Article Text
Abstract
Introduction Public health decision-making requires the balancing of numerous, often conflicting factors. However, participatory, evidence-informed decision-making processes to identify and weigh these factors are often not possible- especially, in the context of the SARS-CoV-2 pandemic. While evidence-to-decision frameworks are not able or intended to replace stakeholder participation, they can serve as a tool to approach relevancy and comprehensiveness of the criteria considered.
Objective To develop a decision-making framework adapted to the challenges of decision-making on non-pharmacological interventions to contain the global SARS-CoV-2 pandemic.
Methods We employed the ‘best fit’ framework synthesis technique and used the WHO-INTEGRATE framework as a starting point. First, we adapted the framework through brainstorming exercises and application to case studies. Next, we conducted a content analysis of comprehensive strategy documents intended to guide policymakers on the phasing out of applied lockdown measures in Germany. Based on factors and criteria identified in this process, we developed the WICID (WHO-INTEGRATE COVID-19) framework version 1.0.
Results Twelve comprehensive strategy documents were analysed. The revised framework consists of 11+1 criteria, supported by 48 aspects, and embraces a complex systems perspective. The criteria cover implications for the health of individuals and populations due to and beyond COVID-19, infringement on liberties and fundamental human rights, acceptability and equity considerations, societal, environmental and economic implications, as well as implementation, resource and feasibility considerations.
Discussion The proposed framework will be expanded through a comprehensive document analysis focusing on key stakeholder groups across the society. The WICID framework can be a tool to support comprehensive evidence-informed decision-making processes.
- health policy
- public health
- qualitative study
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Footnotes
Handling editor Seye Abimbola
Twitter @maike_voss
Contributors JMS and LA conceived the study. JMS, Prof. Eva Rehfuess, MV and LA engaged in the activities of phase I to develop the a priori framework. JMS and LA conducted the literature search for strategy documents, with support from MV. JMS and LA conducted the coding and analysis of the strategy documents and revised the a priori framework. JMS drafted the manuscript with support from LA and MV.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests JMS is the author of the WHO-INTEGRATE framework. JMS and MV were part of an expert group which developed strategy documents intended to inform the COVID-19 crisis task force of the German government. One (in the case of JMS) and two (in the case of MV) of which were included as comprehensive strategy documents in this analysis. We received support by the Bundeszentrale für gesundheitliche Aufklärung (BZgA; the German Federal Center for Health Education) to cover the publication fees for this manuscript. The BZgA did not have any editorial or scientific influence on the content of this publication.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement The underlying data are available in a public, open access repository. Data are available upon request. Most strategy documents are publicly available with the reference included in the manuscript. Those strategy documents not publicly available can be provided upon request.
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