Academic interests
Research interests within global health policy:
- Health systems strengthening, including priority setting and public health interventions
- Global health security, including pandemic preparedness and antimicrobial resistance
- Development assistance for health
Background
- MD, PhD
- Currently Executive Director at the Norwegian Institute of Public Health; Associate Professor at the University of Oslo; and Adjunct Professor of Law at the University of Ottawa.
- Directs the Oslo Group on Global Health Policy
- Previously worked with the Norwegian Committee on Priority Setting in the Health Sector; the WHO Consultative Group on Equity and Universal Health Coverage; the Centre on Global Health Security at Chatham House; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and the UN Special Envoy on Ebola.
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Partners
Tags:
global health,
global health policy,
Global South
Publications
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Ottersen, Trygve
(2025).
Det er fem år siden Norge stengte ned som følge av pandemien – den største nasjonale krisen siden andre verdenskrig. De neste årene kan være en historisk god mulighet til å styrke beredskapen før neste krise treffer.
Tidsskrift for Den norske legeforening (Tidsskriftet).
ISSN 0029-2001.
145(6).
doi:
10.4045/tidsskr.25.0255.
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Dale, Elina; Peacocke, Elizabeth F.; Movik, Espen; Voorhoeve, Alex; Ottersen, Trygve & Kurowski, Christoph
[Show all 9 contributors for this article]
(2023).
Criteria for the procedural fairness of health financing decisions: a scoping review.
Health Policy and Planning.
ISSN 0268-1080.
38,
p. i13–i35.
doi:
10.1093/heapol/czad066.
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Due to constraints on institutional capacity and financial resources, the road to universal health coverage (UHC) involves difficult policy choices. To assist with these choices, scholars and policy makers have done extensive work on criteria to assess the substantive fairness of health financing policies: their impact on the distribution of rights, duties, benefits and burdens on the path towards UHC. However, less attention has been paid to the procedural fairness of health financing decisions. The Accountability for Reasonableness Framework (A4R), which is widely applied to assess procedural fairness, has primarily been used in priority-setting for purchasing decisions, with revenue mobilization and pooling receiving limited attention. Furthermore, the sufficiency of the A4R framework’s four criteria (publicity, relevance, revisions and appeals, and enforcement) has been questioned. Moreover, research in political theory and public administration (including deliberative democracy), public finance, environmental management, psychology, and health financing has examined the key features of procedural fairness, but these insights have not been synthesized into a comprehensive set of criteria for fair decision-making processes in health financing. A systematic study of how these criteria have been applied in decision-making situations related to health financing and in other areas is also lacking. This paper addresses these gaps through a scoping review. It argues that the literature across many disciplines can be synthesized into 10 core criteria with common philosophical foundations. These go beyond A4R and encompass equality, impartiality, consistency over time, reason-giving, transparency, accuracy of information, participation, inclusiveness, revisability and enforcement. These criteria can be used to evaluate and guide decision-making processes for financing UHC across different country income levels and health financing arrangements. The review also presents examples of how these criteria have been applied to decisions in health financing and other sectors.
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Kurowski, Christoph; Evans, David B.; Ottersen, Trygve; Gopinathan, Unni; Dale, Elina & Norheim, Ole Frithjof
(2023).
New strides towards fair processes for financing universal health coverage.
Health Policy and Planning.
ISSN 0268-1080.
38(1),
p. i5–i8.
doi:
10.1093/heapol/czad065.
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Fair processes in health financing decisions should not be undervalued or perceived as secondary to the goals of universal health coverage. By integrating fair-process principles and criteria into health financing decisions, countries can achieve more equitable outcomes, strengthen the legitimacy of the decision-making process, build trust in public institutions and promote long-term sustainability of reforms. Procedural fairness requires a comprehensive approach, which consists of three core principles of equality, impartiality and consistency over time. To translate these principles into real-world health financing decisions, countries can apply seven criteria, organized into three domains of information, voice and oversight. Countries across income levels with different political systems and health financing arrangements have promising practices and experiments promoting procedural fairness. The report ‘Open and inclusive: fair processes for financing universal health coverage’ builds on insights from a wide range of fields and settings to highlight some of the key policy instruments to support countries in this journey.
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Tschirhart, Naomi Anne; Jiraporncharoen, Wichuda; Angkurawaranon, Chaisiri; Hashmi, Ahmar; Hla, Sophia & Nosten, Suphak
[Show all 8 contributors for this article]
(2023).
Giving birth on the way to the clinic: undocumented migrant women’s perceptions and experiences of maternal healthcare accessibility along the Thailand–Myanmar border.
Reproductive Health.
20(1).
doi:
10.1186/s12978-023-01722-9.
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Background Millions of women give birth annually without the support of a trained birth attendant. Generally and globally, countries provide maternal health services for their citizens but there is a coverage gap for undocumented migrant women who often can’t access the same care due to their legal status. The objective of this investigation is to explore undocumented migrants’ experiences and perceptions of maternal healthcare accessibility. Methods We held focus groups discussions with 64 pregnant women at 3 migrant health clinics on the Thailand–Myanmar border and asked how they learned about the clinic, their health care options, travel and past experiences with birth services. In this context undocumented women could sign up for migrant health insurance at the clinic that would allow them to be referred for tertiary care at government hospitals if needed. Results Women learned about care options through a network approach often relying on information from community members and trusted care providers. For many, choice of alternate care was limited by lack of antenatal care services close to their homes, limited knowledge of other services and inability to pay fees associated with hospital care. Women travelled up to 4 h to get to the clinic by foot, bicycle, tractor, motorcycle or car, sometimes using multiple modes of transport. Journeys from the Myanmar side of the border were sometimes complicated by nighttime border crossing closures, limited transport and heavy rain. Conclusions Undocumented migrant women in our study experienced a type of conditional or variable accessibility where time of day, transport and weather needed to align with the onset of labour to ensure that they could get to the migrant clinic on time to give birth. We anticipate that undocumented migrants in other countries may also experience conditional accessibility to birth care, especially where travel is necessary due to limited local services. Care providers may improve opportunities for undocumented pregnant women to access maternal care by disseminating information on available services through informal networks and addressing travel barriers through mobile services and other travel supports. Trial registration The research project was approved by Research Ethics Committee at the Faculty of Medicine, Chiang Mai University (FAM-2560-05204), and the Department of Community Medicine and Global Health at the University of Oslo—Norwegian Centre for Research Data (58542).
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Clarsen, Benjamin Matthew; Nylenna, Magne; Klitkou, Søren Toksvig; Vollset, Stein Emil; Baravelli, Carl Michael & Bølling, Anette Kocbach
[Show all 31 contributors for this article]
(2022).
