Embedding MCDA in Priority-Setting Policy Processes: Experiences from Low- and Middle-Income Countries

This chapter addresses three policy issues related to the application of multi-criteria decision analysis (MCDA) for priority setting of health interventions in low- and middle-income countries (LMICs), namely, stakeholder involvement, institutionalization, and the impact of MCDA on policy decisions. Based on a literature review, we evaluate 11 case studies in the light of these issues. We found that there is no systematic approach for the involvement of stakeholders. Only four case studies implemented MCDA in an institutional context, and three studies evaluated the impact of MCDA on policy decisions. A detailed case study that explicitly integrated MCDA in the policy-making process for HIV/AIDS control in Indonesia is presented, and enablers and barriers of such an approach with regard to the three policy issues are outlined. The final part of the chapter provides recommendations of the future application of MCDA in policy processes. It provides methodological guidance on which stakeholders to involved and why. Recommendations are given on the institutionalization of MCDA and to improve the evaluation of the impact of MCDA on policy decisions.