Impacts on safety and security
Coverage decisions for some health interventions may have special considerations that relate to people’s exposure to unsafe environments or dangerous encounters. Feeling safe and being protected from harms while seeking health services, getting care, or—in the case of health workers—providing care, is important for the broader wellbeing of patients and providers alike. Here we look at whether the health intervention has any special significance for people’s safety and security.
To assess whether covering an intervention will have additional or special significance for people’s safety and security, consider:
People managing their health needs
- Does the intervention reduce the need for people to travel through unsafe areas?
- For example, a mobile clinic or intervention that can be self-administered at home to reduce exposures to harm or harm in transit?
- Does the intervention help address the needs of patients who may be targets of violence, including based on gender or stigmatised health conditions?
- For example, is the intervention directly related to prevention or response services for gender-based violence?
- Does the intervention improve safety within the context of receiving care or services? For example:
- an intervention that reduces possibility of injury or infection while in health facilities
- an intervention that covers childbirth companions or patient advocates to help address possible abuse or mistreatment within the clinical context
- Could the management of the condition lead to fewer unsafe or violent encounters?
- For example, a health intervention that addresses a substance use disorder or mental health problem that may put people in unsafe situations
Health workers’ delivering the intervention
- Does the intervention have positive or negative impacts on the safety and security of providers? For example:
- an intervention that relies on community health workers to deliver services in unsafe areas
- an intervention that reduces workplace exposures to harm from infection, contamination, or threats of violence
Note: This domain will not necessarily be applicable to every intervention. It is possible that some elements (such as prevention of infection or injury in care settings) may be captured in the economic evaluation, in which case they may not need to be assessed independently.
Safety & Security and Systems Factors & Constraints
In the real-world context of the health system & other factors
- Many of the considerations relevant to this domain will depend on other systems factors. For instance, the safety and availability of public transport as well as efforts to address crime and violence in communities will affect the kinds of harmful exposures people may face when they seek care. There may be opportunities to improve safety and security through partnerships with other sectors, so that the health intervention can be safely accessed.
- There are also health systems factors that influence safety and security within the care setting, for all interventions. These may need to be addressed through training, changes to facilities, and other quality improvement measures.