Changes in life expectancy and disease burden in Norway, 1990–2019: an analysis of the Global Burden of Disease Study 2019.
The Lancet Public Health.
ISSN 2468-2667.
7(7),
p. e593–e605.
doi:
10.1016/S2468-2667(22)00092-5.
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Background: Geographical differences in health outcomes are reported in many countries. Norway has led an active policy aiming for regional balance since the 1970s. Using data from the Global Burden of Disease Study (GBD) 2019, we examined regional differences in development and current state of health across Norwegian counties.
Methods: Data for life expectancy, healthy life expectancy (HALE), years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) in Norway and its 11 counties from 1990 to 2019 were extracted from GBD 2019. County-specific contributors to changes in life expectancy were compared. Inequality in disease burden was examined by use of the Gini coefficient.
Findings: Life expectancy and HALE improved in all Norwegian counties from 1990 to 2019. Improvements in life expectancy and HALE were greatest in the two counties with the lowest values in 1990: Oslo, in which life expectancy and HALE increased from 71·9 years (95% uncertainty interval 71·4-72·4) and 63·0 years (60·5-65·4) in 1990 to 81·3 years (80·0-82·7) and 70·6 years (67·4-73·6) in 2019, respectively; and Troms og Finnmark, in which life expectancy and HALE increased from 71·9 years (71·5-72·4) and 63·5 years (60·9-65·6) in 1990 to 80·3 years (79·4-81·2) and 70·0 years (66·8-72·2) in 2019, respectively. Increased life expectancy was mainly due to reductions in cardiovascular disease, neoplasms, and respiratory infections. No significant differences between the national YLD or DALY rates and the corresponding age-standardised rates were reported in any of the counties in 2019; however, Troms og Finnmark had a higher age-standardised YLL rate than the national rate (8394 per 100 000 [95% UI 7801-8944] vs 7536 per 100 000 [7391-7691]). Low inequality between counties was shown for life expectancy, HALE, all level-1 causes of DALYs, and exposure to level-1 risk factors.
Interpretation: Over the past 30 years, Norway has reduced inequality in disease burden between counties. However, inequalities still exist at a within-county level and along other sociodemographic gradients. Because of insufficient Norwegian primary data, there remains substantial uncertainty associated with regional estimates for non-fatal disease burden and exposure to risk factors.
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Cyr, Pascale Renée; Jain, Vageesh; Chalkidou, Kalipso; Ottersen, Trygve & Gopinathan, Unni
(2021).
Evaluations of public health interventions produced by health technology assessment agencies: A mapping review and analysis by type and evidence content.
Health Policy.
ISSN 0168-8510.
125(8),
p. 1054–1064.
doi:
10.1016/j.healthpol.2021.05.009.
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Objectives: Health technology assessments (HTAs) have been suggested as a strategy to bridge the evidence-to-policy gap in public health. It is unclear to what extent HTAs have been prepared to assist decisions to implement public health interventions (PHIs). We aimed to describe the experience of HTA agencies by mapping, classifying, and analyzing the evidence content of HTAs of PHIs. Methods: We systematically searched databases of 35 HTA agencies from 18 countries for evaluations of PHIs between 2008-2018. Interventions were classified using the International Classification of Health Interventions and the evidence content analysed with the INAHTA Product-Type-mark checklist. Results: Only 1010 (9%) of HTAs were on PHIs. 500 (50%) publications targeted Body Systems and Functions, 302 (30%) Health-related Behaviours, 137 (14%) the Environment and 44 (4%) Activities and Participation Domains. Out of 734 publications perused, few met the criteria of full-HTAs (71;10%) or mini-HTAs (110;15%). Most were rapid reviews (420;57%). 72% of all reports came from only 6 countries. Conclusion: HTAs on PHIs were uncommon relative to clinical interventions. HTAs on population-based PHIs were less comprehensive in quality and rigor of the evidence. Countries with more resources and mature HTA-systems had done the most evaluations. Exploring the experiences of forerunners could help overcome barriers to evaluations of PHIs and exploit the full potential of HTAs to promote evidence-based public health.
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Tschirhart, Naomi Anne; Jiraporncharoen, Wichuda; Thongkhamcharoen, Rojanasak; Yoonut, Kulyapa; Ottersen, Trygve & Angkurawaranon, Chaisiri
(2021).
Including undocumented migrants in universal health coverage: a maternal health case study from the Thailand-Myanmar border.
BMC Health Services Research.
21.
doi:
10.1186/s12913-021-07325-z.
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Background Many countries aspiring to achieve universal health coverage struggle with how to ensure health coverage for undocumented migrants. Using a case study of maternal health care in a Thailand-Myanmar border region this article explores coverage for migrants, service provision challenges and the contribution of a voluntary health insurance program. Methods In 2018 we interviewed 18 key informants who provided, oversaw or contributed to maternal healthcare services for migrant women in the border region of Tak province, Thailand. Results In this region, we found that public and non-profit providers helped increase healthcare coverage beyond undocumented migrants’ official entitlements. Interview participants explained that Free and low-cost antenatal care (ANC) is provided to undocumented migrants through migrant specific clinics, outreach programs and health posts. Hospitals offer emergency birth care, although uninsured migrant patients are subsequently billed for the services. Care providers identified sustainability, institutional debt from unpaid obstetric hospital bills, cross border logistical difficulties and the late arrival of patients requiring emergency lifesaving interventions as challenges when providing care to undocumented migrants. An insurance fund was developed to provide coverage for costly emergency interventions at Thai government hospitals. The insurance fund, along with existing free and low-cost services, helped increase population coverage, range of services and financial protection for undocumented migrants. Conclusions This case study offers considerations for extending health coverage to undocumented populations. Non-profit insurance funds can help to improve healthcare entitlements, provide financial protection and reduce service providers’ debt. However, there are limits to programs that offer voluntary coverage for undocumented migrants. High costs associated with emergency interventions along with gaps in insurance coverage challenge the sustainability for NGO, non-profit and government health providers and may be financially disastrous for patients. Finally, in international border regions with high mobility, it may be valuable to implement and strengthen cross border referrals and health insurance for migrants.
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Tranvåg, Eirik Joakim; Strand, Roger; Ottersen, Trygve & Norheim, Ole Frithjof
(2021).
Precision medicine and the principle of equal treatment: a conjoint analysis.
BMC Medical Ethics.
22.
doi:
10.1186/s12910-021-00625-3.
