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. 2016 Apr 12;13(4):419.
doi: 10.3390/ijerph13040419.

Multi-Stakeholder Decision Aid for Improved Prioritization of the Public Health Impact of Climate Sensitive Infectious Diseases

Valerie Hongoh  1   2 , Pascal Michel  3   4 , Pierre Gosselin  5   6 , Karim Samoura  7   8 , André Ravel  9 , Céline Campagna  10   11 , Hassane Djibrilla Cissé  12 , Jean-Philippe Waaub  13
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Multi-Stakeholder Decision Aid for Improved Prioritization of the Public Health Impact of Climate Sensitive Infectious Diseases

Valerie Hongoh et al. Int J Environ Res Public Health. .

Abstract

The effects of climate change on infectious diseases are an important global health concern and necessitate decisions for allocation of resources. Economic tools have been used previously; however, how prioritization results might differ when done using broader considerations identified by local stakeholders has yet to be assessed. A multicriteria decision analysis (MCDA) approach was used to assess multi-stakeholder expressed concerns around disease prioritization via focus groups held in Quebec and Burkina Faso. Stakeholders weighted criteria and comparisons were made across study sites. A pilot disease prioritization was done to examine effects on disease rankings. A majority of identified criteria were common to both sites. The effect of context specific criteria and weights resulted in similar yet distinct prioritizations of diseases. The presence of consistent criteria between sites suggests that common concerns exist for prioritization; however, context-specific adjustments reveal much regarding resource availability, capacity and concerns that should be considered as this impacts disease ranking. Participatory decision aid approaches facilitate rich knowledge exchange and problem structuring. Furthermore, given multiple actors in low- and middle-income countries settings, multi-actor collaborations across non-governmental organizations, local government and community are important. Formal mechanisms such as MCDA provide means to foster consensus, shared awareness and collaboration.

Keywords: infectious disease prioritization; multi-criteria decision analysis; participatory decision aid.

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Figures

Figure 1
Figure 1
Average weighting of decision criteria categories by regions (Burkina Faso values are represented by black triangular markers with solid lines and Quebec values are represented by unfilled circular markers and dotted lines. The length of the lines indicates the range of weight values assigned by stakeholders). Criteria categories are shown along the X axis and average weights by category are shown along the y axis. Bars indicate the stakeholder assigned weight ranges for criteria categories. * The differences between the two groups (BF and QC) were found to be significant for the “Risk and Epidemiology” (REC) and “Economic” (ECC) categories only (unequal variance t-test, p < 0.5). Criteria category Legend: PHC: Public Health Criteria; SIC: Social Impact Criteria; REC: Risk and Epidemiology Criteria; AEC: Animal and Environmental Health Criteria; ECC: Economic Criteria; SOC: Strategic and Operational Criteria.
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