Evidence-based priority setting for health care and research : tools to support policy in maternal, neonatal, and child health in Africa

Rudan, Igor ; Kapiriri, Lydia ; Tomlinson, Mark ; Balliet, Manuela ; Cohen, Barney ; Chopra, Mickey (2010-07-13)

CITATION: Rudan, I., et al. 2010. Evidence-based priority setting for health care and research : tools to support policy in maternal, neonatal, and child health in Africa. PLoS Medicine, 7(7): e1000308, doi: 10.1371/journal.pmed.1000308.

The original publication is available at http://journals.plos.org/plosmedicine

Article

Priority setting is required in every health care system. It guides investments in health care and health research, and respects resource constraints. It happens continuously, with or without appropriate tools or processes. Although priority-setting decisions have been described as difficult, value laden, and political, only a few research groups are focused on advancing the theory of priority setting and the development and validation of priority setting tools. These groups advocate the use of their tools, but their work is often not widely recognized, especially among the policy makers in developing countries, where these tools would be most helpful. Our primary objective in this essay is to present the available tools for priority setting that could be used by policy makers in low-resource settings. We also provide an assessment of the applicability and strengths of different tools in the context of maternal and child health in sub-Saharan Africa. The analyses of investments in neglected diseases showed that they lack transparent priority-setting processes. This persisting situation results in remarkable levels of inequity between investments in different health priorities. Therefore, our secondary objective is to advocate for the use of the tools that could lead to more rational priority setting in sub-Saharan Africa. An optimal tool should be able to draw on the best local evidence and guide policy makers and governments to identify, prioritize, and implement evidence-based health interventions for scale-up and delivery.

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