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Background: In precision medicine biomarkers stratify patients into groups that are offered different treatments, but this may conflict with the principle of equal treatment. While some patient characteristics are seen as relevant for unequal treatment and others not, it is known that they all may influence treatment decisions. How biomarkers influence these decisions is not known, nor is their ethical relevance well discussed. Methods: We distributed an email survey designed to elicit treatment preferences from Norwegian doctors working with cancer patients. In a forced-choice conjoint analysis pairs of hypothetical patients were presented, and we calculated the average marginal component effect of seven individual patient characteristics, to estimate how each of them influence doctors’ priority-setting decisions. Results: A positive biomarker status increased the probability of being allocated the new drug, while older age, severe comorbidity and reduced physical function reduced the probability. Importantly, sex, education level and smoking status had no significant influence on the decision. Conclusion: Biomarker status is perceived as relevant for priority setting decisions, alongside more well-known patient characteristics like age, physical function and comorbidity. Based on our results, we discuss a framework that can help clarify whether biomarker status should be seen as an ethically acceptable factor for providing unequal treatment to patients with the same disease.
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Gopinathan, Unni; Ottersen, Trygve; Cyr, Pascale Renée & Chalkidou, Kalipso
(2021).
Evidence-Informed Deliberative Processes for HTA Around the Globe: Exploring the Next Frontiers of HTA and Best Practices; Comment on “Use of Evidence-informed Deliberative Processes by Health Technology Assessment Agencies Around the Globe”.
International Journal of Health Policy and Management.
10(4),
p. 232–236.
doi:
10.34172/ijhpm.2020.145.
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Tschirhart, Naomi Anne; Jiraporncharoen, Wichuda; Angkurawaranon, Chaisiri; Hashmi, Ahmar; Nosten, Suphak & McGready, Rose
[Show all 7 contributors for this article]
(2020).
Choosing where to give birth: Factors influencing migrant women's decision making in two regions of Thailand.
PLOS ONE.
15(4).
doi:
10.1371/journal.pone.0230407.
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Background Choosing where to give birth can be a matter of life and death for both mother and child. Migrants, registered or unregistered, may face different choices and challenges than non-migrants. Despite this, previous research on the factors migrant women consider when deciding where to give birth is very limited. This paper addresses this gap by examining women’s decision making in a respective border and urban locale in Thailand. Methods We held focus group discussions [13] with 72 non-Thai pregnant migrant women at non-government clinics in a rural border area and at two hospitals in Chiang Mai, a large city in Northern Thailand in 2018. We asked women where they will go to give birth and to explain the factors that influenced their decision. Results Women identified getting the relevant documentation necessary to register their child’s birth, safe birth and medical advice/quality care, as the top three factors that influenced their care seeking decision making. Language of service, free or low cost care, language of services, proximity to home, and limited alternate options for care were also identified as important considerations. Conclusion Understanding factors that migrant women value when choosing where to deliver can help health care providers to create services that are responsive to migrants’ preferences and encourage provision of relevant information which may influence patient decision making. The desire to obtain birth documentation for their child appears to be important for migrants who understand the importance of personal documentation for the lives of their children. Healthcare institutions may wish to introduce processes to facilitate obtaining documentation for pregnant migrant women and their newborns.
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Kriegner, Sabrina; Ottersen, Trygve; Røttingen, John-Arne & Gopinathan, Unni
(2020).
Promoting Intersectoral Collaboration Through the Evaluations of Public Health Interventions: Insights From Key Informants in 6 European Countries.
International Journal of Health Policy and Management.
10(2),
p. 67–76.
doi:
10.34172/ijhpm.2020.19.
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Background: Intersectoral collaboration is critical to the successful implementation of many public health interventions (PHIs). Little attention has been paid to whether and how processes at the stage of evaluation can promote intersectoral collaboration. The objective of this study was to examine European experiences and views on whether and how the evaluation of PHIs promote intersectoral collaboration. Methods: A qualitative study design was used. We conducted semi-structured interviews with 15 individuals centrally involved in the evaluation of PHIs in 6 European countries (Austria, Denmark, England, Germany, Norway, and Switzerland). Questions pertained to current processes for evaluating PHIs in the country and current and potential strategies for promoting intersectoral collaboration. Transcripts were analyzed using thematic analysis to identify key themes responding to our primary objective. Results: Experiences with promoting intersectoral collaboration through the evaluation of PHIs could be summarized in 4 themes: (1) Early involvement of non-health sectors in the evaluative process and inclusion of non-health benefits can promote intersectoral collaboration, but should be combined with greater influence of these sectors in shaping PHIs; (2) Harmonization of methodological approaches may enable comparison of results and facilitate intersectoral collaboration, but should not be an overriding goal; (3) Involvement in health impact assessments (HIAs) can promote intersectoral collaboration, but needs to be incentivized and be conducted without putting overwhelming demands on non-health sectors; (4) A designated body for evaluating PHIs may promote intersectoral collaboration, but its design needs to take account of realities of policy-making. Conclusion: The full potential for promoting intersectoral collaboration through the evaluation of PHIs appears currently unrealized in the settings we studied. To further promote intersectoral collaboration, evaluators and decisionmakers may consider the full range of strategies characterized in this study. This may be most effective if the strategies are deployed so that they reinforce each other, value outcomes beyond health, and are tailored to maximize political priority for PHIs across sectors.
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Tschirhart, Naomi Anne; Straiton, Melanie Lindsay; Ottersen, Trygve & Winkler, Andrea Sylvia
(2019).
“Living like I am in Thailand”: stress and coping strategies among Thai migrant masseuses in Oslo, Norway.
BMC Women's Health.
19(1),
p. 1–11.
doi:
10.1186/s12905-019-0836-9.
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Background
Migrants experience stress before, during and after migrating to a new country, all of which influences their mental wellbeing. In Norway, migration from Thailand is highly gendered as most Thai migrants are women who migrate to live with their Norwegian spouse. Massage shops, often owned by Thai entrepreneurs, are a locale where women use their cultural knowledge to bridge into the local economy. There is little knowledge about Thai migrant masseuses’ experience of stress in daily life and associated coping strategies. The objective of this inquiry was to examine stressors and coping strategies among Thai migrant masseuses in Oslo, Norway. Methods
We conducted in-depth interviews with 14 Thai migrants who were working as masseuses in Oslo, Norway. We asked participants about their health, experiences of stress, and coping strategies and subsequently analyzed the data using thematic analysis. Results
Stress in participants’ lives related to settling in, loneliness, finances and spousal relationships. Of these, relationship conflict was the largest source of stress. Women largely embraced self-coping strategies and utilized Thai cultural practices and Buddhist cognitive thinking. Once relationship conflict became untenable, participants fought to change their situation. Limited fluency in Norwegian, Thai stigma about mental health and limited knowledge of the Norwegian health system were barriers to seeking healthcare. Conclusions
Migrants in our study often adopted “Thainess”, the use of Thai cultural practices and Buddhist cognitive thinking, as a strategy for coping with stress. Preferences for self-coping, mental health stigma, and linguistic competency are important considerations when designing mental wellbeing interventions for Thai women. Use of an interpreter or systems navigator can help overcome language barriers. Clinicians can take detailed case histories to better understand Thai patients’ stress, coping strategies and wellbeing. Health policy makers could consider network approaches, including using Thai health systems navigators to bridge the health system and Thai communities.
