A tool to analyze and prioritize health interventions
What is HIPtool?
The Health Interventions Prioritization Tool (HIPtool) is a cloud-based, open-access, user-friendly, high-impact resource to assist with health intervention prioritization at the country level. It combines context-specific data on burden of disease and intervention effectiveness to help stakeholders identify funding priorities and targets.
Why define a Health Benefits Package?
Global momentum towards Universal Health Care (UHC) continues to accelerate since its inclusion in the UN Sustainable Development Goal on ‘Good Health and Wellbeing’. While universal access remains the ultimate goal, most countries will have to transition to universality through a gradual process of widening provision. Research has highlighted the advantages of defining explicit health service packages on the path to UHC, sometimes called Health Benefits Packages (HBP), which are free at the point of use. Defined Health Benefits Packages can:
- Improve transparency and accountability within the health system
- Clarify entitlements for service users, particularly poor and marginalized groups
- Help systems understand and adhere to budget limits, which might otherwise be attained only through arbitrary restrictions on services
- Create a need to identify whether funds are being spent effectively on services that maximise benefits for society
- Reduce the risk of informal payments to secure access to services
- Generate information for provider commissioning or payment
- Provide pre-conditions for complementary health insurance for non-HBP services
How do we know what a Health Benefits Package might contain?
Significant investments in health systems data collection and synthesis are maturing. We now have more information than ever before about current and future trends in burden of disease, health service costs and the expected impact of service provision. This information can be used to support the evidence-based formulation of HBPs.
In December 2017, two packages of the most cost-effective health interventions across disease areas were published in Disease Control Priorities, Third Edition (DCP3). The DCP3 Essential UHC (EUHC) package and Highest-Priority Package (HPP) provide a foundation on which to prioritize services. However, each country has its own epidemiological profile, cost base and service delivery system. So, while the EUHC and HPP provide general guidelines, they need to be adapted to a country’s own context. Countries may also want to compare DCP3 recommendations with those of the World Health Organization, or to monitor progress towards national or global targets.
Decision makers thus have an unprecedented body of evidence to inform their selection of high priority health services but navigating such complex evidence can prove challenging.
HIPtool has been developed to assist decision makers in selecting, synthesising and generating evidence to aid policy discussions around health intervention prioritization and HBP design.
What is a HIPtool analysis?
HIPtool analyses bring together IHME data on burden of disease and DCP3 data on the EUHC and HPP packages, together with other secondary data sources.
These data are combined in an open-access, online interface that is intended to be user-friendly and flexible. While a set of default data are included in the tool, these can be amended by users to better reflect local contexts.
The first step in a HIPtool analysis is to identify what services are currently provided, and which of those are included in the HBP if one exists or is clearly defined. Once relevant services are identified, the following five steps constitute a HIPtool analysis:
- Automatically upload a country’s disease burden
- Import best evidence for health program cost and effectiveness
- Calculate the cost and impact of globally recommended packages in context
- Identify interventions with greatest estimated impact on burden of disease
- Compare current spending and impact against alternative allocation scenarios, with the option of running an optimisation analysis
A range of stakeholders should usually be involved throughout the process to help validate both the inputs and outputs of a HIPtool analysis, and to inform the feasibility of different scenarios by identifying ethical, financial, logistic, political and other potential constraints.
HIPtool is designed to produce clear graphic outputs that can be understood by stakeholders with a wide range of expertise. The aim of these outputs is to support discussions across different branches of government, such as ministries of finance or transport, which are essential if progress toward UHC is to be made.
What type of policy questions can the HIPtool answer?
What is the impact of current health spending?
When setting priorities for a health benefits package, countries may want to compare any changes against current spending and service provision. The HIPtool can compare the impact of different packages so that stakeholders can compare the gains and losses that may result from any changes.
How might current spending be allocated to maximise system objectives?
The HIPtool includes an optimisation algorithm and offers the option to estimate allocations of spending to maximise:
- health outcomes,
- equity, and
- financial risk protection.
How will an "optimal" budget allocation differ from current spending and what would be gained?
The HIPtool can be used to estimate the impact of different spending scenarios to help inform decision-makers about (a) which services would benefit most from additional funding, (b) which services might be prioritised if overall funding decreases, or (c) to help advocate for additional future funding by quantifying the impact of different funding scenarios.