The development

Development of the SAVE-UHC Ethics Framework started with the high-level principles outlined in the NHI White Paper in order to translate and apply them to decision-making for specific health interventions.

The project then brought together a multi-stakeholder Working Group to discuss how these principles and other relevant considerations should be included in the HTA process. Drawing on the experience and perspectives of its members—policymakers, civil society and patient group representatives, academics, providers, and payers—the Working Group identified the set of specific domains and considerations that reflect South Africa’s core values for HTA.

NHI White Paper Principles

Right to access health care
Equity
Affordability
Effectiveness
Social solidarity
Health as a public good
Efficiency
Appropriateness

How was the ethics framework was piloted and refined?

After the SAVE-UHC Working Group developed the draft Ethics Framework, the project brought together participants from diverse backgrounds, fields, and perspectives to simulate the process of using the framework for health priority-setting. The project convened meetings across three provinces: Gauteng, Western Cape, and KwaZulu-Natal. At these meetings, participants used the draft Framework to review and discuss two sample health interventions, similar to how a government committee might use a framework like this in the future to decide if a health intervention should be included under National Health Insurance. By simulating the process of a health technology appraisal and soliciting feedback from the meeting participants, the research team was able to identify areas to refine and strengthen the Ethics Framework.

For additional details about the approach taken to develop the SAVE-UHC Ethics Framework, please see the full write-up of the methodology available here.