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Gouglas, Dimitrios; Hoyt, Kendall; Peacocke, Elizabeth Fleur; Kaloudis, Aris; Ottersen, Trygve & Røttingen, John-Arne
(2019).
Setting strategic objectives for the coalition for epidemic preparedness innovations: An exploratory decision analysis process.
INFORMS Journal on Applied Analytics (IJAA).
ISSN 2644-0865.
49(6),
p. 430–446.
doi:
10.1287/inte.2019.1011.
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The Coalition for Epidemic Preparedness Innovations (CEPI) was established in 2016 in response to the West African Ebola epidemic. The vision for CEPI is to develop vaccines to prevent future emerging infectious disease outbreaks from becoming humanitarian crises. Leaders from governments, foundations, industry, and civil society convened earlier that year to formulate strategic objectives to support CEPI’s first business plan. We demonstrate how decision analysis can support a rational and transparent approach to strategy formulation that accounts for and ranks the preferences of multiple stakeholders in an international coalition setting. We use value-focused thinking to identify and structure objectives and we combine this with an explorative discrete-choice experiment to elicit preferences between objectives. Our findings suggest that decision-analytic methodologies can rationalize strategic objective setting in a highly complex global health research and development planning context characterized by strong stakeholder interests and conflicting priorities.
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Tschirhart, Naomi Anne; Diaz, Esperanza & Ottersen, Trygve
(2019).
Accessing public healthcare in Oslo, Norway: The experiences of Thai immigrant masseuses.
BMC Health Services Research.
19(1).
doi:
10.1186/s12913-019-4560-9.
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Background: Thai massage is a highly gendered and culturally specific occupation. Many female Thai masseuses migrate to Norway as marriage migrants and as such are entitled to the same public healthcare as Norwegian citizens. Additionally, anyone who is not fluent in Norwegian is entitled to have an interpreter provided by the public healthcare system. Norway and most other countries aspire to universal health coverage, but certain immigrant populations continue to experience difficulties accessing appropriate healthcare. This study examined healthcare access among Thai migrant masseuses in Oslo. Methods: Guided by access to healthcare theory, we conducted a qualitative exploratory study in 2018 with Thai women working as masseuses in Oslo, Norway. Through semi-structured in-depth interviews with 14 Thai women, we explored access to healthcare, health system navigation and care experiences. We analyzed the data using thematic analysis and grouped the information into themes relevant to healthcare access. Results: Participants did not perceive that their occupation limited their access to healthcare. Most of the barriers participants experienced when accessing care were related to persistent language challenges. Women who presented at healthcare facilities with their Norwegian spouse were rarely offered interpreters, despite their husband’s limited capacity to translate effectively. Cultural values inhibit women from demanding the interpretation services to which they are entitled. In seeking healthcare, women sought information about health services from their Thai network and relied on family members, friends and contacts to act as informal interpreters. Some addressed their healthcare needs through self-treatment using imported medication or sought healthcare abroad. Conclusions: Despite having the same entitlements to public healthcare as Norwegian citizens, Thai migrants experience difficulties accessing healthcare due to pervasive language barriers. A significant gap exists between the official policy that professional interpreters should be provided and the reality experienced by study participants. To improve communication and equitable access to healthcare for Thai immigrant women in Norway, health personnel should offer professional interpreters and not rely on Norwegian spouses to translate. Use of community health workers and outreach through Thai networks, may also improve Thai immigrants’ knowledge and ability to navigate the Norwegian healthcare system.
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Martinsen, Lene; Ottersen, Trygve; Dieleman, Joseph; Hessel, Philipp; Kinge, Jonas Minet & Skirbekk, Vegard Fykse
(2018).
Do less populous countries receive more development assistance for health per capita? Longitudinal evidence for 143 countries, 1990–2014.
BMJ Global Health.
3:e000528(1),
p. 1–8.
doi:
10.1136/bmjgh-2017-000528.
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Ooms, Gorik; Ottersen, Trygve; Jahn, Albrecht & Agyepong, Irene Akua
(2018).
Addressing the fragmentation of global health: the Lancet Commission on synergies between universal health coverage, health security, and health promotion.
The Lancet.
ISSN 0140-6736.
392(10153),
p. 1098–1099.
doi:
10.1016/S0140-6736(18)32072-5.
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Grépin, Karen A.; Pinkstaff, Crossley B.; Hole, Arne Risa; Henderson, Klara; Norheim, Ole Frithjof & Røttingen, John-Arne
[Show all 7 contributors for this article]
(2018).
Allocating external financing for health: A discrete choice experiment of stakeholder preferences.
Health Policy and Planning.
ISSN 0268-1080.
33,
p. i24–i30.
doi:
10.1093/heapol/czx017.
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Most donors of external financing for health use allocation policies to determine which countries are eligible to receive financial support and how much support each should receive. Currently, most of these policies place a great deal of weight on income per capita as a determinant of aid allocation but there is increasing interest in putting more weight on other country characteristics in the design of such policies. It is unclear, however, how much weight should be placed on other country characteristics. Using an online discrete choice experiment designed to elicit preferences over country characteristics to guide decisions about the allocation of external financing for health, we find that stakeholders assign a great deal of importance to health inequalities and the burden of disease but put very little weight on income per capita. We also find considerable variation in preferences across stakeholders, with people from low- and middle-income countries putting more weight on the burden of disease and people from high-income countries putting more weight on health inequalities. These findings suggest that stakeholders put more weight on burden of disease and health inequalities than on income per capita in evaluating which countries should received external financing for health and that that people living in aid recipient may have different preferences than people living in donor countries. Donors may wish to take these differences in preferences in mind if they are reconsidering their aid allocation policies.
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Tranvåg, Eirik Joakim; Norheim, Ole Frithjof & Ottersen, Trygve
(2018).
Clinical decision making in cancer care: a review of current and future roles of patient age.
BMC Cancer.
18.
doi:
10.1186/s12885-018-4456-9.
