Browsing by Author "Garcia Marti, Sebastian"

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    Alma-Ata: Rebirth and revision 2 - Supporting the delivery of cost-effective interventions in primary health-care systems in low-income and middle-income countries: an overview of systematic reviews
    (ELSEVIER SCIENCE INC, 2008) Lewin, Simon; Lavis, John N.; Oxman, Andrew D.; Bastias, Gabriel; Chopra, Mickey; Ciapponi, Agustin; Flottorp, Signe; Garcia Marti, Sebastian; Pantoja, Tomas; Rada, Gabriel; Souza, Nathan; Treweek, Shaun; Wiysonge, Charles S.; Haines, Andy
    Strengthening health systems is a key challenge to improving the delivery of cost-effective interventions in primary health care and achieving the vision of the Alma-Ata Declaration. Effective governance, financial and delivery arrangements within health systems, and effective implementation strategies are needed urgently in low-income and middle-income countries. This overview summarises the evidence from systematic reviews of health systems arrangements and implementation strategies, with a particular focus on evidence relevant to primary health care in such settings. Although evidence is sparse, there are several promising health systems arrangements and implementation strategies for strengthening primary health care. However, their introduction must be accompanied by rigorous evaluations. The evidence base needs urgently to be strengthened, synthesised, and taken into account in policy and practice, particularly for the benefit of those who have been excluded from the health care advances of recent decades.
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    Governance arrangements for health systems in low-income countries: An overview of systematic reviews
    (2017) Herrera Riquelme, Cristian Alberto; Lewin, Simon; Paulsen, Elizabeth; Ciapponi, Agustín; Opiyo, Newton; Pantoja Calderón, Tomás; Rada G., Gabriel; Wiysonge, Charles S; Bastías, Gabriel; Garcia Marti, Sebastian; Okwundu, Charles I.; Peñaloza Hidalgo, Blanca Elvira; Oxman, Andrew D.
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    Real-world evidence: experiences and challenges for decision making in Latin America
    (2023) Garcia Marti, Sebastian; Pichon-Riviere, Andres; Augustovski, Federico; Espinoza, Manuel
    ObjectiveThe Health Technology Assessment (HTA) process aims to optimize health system funding of technologies. In recent years there has been an increase in what is known as Real-World Evidence (RWE) as a complement to clinical trials. The objective of Health Technology Assessment International's Latin American Policy Forum 2022 was to explore the utility of incorporating RWE into HTA and decision-making processes in the region.MethodsThis article is based on a background document, survey, and the deliberative work of the country representatives who participated in the Forum.ResultsThere is a growing interest in the use of Real-World Data / Real-World Evidence in HTA processes in Latin America, although currently there are no specific local guidelines for RWE use by HTA agencies. At present, its use is limited to certain areas such as adding context to HTA reports, the evaluation of adverse events, or cost estimation.Potential future uses of RWE were identified, including the creation of risk-sharing agreements, the assessment of technology performance in routine practice, providing information on outcomes that are not so easily evaluated in clinical trials (e.g., the identification of specific subpopulations or quality of life), and the estimation of input parameters for economic evaluations.ResultsThere is a growing interest in the use of Real-World Data / Real-World Evidence in HTA processes in Latin America, although currently there are no specific local guidelines for RWE use by HTA agencies. At present, its use is limited to certain areas such as adding context to HTA reports, the evaluation of adverse events, or cost estimation.Potential future uses of RWE were identified, including the creation of risk-sharing agreements, the assessment of technology performance in routine practice, providing information on outcomes that are not so easily evaluated in clinical trials (e.g., the identification of specific subpopulations or quality of life), and the estimation of input parameters for economic evaluations.ConclusionsThe participants agreed that there are several areas presenting significant potential to expand the application of RWD/RWE and that the development of normative frameworks for its use could be helpful.