Document Type : Scoping Review

Authors

• Shiva Onegh ¹
• Shaghayegh vahdat ¹
• Shahram Tofighi ²
• Somayeh Hessam ¹

¹ Department of Health Service Administration, ST.C., Islamic Azad University, Tehran, Iran.

² Department of Forecasting, Theory Building and Health Observatory, Medical Academy of IRI, Tehran, Iran

Abstract

Objectives: The aim of this study was to identify effective criteria, approaches, and models for prioritizing health interventions across various countries to inform the design of the Basic Health Benefits Package (BHBP).

Materials and Methods: The scoping review was conducted based on the PRISMA-ScR checklist. Electronic searches were performed in PubMed, Cochrane Library, and—for broader coverage—Google Scholar, ScienceDirect (Elsevier), SpringerLink, and Persian databases (MagIran, SID) from January 2005 to June 2024. These were supplemented by manual searches in WHO and World Bank resources, Google, and article references. Of 2,266 studies identified, 42 were selected for final analysis, with reference management handled using EndNote.

Results: Criteria were categorized as economic, effectiveness-related, equity-social, and subsidiary. Economic criteria (cost-effectiveness) and effectiveness (disease burden) were prevalent in most countries; however, equity-social criteria predominated in high-income countries. Health Technology Assessment (HTA) approaches and evidence-based deliberative processes (EDPs) were common in high-income countries, whereas low-income countries relied on stakeholder engagement and global models such as Disease Control Priorities (DCP3), Essential Universal Health Coverage (EUHC), Global Burden of Disease, and WHO-CHOICE cost-effective interventions—or combinations thereof.

Conclusions: Economic and effectiveness criteria are commonly used in prioritizing BHBP interventions, but equity/justice and subsidiary criteria gain prominence with increasing income levels. HTA approaches prevail in high-income countries, while DCP3 models are more common in low-income settings. These findings align with the Sustainable Development Goals.

Key Message: Policymakers in low-income countries should integrate HTA with DCP3 models, emphasizing stakeholder engagement and equity, to optimize resource allocation, balance economic and equity/justice considerations, and reduce access inequalities.

Keywords

• Essential Health Benefit Package
• Health Benefit Package
• Basic Health Insurance Package
• Healthcare Prioritization

Main Subjects

• Health services management