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Background: Patient age is among the most controversial patient characteristics in clinical decision making. In personalized cancer medicine it is important to understand how individual characteristics do affect practice and how to appropriately incorporate such factors into decision making. Some argue that using age in decision making is unethical, and how patient age should guide cancer care is unsettled. This article provides an overview of the use of age in clinical decision making and discusses how age can be relevant in the context of personalized medicine. Methods: We conducted a scoping review, searching Pubmed for English references published between 1985 and May 2017. References concerning cancer, with patients above the age of 18 and that discussed age in relation to diagnostic or treatment decisions were included. References that were non-medical or concerning patients below the age of 18, and references that were case reports, ongoing studies or opinion pieces were excluded. Additional references were collected through snowballing and from selected reports, guidelines and articles. Results: Three hundred and forty-seven relevant references were identified. Patient age can have many and diverse roles in clinical decision making: Contextual roles linked to access (age influences how fast patients are referred to specialized care) and incidence (association between increasing age and increasing incidence rates for cancer); patient-relevant roles linked to physiology (age-related changes in drug metabolism) and comorbidity (association between increasing age and increasing number of comorbidities); and roles related to interventions, such as treatment (older patients receive substandard care) and outcome (survival varies by age). Conclusions: Patient age is integrated into cancer care decision making in a range of ways that makes it difficult to claim age-neutrality. Acknowledging this and being more transparent about the use of age in decision making are likely to promote better clinical decisions, irrespective of one’s normative viewpoint. This overview also provides a starting point for future discussions on the appropriate role of age in cancer care decision making, which we see as crucial for harnessing the full potential of personalized medicine
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Ottersen, Trygve; Grépin, Karen A.; Henderson, Klara; Pinkstaff, Crossley Beth; Norheim, Ole Frithjof & Røttingen, John-Arne
(2018).
New approaches to ranking countries for the allocation of development assistance for health: Choices, indicators and implications.
Health Policy and Planning.
ISSN 0268-1080.
33,
p. i31–i46.
doi:
10.1093/heapol/czx027.
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The distributions of income and health within and across countries are changing. This challenges the way donors allocate development assistance for health (DAH) and particularly the role of gross national income per capita (GNIpc) in classifying countries to determine whether countries are eligible to receive assistance and how much they receive. Informed by a literature review and stakeholder consultations and interviews, we developed a stepwise approach to the design and assessment of country classification frameworks for the allocation of DAH, with emphasis on critical value choices. We devised 25 frameworks, all which combined GNIpc and at least one other indicator into an index. Indicators were selected and assessed based on relevance, salience, validity, consistency, and availability and timeliness, where relevance concerned the extent to which the indicator represented country’s health needs, domestic capacity, the expected impact of DAH, or equity. We assessed how the use of the different frameworks changed the rankings of low- and middle-income countries relative to a country’s ranking based on GNIpc alone. We found that stakeholders generally considered needs to be the most important concern to be captured by classification frameworks, followed by inequality, expected impact and domestic capacity. We further found that integrating a health-needs indicator with GNIpc makes a significant difference for many countries and country categories—and especially middle-income countries with high burden of unmet health needs—while the choice of specific indicator makes less difference. This together with assessments of relevance, salience, validity, consistency, and availability and timeliness suggest that donors have reasons to include a health-needs indicator in the initial classification of countries. It specifically suggests that life expectancy and disability-adjusted life year rate are indicators worth considering. Indicators related to other concerns may be mainly relevant at different stages of the decision-making process, require better data, or both.
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Hoffman, Steven J.; Ottersen, Trygve; Tejpar, A; Baral, Prativa & Fafard, Patrick
(2018).
Towards a Systematic Understanding of How to Institutionally Design Scientific Advisory Committees: A Conceptual Framework and Introduction to a Special Journal Issue.
Global Challenges.
2(9).
doi:
10.1002/gch2.201800020.
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Gopinathan, Unni; Hoffman, Steven J & Ottersen, Trygve
(2018).
Scientific Advisory Committees at the World Health
Organization: A Qualitative Study of How Their Design
Affects Quality, Relevance, and Legitimacy.
Global Challenges.
doi:
10.1002/gch2.201700074.
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Governments and international organizations frequently convene scientific advisory committees (SACs) to support decision‐making with scientific advice. In this study, thematic analysis of interviews with 35 senior WHO staff identified five main themes characterizing WHO's experience with designing SACs to ensure quality, relevance, and legitimacy of scientific advice. First, in addition to technical matters, SACs are established to serve broader strategic objectives, including consensus building to promote high‐level political messages. Second, for SACs to be fully independent, they must have autonomy from the institutions convening or funding them, from the institutions from where SAC members are recruited, and from the institutions to whom the advice is directed. Third, since choices affecting quality, relevance, and legitimacy are closely linked, designing SACs often require trade‐offs among these three attributes. Fourth, staff supporting SACs need to balance between safeguarding SACs from external influence and being receptive to the external political environment. Fifth, the design of SACs need to balance the involvement of stakeholders with the power to act on recommendations against the need to protect the independence and integrity of the scientific process. Overall, this study highlights key choices conveners of SACs must make when seeking to promote quality, relevance, and legitimacy of scientific advice.
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Groux, Gaëlle; Hoffman, Steven J. & Ottersen, Trygve
(2018).
A Typology of Scientific Advisory Committees.
Global Challenges.
doi:
10.1002/gch2.201800004.
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The era of evidence-informed decision-making has seen increased use of the scientific advisory committee (SAC) to provide decision-makers with scientific advice, despite limited evidence of the effectiveness or best strategies for designing these committees. In this study, an in-depth review of academic and gray literature is undertaken to outline the global landscape of SACs. The development of a typology is also undertaken that categorizes SACs along six dimensions: 1) sector, 2) level of operation, 3) permanence, 4) target audience, 5) autonomy, and 6) nature of advice. It is found that SACs differ profoundly in each of these dimensions and provide examples demonstrating this variation. The landscape and typology can help decision-makers understand the key elements of SAC design and reform, and the results will also inform future research on the design and effectiveness of SACs. With SACs expected to promote evidence-informed decision-making, it is imperative that the design of these committees themselves is guided by evidence.
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Ottersen, Trygve; Moon, Suerie & Røttingen, John-Arne
(2017).
The challenge of middle-income countries to development assistance for health: recipients, funders, both or neither.
Health Economics, Policy and Law.
ISSN 1744-1331.
12(2),
p. 265–284.
doi:
10.1017/S1744133116000499.
