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Strengthening fairness and accountability in priority setting for improving equity and access to quality health care at district level in Tanzania, Kenya and Zambia

Objective

Health systems in many low income countries are strangled in a vicious circle: management capacity isperceived insufficient to be given full responsibility for priority setting, but without effective decentralization of the priority setting process, the capacity will never increase. District level services cater for a majority of service contacts. Therefore, a District focus is necessary to improve quality, equity, accessibility and affordability of care of the overall country services. Attempts have been made to strengthen district level planning and management mainly based on burden disease measures, cost effectiveness and capacity considerations and related planning tools, but adequate and sustainability improvements have not been achieved. National health policies promote more inclusive planning processes, but concrete involvement of others is still limited. This proposal aims to improve equity, access, affordability and quality of health care through introducing and evaluating improved priority setting according to the Accountability for Reasonableness (AFR) framework in Tanzania, Kenya and Zambia. AFR provides practical guidance for decision makers in making the fair balances within finite resource limits between mainly expert defined need, programmatic and other supply pressures, stakeholder interests and demands from users, their representatives and their communities. A case study and action research approach isused. Each country will involve Public Health and Social Science oriented academic institutions all in partnership with 4 leading and interdisciplinary PublicHealth Institutions in the EU.
Results will be disseminated targeted to application through policies and plans and are expected to assist in a major strengthening of health systems self reliance and performance.

Call for proposal

FP6-2003-INCO-DEV-2
See other projects for this call

Funding Scheme

STIP - Specific Targeted Innovation Project

Coordinator

UNIVERSITY OF COPENHAGEN
Address
Nørregade 10
Copenhagen K
Denmark

Participants (9)

UNIVERSITETET I BERGEN
Norway
Address
Muséplass 1
Bergen
PRINCE LEOPOLD INSTITUTE OF TROPICAL MEDICINE
Belgium
Address
Nationalestraat 155
Antwerpen
UMEÅ UNIVERSITY
Sweden
Address
Universitetsomraadet
Umeå
UNIVERSITY OF DAR ES SALAAM
Tanzania
Address
University Road
35091 Dar Es Salaam
NATIONAL INSTITUTE FOR MEDICAL RESEARCH
Tanzania
Address
Ocean Road
9653 Dar Es Salaam
PRIMARY HEALTH CARE INSTITUTE
Tanzania
Address
Haile Selassie Road, Gangilonga Area
235 Iringa
KENYA MEDICAL RESEARCH INSTITUTE
Kenya
Address
Mbagathi Road (At Armed Forces Memorial Hospital)
54840 Nairobi
UNIVERSITY OF ZAMBIA
Zambia
Address
Great East Road, Main Campus
32379 Lusaka
UNIVERSITY OF NAIROBI - INSTITUTE OF AFRICAN STUDIES
Kenya
Address
University Way
30197 Nairobi