcomes: Comment on “expanded HTA: Enhancing fairness and legitimacy”. International Journal of Health Policy and Management, 6(2), 115-118. https://doi.org/10.15171/ijhpm.2016.106

Vancouver

Byskov J, Maluka SO, Marchal B, Shayo EH, Bukachi S, Zulu JM et al. The need for global application of the accountability for reasonableness approach to support sustainable outcomes: Comment on “expanded HTA: Enhancing fairness and legitimacy”. International Journal of Health Policy and Management. 2017;6(2):115-118. https://doi.org/10.15171/ijhpm.2016.106

Author

Byskov, Jens ; Maluka, Stephen Oswald ; Marchal, Bruno ; Shayo, Elizabeth H. ; Bukachi, Salome ; Zulu, Joseph M. ; Blas, Erik ; Michelo, Charles ; Ndawi, Benedict ; Hurtig, Anna Karin. / The need for global application of the accountability for reasonableness approach to support sustainable outcomes : Comment on “expanded HTA: Enhancing fairness and legitimacy”. In: International Journal of Health Policy and Management. 2017 ; Vol. 6, No. 2. pp. 115-118.

Bibtex

@article{ac1aaa334ebd4e9b9d54340caa71b797,
title = "The need for global application of the accountability for reasonableness approach to support sustainable outcomes: Comment on “expanded HTA: Enhancing fairness and legitimacy”",
abstract = "The accountability for reasonableness (AFR) concept has been developed and discussed for over two decades. Its interpretation has been studied in several ways partly guided by the specific settings and the researchers involved. This has again influenced the development of the concept, but not led to universal application. The potential use in health technology assessments (HTAs) has recently been identified by Daniels et al as yet another excellent justification for AFR-based process guidance that refers to both qualitative and a broader participatory input for HTA, but it has raised concerns from those who primarily support the consistency and objectivity of more quantitative and reproducible evidence. With reference to studies of AFR-based interventions and the through these repeatedly documented motivation for their consolidation, we argue that it can even be unethical not to take AFR conditions beyond their still mainly formative stage and test their application within routine health systems management for their expected support to more sustainable health improvements. The ever increasing evidence and technical expertise are necessary but at times contradictory and do not in isolation lead to optimally accountable, fair and sustainable solutions. Technical experts, politicians, managers, service providers, community members, and beneficiaries each have their own values, expertise and preferences, to be considered for necessary buy in and sustainability. Legitimacy, accountability and fairness do not come about without an inclusive and agreed process guidance that can reconcile differences of opinion and indeed differences in evidence to arrive at a by all understood, accepted, but not necessarily agreed compromise in a current context - until major premises for the decision change. AFR should be widely adopted in projects and services under close monitoring and frequent reviews.",
keywords = "Accountability, Democratic development, Fairness, Health systems, Legitimacy, Sustainability, Values",
author = "Jens Byskov and Maluka, {Stephen Oswald} and Bruno Marchal and Shayo, {Elizabeth H.} and Salome Bukachi and Zulu, {Joseph M.} and Erik Blas and Charles Michelo and Benedict Ndawi and Hurtig, {Anna Karin}",
year = "2017",
doi = "10.15171/ijhpm.2016.106",
language = "English",
volume = "6",
pages = "115--118",
journal = "International Journal of Health Policy and Management",
issn = "2322-5939",
publisher = "Kerman University of Medical Sciences",
number = "2",

}

RIS

TY - JOUR

T1 - The need for global application of the accountability for reasonableness approach to support sustainable outcomes

T2 - Comment on “expanded HTA: Enhancing fairness and legitimacy”

AU - Byskov, Jens

AU - Maluka, Stephen Oswald

AU - Marchal, Bruno

AU - Shayo, Elizabeth H.

AU - Bukachi, Salome

AU - Zulu, Joseph M.

AU - Blas, Erik

AU - Michelo, Charles

AU - Ndawi, Benedict

AU - Hurtig, Anna Karin

PY - 2017

Y1 - 2017

N2 - The accountability for reasonableness (AFR) concept has been developed and discussed for over two decades. Its interpretation has been studied in several ways partly guided by the specific settings and the researchers involved. This has again influenced the development of the concept, but not led to universal application. The potential use in health technology assessments (HTAs) has recently been identified by Daniels et al as yet another excellent justification for AFR-based process guidance that refers to both qualitative and a broader participatory input for HTA, but it has raised concerns from those who primarily support the consistency and objectivity of more quantitative and reproducible evidence. With reference to studies of AFR-based interventions and the through these repeatedly documented motivation for their consolidation, we argue that it can even be unethical not to take AFR conditions beyond their still mainly formative stage and test their application within routine health systems management for their expected support to more sustainable health improvements. The ever increasing evidence and technical expertise are necessary but at times contradictory and do not in isolation lead to optimally accountable, fair and sustainable solutions. Technical experts, politicians, managers, service providers, community members, and beneficiaries each have their own values, expertise and preferences, to be considered for necessary buy in and sustainability. Legitimacy, accountability and fairness do not come about without an inclusive and agreed process guidance that can reconcile differences of opinion and indeed differences in evidence to arrive at a by all understood, accepted, but not necessarily agreed compromise in a current context - until major premises for the decision change. AFR should be widely adopted in projects and services under close monitoring and frequent reviews.

AB - The accountability for reasonableness (AFR) concept has been developed and discussed for over two decades. Its interpretation has been studied in several ways partly guided by the specific settings and the researchers involved. This has again influenced the development of the concept, but not led to universal application. The potential use in health technology assessments (HTAs) has recently been identified by Daniels et al as yet another excellent justification for AFR-based process guidance that refers to both qualitative and a broader participatory input for HTA, but it has raised concerns from those who primarily support the consistency and objectivity of more quantitative and reproducible evidence. With reference to studies of AFR-based interventions and the through these repeatedly documented motivation for their consolidation, we argue that it can even be unethical not to take AFR conditions beyond their still mainly formative stage and test their application within routine health systems management for their expected support to more sustainable health improvements. The ever increasing evidence and technical expertise are necessary but at times contradictory and do not in isolation lead to optimally accountable, fair and sustainable solutions. Technical experts, politicians, managers, service providers, community members, and beneficiaries each have their own values, expertise and preferences, to be considered for necessary buy in and sustainability. Legitimacy, accountability and fairness do not come about without an inclusive and agreed process guidance that can reconcile differences of opinion and indeed differences in evidence to arrive at a by all understood, accepted, but not necessarily agreed compromise in a current context - until major premises for the decision change. AFR should be widely adopted in projects and services under close monitoring and frequent reviews.

KW - Accountability

KW - Democratic development

KW - Fairness

KW - Health systems

KW - Legitimacy

KW - Sustainability

KW - Values

U2 - 10.15171/ijhpm.2016.106

DO - 10.15171/ijhpm.2016.106

M3 - Comment/debate

C2 - 28812788

AN - SCOPUS:85029214380

VL - 6

SP - 115

EP - 118

JO - International Journal of Health Policy and Management

JF - International Journal of Health Policy and Management

SN - 2322-5939

IS - 2

ER -

ID: 184415697