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Recent developments have transformed the role and characteristics of middle-income countries (MICs). Many stakeholders now question the appropriate role of MICs in the system of development assistance for health (DAH), and key funders have already recast their approach to these countries. The pressing question is whether MICs should be recipients, funders, both or neither. The answer has deep implications for individual countries and their citizens, and for the DAH system as a whole. We clarify the fundamental issues involved and emphasise a special feature of many MICs: mid-level gross national income per capita (GNIpc) combined with substantial health needs and large inequalities. We discuss the trade-off between concerns for capacity and need, and illustrate a capacity-based approach to setting the level of a GNIpc eligibility threshold. We also discuss how needs-based exceptions and incentive-preserving instruments can complement such a threshold. Against this background, we outline options for the future roles of MICs in various circumstances. We conclude that major players in the DAH system have reason to reconsider the criteria for allocating DAH among countries and the norms for which countries should contribute and how much.
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Voorhoeve, Alex; Edejer, Tessa Tan-Torres; Kapiriri, Lydia; Norheim, Ole Frithjof; Snowden, James & Basenya, Olivier
[Show all 20 contributors for this article]
(2017).
Three case studies in making fair choices on the path to universal health coverage.
Health and Human Rights: An International Journal.
ISSN 1079-0969.
18(2),
p. 11–22.
Full text in Research Archive
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Ottersen, Trygve; Moon, Suerie & Røttingen, John-Arne
(2017).
Distributing development assistance for health: Simulating the implications of 11 criteria.
Health Economics, Policy and Law.
ISSN 1744-1331.
12(2),
p. 245–263.
doi:
10.1017/S1744133116000487.
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After years of unprecedented growth in development assistance for health (DAH), the DAH system is challenged on several fronts: by the economic downturn and stagnation of DAH, by the epidemiological transition and increase in non-communicable diseases and by the economic transition and rise of the middle-income countries. Central to any potent response is a fair and effective allocation of DAH across countries. A myriad of criteria has been proposed or is currently used, but there have been no comprehensive assessment of their distributional implications. We simulated the implications of 11 quantitative allocation criteria across countries and country categories. We found that the distributions varied profoundly. The group of low-income countries received most DAH from needs-based criteria linked to domestic capacity, while the group of upper-middle-income countries was most favoured by an income-inequality criterion. Compared to a baseline distribution guided by gross national income per capita, low-income countries received less DAH by almost all criteria. The findings can inform funders when examining and revising the criteria they use, and provide input to the broader debate about what criteria should be used.
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Ottersen, Trygve; Elovainio, Riku; Evans, David B.; McCoy, David; McIntyre, Di & Meheus, Filip
[Show all 9 contributors for this article]
(2017).
Towards a coherent global framework for health financing: recommendations and recent developments.
Health Economics, Policy and Law.
ISSN 1744-1331.
12(2),
p. 285–296.
doi:
10.1017/S1744133116000505.
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The articles in this special issue have demonstrated how unprecedented transitions have come with both challenges and opportunities for health financing. Against the background of these challenges and opportunities, the Working Group on Health Financing at the Chatham House Centre on Global Health Security laid out, in 2014, a set of policy responses encapsulated in 20 recommendations for how to make progress towards a coherent global framework for health financing. These recommendations pertain to domestic financing of national health systems, global public goods for health, external financing for national health systems and the cross-cutting issues of accountability and agreement on a new global framework. Since the Working Group concluded its work, multiple events have reinforced the group’s recommendations. Among these are the agreement on the Addis Ababa Action Agenda, the adoption of the Sustainable Development Goals, the outbreak of Ebola in West Africa and the release of the Panama Papers. These events also represent new stepping stones towards a new global framework.
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Ottersen, Trygve; Kamath, Aparna; Moon, Suerie; Martinsen, Lene & Røttingen, John-Arne
(2017).
Development assistance for health: what criteria do multi- and bilateral funders use?
Health Economics, Policy and Law.
ISSN 1744-1331.
12(2),
p. 223–244.
doi:
10.1017/S1744133116000475.
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After years of unprecedented growth in development assistance for health (DAH), the system is challenged on several fronts: by the economic downturn and stagnation of DAH, by the epidemiological transition and increase in non-communicable diseases, and by the economic transition and rise of the middle-income countries. This raises questions about which countries should receive DAH and how much, and, fundamentally, what criteria that promote fair and effective allocation. Yet, no broad comparative assessment exists of the criteria used today. We reviewed the allocation criteria stated by five multilateral and nine bilateral funders of DAH. We found that several funders had only limited information about concrete criteria publicly available. Moreover, many funders not devoted to health lacked specific criteria for DAH or criteria directly related to health, and no funder had criteria directly related to inequality. National income per capita was emphasised by many funders, but the associated eligibility thresholds varied considerably. These findings and the broad overview of criteria can assist funders in critically examining and revising the criteria they use, and inform the wider debate about what the optimal criteria are.
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Skirbekk, Vegard; Ottersen, Trygve; Hamavid, Hannah; Sadat, Nafis; Sadat, Nafis & Dieleman, Joseph
(2017).
Vast majority of development assistance for health funds target those below age sixty.
Health Affairs.
ISSN 0278-2715.
36(5),
p. 926–930.
doi:
10.1377/hlthaff.2016.1370.
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Hernæs, Ulrikke Johanne Voltersvik; Johansson, Kjell Arne; Ottersen, Trygve & Norheim, Ole Frithjof
(2017).
Distribution-Weighted Cost-Effectiveness Analysis Using Lifetime Health Loss.
PharmacoEconomics (Auckland).
ISSN 1170-7690.
35(9),
p. 965–974.
doi:
10.1007/s40273-017-0524-2.
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Gopinathan, Unni & Ottersen, Trygve
(2017).
Evidence-informed deliberative processes for universal health coverage: broadening the scope.
International Journal of Health Policy and Management.
6(8),
p. 473–475.
doi:
10.15171/ijhpm.2016.148.
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Ottersen, Trygve; Hoffman, Steven J. & Groux, Gaëlle
(2016).
Ebola again shows the International Health Regulations are broken: What can be done differently to prepare for the next epidemic?
American Journal of Law & Medicine (AJLM).
ISSN 0098-8588.
42(2–3),
p. 356–392.
doi:
10.1177/0098858816658273.
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Epidemics are among the greatest threats to humanity, and the International Health Regulations are the world's key legal instrument for addressing this threat. Since their revision in 2005, the IHR have faced two big tests: the 2009 H1N1 influenza pandemic and the 2014 Ebola epidemic in West Africa. Both exposed major shortcomings of the IHR, and both offered profound lessons for the future.
The objective of this Article is twofold. First, we seek to compare the lessons learned from H1N1 and Ebola for reforming the IHR in order to test the hypothesis that they are similar. Second, we seek to examine the barriers to implementing these lessons and to identify strategies for overcoming those barriers.
