Preparation of Recommendations & Decision‑Making
Organisation of Working Groups
For agenda topics requiring decisions, the Chair tasks one or more Working Groups (WGs) to review evidence and prepare a technical report. WGs are time‑bound, chaired by a core member, supported by the secretariat, and may include external experts. COI and confidentiality rules apply to all WG participants.
Development of Technical Reports
WGs define a recommendation framework and research questions. For efficacy, effectiveness, or safety questions, a PICO approach is used. Evidence is sourced (including grey literature), collected (favoring recent reviews), the search process documented, and quality assessed (e.g., GRADE, AMSTAR, CASP, SIGN). Evidence is analyzed for benefits/harms, confidence in estimates, resources, programmatic issues, and other criteria. Technical reports include an executive summary, introduction, context, methods, analysis, options, conclusions, references, and annexes.
Presentation/Discussion
Reports are circulated two weeks before meetings. Core members deliberate and reach consensus; the WG Chair drafts a recommendation note for Chair approval and signature by attending core members. Approved reports are submitted via Rwanda EPI and may be disseminated publicly after six months with appropriate caution for confidential data.
Submission to Authorities
Signed recommendations are forwarded within two weeks via Rwanda EPI. The secretariat tracks submissions and actions taken by MOH and reports back to NITAG.
Ethics
Members are bound to confidentiality and precautionary principles. Only the Chair (or delegate) communicates externally on behalf of NITAG.
Appendix 2 – Recommendation Framework (Summary)
Six broad areas are considered: (1) Disease; (2) Vaccine & immunization characteristics; (3) Vaccine intervention outcomes (safety, efficacy, effectiveness); (4) Economic considerations; (5) Health policy & programmatic issues; (6) Acceptability & equity. Critical and important elements should be systematically reviewed.
PICO approach
Population; Intervention; Comparator; Outcome – used to frame research questions, especially for efficacy, effectiveness, and safety.