Health technology assessment in Ghana: the development of the process guidelines using evidence-informed deliberative processes

Health technology assessment (HTA) is increasingly recognised as a critical tool for advancing universal health coverage in Ghana. Despite national health policies emphasising the importance of HTA, the country has historically lacked a formal framework and clear process guidelines to incorporate HTA systematically into healthcare decision-making. The development of Ghana’s HTA process guidelines began in 2019. It was finalised in December 2022, based on the concept of evidence-informed deliberative processes and best practices from functional HTA frameworks in other countries. Key activities involved creating a governance structure, defining decision criteria, and establishing an eight-step HTA process. Capacity-strengthening activities enabled the Technical Working Group (TWG) to participate in developing the guidelines and ensured buy-in at all levels. The resulting process guidelines outline an eight-step framework that provides clear guidance for each stage: topic nomination, selection and approval, scoping and stakeholder engagement, assessment, appraisal, deliberations and recommendations, communication, and implementation. Surveys conducted during the development phase revealed high levels of satisfaction, indicating the enhanced legitimacy of healthcare decisions under the new framework. The guidelines establish a transparent, inclusive, and evidence-informed HTA process in Ghana. Adopting formal HTA process guidelines marks a significant step toward strengthening healthcare decision-making in Ghana, aligning with the nation’s universal health coverage goals. By institutionalising HTA within a transparent and participatory framework, Ghana is better positioned to prioritise and allocate healthcare resources effectively, promoting efficiency, equity and sustainability in its health system.