We find that the lessons from H1N1 and Ebola are indeed similar, and that opportunities to act on lessons from H1N1 were woefully missed. We identify many political barriers to global collective action and implementation of lessons for the IHR. On that basis, we describe strategies to overcome these barriers, which will hopefully be deployed now to reform the IHR before the policy window following Ebola closes, and before the inevitable next epidemic comes. The emerging threat of the Zika virus underscores that we have no time to waste.
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Voorhoeve, Alex; Edejer, Tessa Tan-Torres; Kapiriri, Lydia; Norheim, Ole Frithjof; Snowden, James & Basenya, Olivier
[Show all 20 contributors for this article]
(2016).
Three case studies in making fair choices on the path to universal health coverage.
Health and Human Rights: An International Journal.
ISSN 1079-0969.
18(2),
p. 11–22.
Full text in Research Archive
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Hoffman, Steven J. & Ottersen, Trygve
(2015).
Addressing antibiotic resistance requires robust international accountability mechanisms.
Journal of Law, Medicine & Ethics (JLME).
ISSN 1073-1105.
43,
p. 53–64.
doi:
10.1111/jlme.12275.
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Ottersen, Trygve; Mæstad, Ottar & Norheim, Ole Frithjof
(2014).
Lifetime QALY prioritarianism in priority setting: Quantification of the inherent trade-off.
Cost Effectiveness and Resource Allocation.
12:2.
doi:
10.1186/1478-7547-12-2.
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Background: Multiple principles are relevant in priority setting, two of which are often considered particularly important. According to the greater benefit principle, resources should be directed toward the intervention with the greater health benefit. This principle is intimately linked to the goal of health maximization and standard cost-effectiveness analysis (CEA). According to the worse off principle, resources should be directed toward the intervention benefiting those initially worse off. This principle is often linked to an idea of equity. Together, the two principles accord with prioritarianism; a view which can motivate non-standard CEA. Crucial for the actual application of prioritarianism is the trade-off between the two principles, and this trade-off has received scant attention when the worse off are specified in terms of lifetime health. This paper sheds light on that specific trade-off and on the public support for prioritarianism by providing fresh empirical evidence and by clarifying the close links between the findings and normative theory. Methods: A new, self-administered, computer-based questionnaire was used, to which 96 students in Norway responded. How respondents wanted to balance quality-adjusted life years (QALYs) gained against benefiting those with few lifetime QALYs was quantified for a range of different cases. Results: Respondents supported both principles and were willing to make trade-offs in a particular way. In the baseline case, the median response valued a QALY 3.3 and 2.5 times more when benefiting someone with lifetime QALYs of 10 and 25 rather than 70. Average responses harbored fundamental disagreements and varied modestly across distributional settings. Conclusion: In the specific context of lifetime health, the findings underscore the insufficiency of pure QALY maximization and explicate how people make trade-offs in a way that can help operationalize lifetime prioritarianism and non-standard CEA. Seen through the lens of normative theory, the findings highlight key challenges for prioritarianism applied to priority setting.
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Grødeland, Gunnveig; Pettersen, Frank O.; Hauge, Siri Helene & Ottersen, Trygve
(2026).
Vaksinepodden - Episode 40 - Vaksineprioriteringer.
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Hvordan bruker vi vaksiner i Norge? Hvem velger hvilke vaksiner som tas i bruk, og hvordan de brukes?
Sommeren 2025 innførte Norge et voksenvaksinasjonsprogram, men hvordan ble det bestemt hvilke vaksiner som skulle inngå i dette, og hva medfører det?
I denne episoden har vi besøk av Siri Helene Hauge, som er avdelingsdirektør for smittevern og vaksiner på Folkehelseinstituttet, og Trygve Ottersen, som er direktør i Direktoratet for Medisinske Produkter. I studio er ellers som vanlig overlege Frank Olav Pettersen fra Infeksjonsmedisinsk avdeling ved Ullevål, og Gunnveig Grødeland som er professor i immunologi og leder for Senter for pandemi- og en-helseforskning ved Universitetet i Oslo.
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Solvang, Fredrik; Grødeland, Gunnveig; Nakstad, Anders Rostrup; Kjerkhol, Ingvild; Ottersen, Trygve & Haugen, Heidi Østbø
(2023).
Debatten - Virusene herjer.
[TV].
NRK - Debatten.
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Ottersen, Trygve; Høstmælingen, Njål; Forland, Frode & Røttingen, John-Arne
(2021).
Norge og den globale krisen.
In Tvedten, Hilde Marie; Vikum, Eirik Frønæs; Holtermann, Merete Kile & Larsen, Vilde Bergstad (Ed.),
Folkehelserapportens temautgave 2021. Folkehelsen etter covid-19. Pandemiens konsekvenser for ulike grupper i befolkningen.
Folkehelseinstituttet.
ISSN 9788284062440.
p. 61-66–61-66.
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Til tross for at Norge har godt utbygde helse- og omsorgstjenester og høy tillit til myndighetene i befolkningen, er vi helt avhengige av internasjonalt samarbeid for å håndtere helsekriser. Samtidig har pandemien satt de store globale ulikhetene i helse på spissen.
Kan pandemien påvirke det globale samarbeid om helse på lengre sikt?
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Larsen, Vilde Bergstad; Telle, Kjetil Elias & Ottersen, Trygve
(2021).
Helse- og omsorgstjenestene under pandemien.
In Tvedten, Hilde Marie; Vikum, Eirik Frønæs; Holtermann, Merete Kile & Larsen, Vilde Bergstad (Ed.),
Folkehelserapportens temautgave 2021. Folkehelsen etter covid-19. Pandemiens konsekvenser for ulike grupper i befolkningen.
Folkehelseinstituttet.
ISSN 9788284062440.
p. 56–60.
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Mye av kampen mot pandemien har blitt ført av helse- og omsorgstjenestene, og en viktig forutsetning i pandemihåndteringen har vært å unngå å overbelaste sykehusene.
Som et resultat har kommuner og sykehus måttet omdisponere helsepersonell og prioritere hardt mellom pasientgruppene som ikke har hatt covid-19. Kan det få konsekvenser på sikt?
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Norheim, Ole Frithjof & Ottersen, Trygve
(2020).
Setting Priorities in the Pursuit of Universal Health Coverage.
In Norheim, Ole Frithjof; Emanuel, Ezekiel J. & Millum, Joseph (Ed.),
Global Health Priority-Setting: Beyond Cost-Effectiveness.
Oxford University Press.
ISSN 9780190912765.
doi:
10.1093/oso/9780190912765.003.0017.
