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Priority setting for the prevention and control of cardiovascular diseases: multi-criteria decision analysis in four eastern Mediterranean countries



To explore the feasibility of using a simple multi-criteria decision analysis method with policy makers/key stakeholders to prioritize cardiovascular disease (CVD) policies in four Mediterranean countries: Palestine, Syria, Tunisia and Turkey.


A simple multi-criteria decision analysis (MCDA) method was piloted. A mixed methods study was used to identify a preliminary list of policy options in each country. These policies were rated by different policymakers/stakeholders against pre-identified criteria to generate a priority score for each policy and then rank the policies.


Twenty-five different policies were rated in the four countries to create a country-specific list of CVD prevention and control policies. The response rate was 100 % in each country. The top policies were mostly population level interventions and health systems’ level policies.


Successful collaboration between policy makers/stakeholders and researchers was established in this small pilot study. MCDA appeared to be feasible and effective. Future applications should aim to engage a larger, representative sample of policy makers, especially from outside the health sector. Weighting the selected criteria might also be assessed.

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This research received funding from the European Community’s Seventh Framework Programme (FP7/2007–2013) under Grant Agreement No. 223075—the MedCHAMPS project. We also would like to thank the MedCHAMPS working teams (The MedCHAMPS project team comprises: Julia Critchley (St Georges, University of London and Newcastle University, UK), Balsam Ahmad, Peter Phillimore, Shahaduz Zaman (Newcastle University, UK), Simon Capewell, Martin O’Flaherty, Mukesh Dherani (University of Liverpool, UK), Illonca Vartjes (University of Liverpool, UK, and University of Utrecht, NL), Kathleen Bennett (Trinity College Dublin, Ireland), Deniz Altun, Hale Arık, Özgür Aslan, Yücel Demiral, Sinem Doganay, Gül Ergör, Gül Gerçeklioğlu, Bülent Kilic, Gül Saatli, Hatice Şimşek, Kaan Sözmen, Belgin Unal (Dokuz Eylul University, Turkey), Ilhan Satman (Istanbul Faculty of Medicine, Istanbul, Turkey), Sibel Göğen (Primary Health Care General Directorate, Turkish Ministry of Health, Turkey), Sibel Kalaca (Marmara University, Istanbul, Turkey) Radwan Al Ali, Madonna Elias, Fouad Fouad, Samer Rastam, Nesrien Soulaiman, Ghmaez Moukeh (Syrian Center for Tobacco Studies, Aleppo, Syria) Wasim Maziak (Syrian Center for Tobacco Studies, Aleppo, Syria and Florida International University, Miami, US) Maher Abou Mayaleh (Aga Khan Foundation, Hama, Syria), Niveen Abu-Rmeileh, Rula Ghandour, Abdullatif Husseini, Samer Jaber, Rana Khatib, Rasha Khatib, Nahed Mikki, Azza Shoaibi (Birzeit University, Birzeit, oPt), Heidar Abu-Kteish (Palestinian Medical Relief Society, oPt), Waffa Aissi, Riadh Allani, Chokra Arfa, Latifa Beltaifa, Nadia Ben Mansour, Habiba Ben Romdhane, Olfa Lassoued, Olfa Saidi, Faten Tlili (Cardiovascular Epidemiology and Prevention Research Laboratory, Tunis, Tunisia) Nourredine Achour (Institut National de Santé Publique, Tunis, Tunisia), Nabil Ben Salah (Research Department, Ministry of Health, Tunisia), Helen Mason, Marissa Collins (Glasgow Caledonian University, UK), Gojka Roglic (WHO Geneva, Switzerland), Ibtihal Fadhil (Regional Adviser NCDs, WHO EMRO, Cairo, Egypt), Nigel Unwin (Newcastle University and University of the West Indies, Georgetown, Barbados).

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Correspondence to Rula Ghandour.

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This article is part of the supplement “The rising burden of noncommunicable diseases in four Mediterranean countries and potential solutions”.

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Ghandour, R., Shoaibi, A., Khatib, R. et al. Priority setting for the prevention and control of cardiovascular diseases: multi-criteria decision analysis in four eastern Mediterranean countries. Int J Public Health 60 (Suppl 1), 73–81 (2015).

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