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
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Funding SchemeSTIP - Specific Targeted Innovation Project