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Priority-setting is fundamental to the fair and efficient pursuit of universal health coverage (UHC). This chapter addresses the key choices in selecting services for UHC and the alternative criteria, tools, and processes to guide these choices. The authors first describe the choices decision-makers have to make on the path to UHC and the recommendations by the WHO Consultative Group on Equity and Universal Health Coverage for how these choices can be made. Using Thailand as a case study, the authors examine how the Thai government has set priorities in its pursuit of UHC. Against this background, the authors discuss alternative criteria, tools, and processes for guiding service selection and the design of benefit packages for UHC. When doing this, the authors consider past experiences in Thailand and other countries and examine how recent developments and the insights from the preceding chapters in this volume can provide directions for the future.
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Norheim, Ole Frithjof; Asaria, Miqdad; Johansson, Kjell Arne; Ottersen, Trygve & Tsuchiya, Aki
(2020).
Level-dependent equity weights.
In Cookson, Richard; Griffin, Susan; Norheim, Ole Frithjof & Culyer, Anthony J. (Ed.),
Distributional Cost-Effectiveness Analysis.
Oxford University Press.
ISSN 9780198838197.
doi:
10.1093/med/9780198838197.003.0013.
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This chapter explains how you can use level-dependent social welfare functions (SWFs) to evaluate health distributions in a manner that is founded on explicit, challengeable and consistent ethical principles. A level-dependent SWF weights health gains for one person or group relative to another as a function of their absolute health levels. By contrast, a rank-dependent SWF weights health gains for one person or group relative to another as a function of their health ranks in the wider population. A level-dependent SWF is also called a prioritarian SWF. The basic prioritarian principle is a specific value judgement giving priority to the worse off based on their absolute level of health. The aim of this chapter is to describe level-dependent SWFs and how they can be used to conduct equity-efficiency trade-off analysis. A SWF can be consistent with many different sets of weights, which vary according to the chosen value of an equity parameter. We show how level-dependent equity parameters can be used to perform a systematic sensitivity analysis of how different degrees of concern for the worse off have different policy implications.
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Ottersen, Trygve; Evans, David B.; Mossialos, Elias & Røttingen, John-Arne
(2017).
Global health financing towards 2030 and beyond.
Health Economics, Policy and Law.
ISSN 1744-1331.
12(2),
p. 105–111.
doi:
10.1017/S1744133116000372.
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Universal health coverage and healthy lives for all are now widely shared goals and central to the 2030 Agenda for Sustainable Development. Despite significant progress over the last decades, the world is still far from reaching these goals. Billions of people lack basic coverage of health services, live with unnecessary pain and disability, or have their lives cut short by avoidable or treatable conditions (Jamison et al., 2013; Murray et al., 2015; World Health Organization, World Bank, 2015). At the same time, millions are pushed into poverty simply because they need to use health services and must pay for them out-of-pocket. Fundamental to this situation is the way health interventions and the health system are financed. Numerous countries spend less than is required to ensure even the most essential health services, scarce funds are wasted, out-of-pocket payments remain high and disadvantaged groups get the least public resources despite having the greatest needs. It is clear that today’s global and national arrangements for health financing need to change, and this is a multifaceted endeavour. It is about domestic financing of health systems, joint financing of global public goods and external financing of health systems. It is about resource mobilisation, pooling and effective use. And it is about economics, politics, public health, human rights, law and ethics. To get health financing right, these areas, functions and perspectives must all be integrated and aligned.
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Bjerke, Lise; Torjusen, Marius Lamberg & Ottersen, Trygve
(2021).
Prosjekt utveier. Veien ut av koronakrisen: Fire fremtidsbilder og fem avgjørende spørsmål.
Folkehelseinstituttet.
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Hovedbudskap Pandemien har endret Norge og verden på måter vi ennå ikke helt forstår eller har klart å fordøye. Ingen kan si sikkert hvordan pandemien vil utvikle seg fremover og heller ikke hva ringvirkningene av pandemien vil bli. Samtidig kan vi ikke vente. Som samfunn må vi ta beslutninger og handle nå. Her bruker vi systematisk fremtidstenkning – «foresight» – som et bidrag til to diskusjoner som angår alle: Hvordan vil pandemien utvikle seg de neste årene? Og hvordan skal vi håndtere konsekvensene av krisen? Utgangspunktet er mer enn 30 intervjuer med en allsidig gruppe personer, blant annet elever, representanter for studenter og eldre, forskere, leger, ledere, mennesker som har merket pandemien på kroppen og mennesker som kan tenke utradisjonelt om veien videre. Vi presenterer først fire enkle fremtidsbilder for julen 2021 og julen 2025: «Gledelig jul», «Mutert jul», «Gjennombruddet» og «Tilbakeslaget». Deretter belyser vi fem avgjørende spørsmål som handler om pandemiens virkninger på folkehelsen og samfunnet. Hva skjer med tilliten? Blir vi sykere? Hvordan blir den nye hverdagen? Hvordan endrer omverdenen seg? Og sist, men ikke minst: Vil vi lære av denne pandemien?
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Ottersen, Trygve; Grépin, Karen; Pinkstaff, Crossley B.; Clift, Charles; Norheim, Ole Frithjof & Røttingen, John-Arne
(2016).
Health and development: an explicit approach to the design and assessment of country classification frameworks. Final report for the Equitable Access Initiative by the Norwegian Institute of Public Health.
Norwegian Institute of Public Health.
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Ottersen, Trygve; Kamath, Aparna; Moon, Suerie & Røttingen, John-Arne
(2014).
Development assistance for health: quantitative allocation criteria and contribution norms. Centre on Global Health Security Working Group Papers. London: Royal Institute of International Affairs (Chatham House).
Chatham House.
ISSN 9781784130015.
Full text in Research Archive
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Røttingen, John-Arne; Ottersen, Trygve; Ablo, Awo; Arhin-Tenkorang, Dyna; Benn, Christoph & Elovainio, Riku
[Show all 20 contributors for this article]
(2014).
Shared responsibilities for health: a new global framework for sustainable health financing. Final report of the Centre on Global Health Security Working Group on Health Financing. London: Royal Institute of International Affairs (Chatham House).
Chatham House.
ISSN 9781784130213.
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Ottersen, Trygve; Norheim, Ole Frithjof; Chitah, Bona M; Richard, Cookson; Daniels, Norman & Defaye, Frehiwot Berhane
[Show all 18 contributors for this article]
(2014).
Making fair choices on the path to universal health coverage. Final report of the WHO Consultative Group on Equity and Universal Health Coverage.
World Health Organization.
ISSN 9789241507158.
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Published
Mar. 16, 2016 10:23 AM
- Last modified
Dec. 3, 2020 10:41 AM
