2.3. Stakeholder ownership of the HSPA framework in Luxembourg developed through a participatory consensus building on HSPA themes among health sector stakeholders, and, second, the framework was improved for its structural coherence based on expert consultations, technical focus groups and initial indicator repository mapping. stakeholder engagement. Authorities and stakeholders from across Luxembourg's health system gathered and to discuss potential metrics to evaluate elements of performance. A total of 331 domain theme ideas Box 2.2 describes the process and methodology of the development of the first framework draft proposal. Among the initial 38 possible domain themes, identified by stakeholders through an interactive process, integrated