Expected health benefits or harms
Evidence about effectiveness informs us about the health benefits and harms we expect to see if the intervention is provided—both for individuals who receive it and in addressing the broader burden of the health condition for the population. We start with information about the benefits and harms of an intervention under ideal circumstances, like in a controlled research trial. But it is also important to assess benefits or harms based on real-world implementation in the South African context.
To assess expected health benefits or harms, consider:
Expected benefits under ideal and real-world circumstances
How effective is the intervention at preventing or treating disease, improving health and life expectancy, and/or avoiding disability or chronic illness?
- How large are the expected health benefits of the intervention?
- For individuals who benefit, how large is the effect size? If only small health improvements are likely, how clinically meaningful are they for people with the health condition? For example, people with a severe disease or disability may experience minor improvements in their health and how they can function, but these improvements could have significant benefits to their experience of health and overall wellbeing.
- What percent of people with the health condition are likely to experience these benefits/respond well to the intervention?
- How long-lasting are the benefits? Does the intervention require ongoing or consistent use to experience the health benefits?
- Does this intervention have advantages over existing options that may improve ease of use, adherence, and overall effectiveness?
- How severe would the consequences be if the intervention is not covered, for affected individuals and for the population?
- What are the overall expected benefits of health intervention for the broader population in reducing the burden of the health condition?
- Beyond the total direct benefits for people receiving the intervention, are there additional indirect health benefits for the population, like herd immunity or reduced virus circulating in communities?
The known side effects of the intervention
To the extent there are any negative side effects for those using the intervention:
- How frequent and severe are the known side effects of the intervention?
- Are any of the side effects long-lasting or permanent?
- Are there ways to avoid or reduce the impact of the side effects?
- Will the nature of the side effects reduce overall uptake or effectiveness?
- How do the side effects of this intervention compare to other interventions for the condition?
Expected benefits or harms given Systems Factors & Constraints
The real-world context of the health system
- Do health system factors related to quality, availability, and capacity enable effective delivery of the health intervention or could they limit the intervention’s effectiveness?
- How might these factors affect the likely benefits and/or harms we would expect to see from offering the intervention?
Consider:
- the capacity of our health care workforce to implement the intervention
- the facilities and equipment we need for the intervention to be successful
- the quality of the services, products, and care
The real-world context of other systems factors
- Does the intervention rely on other systems factors, such as reliable access to clean water, electricity, data sources, or internet to work properly?
- How might these factors affect the likely benefits and/or harms we would expect to see from offering the intervention?
Because systems factors naturally vary across different parts of the country and for different population groups, see more under Equity as to how systems factors may affect the distribution of who benefits or is harmed by introducing the intervention