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BMC Health Services Research

, 7:180

First Online: 12 November 2007Received: 19 June 2007Accepted: 12 November 2007DOI: 10.1186-1472-6963-7-180

Cite this article as: Mshana, S., Shemilu, H., Ndawi, B. et al. BMC Health Serv Res 2007 7: 180. doi:10.1186-1472-6963-7-180

Abstract

BackgroundPriority setting in every health system is complex and difficult. In less wealthy countries the dominant approach to priority setting has been Burden of Disease BOD and cost-effectiveness analysis CEA, which is helpful, but insufficient because it focuses on a narrow range of values – need and efficiency – and not the full range of relevant values, including legitimacy and fairness. -Accountability for reasonableness- is a conceptual framework for legitimate and fair priority setting and is empirically based and ethically justified. It connects priority setting to broader, more fundamental, democratic deliberative processes that have an impact on social justice and equity. Can -accountability for reasonableness- be helpful for improving priority setting in less wealthy countries?

MethodsIn 2005, Tanzanian scholars from the Primary Health Care Institute PHCI conducted 6 capacity building workshops with senior health staff, district planners and managers, and representatives of the Tanzanian Ministry of Health to discussion improving priority setting in Tanzania using -accountability for reasonableness-. The purpose of this paper is to describe this initiative and the participants- views about the approach.

ResultsThe approach to improving priority setting using -accountability for reasonableness- was viewed by district decision makers with enthusiastic favour because it was the first framework that directly addressed their priority setting concerns. High level Ministry of Health participants were also very supportive of the approach.

ConclusionBoth Tanzanian district and governmental health planners viewed the -accountability for reasonableness- approach with enthusiastic favour because it was the first framework that directly addressed their concerns.

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Autor: Simon Mshana - Haji Shemilu - Benedict Ndawi - Roman Momburi - Oystein Evjen Olsen - Jens Byskov - Douglas K Martin

Fuente: https://link.springer.com/



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