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Developing a Framework for Conducting Health Technology Assessment in a Resource-Constrained Setting
Thesis (PhD)--Stellenbosch University, 2026.
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| Format: | Thesis |
| Language: | English |
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Stellenbosch : Stellenbosch University
2026
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| _version_ | 1867614074711310336 |
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| access_status_str | Open Access |
| author | Chikunichawa, Tinashe Ashley |
| author2 | Grobbelaar, Sara Saartjie |
| author_browse | Chikunichawa, Tinashe Ashley Grobbelaar, Sara Saartjie |
| author_facet | Grobbelaar, Sara Saartjie Chikunichawa, Tinashe Ashley |
| author_sort | Chikunichawa, Tinashe Ashley |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (PhD)--Stellenbosch University, 2026. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/135685 |
| institution | Stellenbosch University (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:46:15.146Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2026 |
| publishDateRange | 2026 |
| publishDateSort | 2026 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/135685 Developing a Framework for Conducting Health Technology Assessment in a Resource-Constrained Setting Chikunichawa, Tinashe Ashley Grobbelaar, Sara Saartjie Persson, Mikael Stellenbosch University. Faculty of Engineering. Dept. of Industrial Engineering. Thesis (PhD)--Stellenbosch University, 2026. Chikunichawa, T. A. 2026. Developing a Framework for Conducting Health Technology Assessment in a Resource-Constrained Setting. Unpublished doctoral dissertation. Stellenbosch: Stellenbosch University [online]. Available: https://scholar.sun.ac.za/items/d07921e5-5d59-4f0b-954e-4f0db59e48a5 Health Technology Assessment (HTA) is crucial for achieving Universal Health Coverage (UHC) but remains underdeveloped for medical devices (MDs) in low- and middle-income countries (LMICs), particularly within fragmented public health sectors. Local MD manufacturers face significant barriers navigating the medical device value chain (MDVC), often failing to bring context-appropriate innovations to market due to regulatory, evidence generation, and market access challenges known as the "valley of death". While early HTA (EHTA) and lifecycle HTA offer potential solutions, practical, context-sensitive frameworks incorporating guidance for these manufacturers are lacking. This study aimed to develop a conceptual HTA framework that incorporates comprehensive guidelines to help local MD manufacturers use EHTA and HTA to navigate MDVC bottlenecks in resource-constrained environments. The research employed a pragmatic paradigm, utilising Design Science Research Methodology (DSRM). The development process involved iterative cycles that incorporated extensive literature reviews, the application of an adapted international framework in an instrumental case study, and rigorous validation through semi-structured interviews and ranking exercises with subject matter experts (SMEs). The research produced a final, validated conceptual HTA framework presented across four canvases, including specific guidelines tailored for local manufacturers. An operational HTA management tool was subsequently developed to implement this framework. The framework provides a systematic, lifecycle-based process that integrates EHTA principles for MD evaluation and is structured around six core processes. The Microsoft Excel-based management tool operationalises this framework, offering practical templates, checklists, and a progress dashboard designed for users with limited HTA expertise. This research contributes a theoretically grounded and empirically validated conceptual framework applicable to real-world healthcare contexts. The framework and its accompanying guidelines, operationalised through the management tool, provide a structured and transparent approach to enhancing the capacity of local MD manufacturers and supporting evidence-informed decision-making among health system actors. Ultimately, this promotes the adoption of appropriate MDs while offering theoretical transferability to other resource-constrained settings. Doctoral 2026-04-08T05:59:46Z 2026-04-08T05:59:46Z 2026-03 Thesis https://scholar.sun.ac.za/handle/10019.1/135685 en Stellenbosch University 456 pages : ill. application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Chikunichawa, Tinashe Ashley Developing a Framework for Conducting Health Technology Assessment in a Resource-Constrained Setting |
| title | Developing a Framework for Conducting Health Technology Assessment in a Resource-Constrained Setting |
| title_full | Developing a Framework for Conducting Health Technology Assessment in a Resource-Constrained Setting |
| title_fullStr | Developing a Framework for Conducting Health Technology Assessment in a Resource-Constrained Setting |
| title_full_unstemmed | Developing a Framework for Conducting Health Technology Assessment in a Resource-Constrained Setting |
| title_short | Developing a Framework for Conducting Health Technology Assessment in a Resource-Constrained Setting |
| title_sort | developing a framework for conducting health technology assessment in a resource constrained setting |
| url | https://scholar.sun.ac.za/handle/10019.1/135685 |
| work_keys_str_mv | AT chikunichawatinasheashley developingaframeworkforconductinghealthtechnologyassessmentinaresourceconstrainedsetting |