Characterizing multi-criteria decision analysis, risk stratification, and hotspot analysis methods to optimise health policymaking and evidence translation for medicines in low- and middle-income countries: A scoping review.

Authors

Luke E Norris, Tessa Rose Cornell, Patricia N Okorie, Lily-May Hudson, Louise A Kelly-Hope

Published in

Gates open research. Volume 10. Pages 68. Epub Oct 15, 2026.

Abstract

Implementing new medicines or health interventions in lower-income and middle-income countries (LMICs) may be complex and challenging, and there is a need for practical structured approaches and tools to support the translation of evidence into practice, including the implementation of evidence-informed interventions and health policy making.
This scoping review aimed to characterise three data analytical methodologies - multi-criteria decision analysis (MCDA), risk stratification, and hotspot analysis - to evaluate their use in guiding the implementation of medicines for human health in LMICs between 2010-2025.
Scientific articles were searched in databases PubMed and Scopus following guidelines from the Preferred Items for Systematic Reviews and Meta-Analysis (PRISMA). Data were extracted in relation to the study aims, geographic scope and scale, author affiliations, disease focus, medicine type (categorised as oral drugs or vaccines), target population, medicine implementation phase, use of templates or tools, and main steps of the methodological process. In addition, grey literature was searched by reviewing conference abstracts, national public health websites and journals.
From the 4,920 articles screened, a total of 40 articles (MCDA=8, risk stratification= 22, hotspot analysis=10) were included from 28 countries across five global regions, mostly Africa. Most articles focused on communicable infectious diseases, and drugs (oral regimens) and vaccines in the pre-implementation stage at a sub-national level. The processes and techniques used for each analytical method varied widely, limiting comparability. However, common methodological steps were identified and used to construct preliminary templates to summarise the processes involved in applying each methodology and support their potential adaptations for decision-making around medicine implementation.
These analytical methodologies provide a structured basis for further developing practical templates and decision-support tools to enhance the medicine translation; however, efforts are needed to raise awareness, strengthen capacity, and facilitate greater uptake.

PMID:
42892762
Bibliographic data and abstract were imported from PubMed on 18 Oct 2026.

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