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Rational and transparent approaches for health priority setting in developing countries : [publication] : a review of experience 2006-2008 and a critical analysis of the multi-criteria decision analysis /

by Freiburghaus, Franziska.
Material type: materialTypeLabelBookPublisher: 2009SAPHIR theme(s): Systèmes de santé | Économie de la santéMeSH subject(s): Health Priorities | Delivery of Health Care | Developing Countries | Decision Support Techniques | Health Care Rationing | Health Priorities -- economics | Health Priorities -- standards | Delivery of Health Care -- methods | Delivery of Health Care -- organization & administrationPUBLICATION TYPE SAPHIR: DissertationSummary: Health care systems throughout the world face crisis of quality, financing and sustainability. These pressures have led governments to look for more efficient and equitable ways to allocate public resources. Especially in developing countries, public finances are far from sufficient to provide a comprehensive set of essential health services. The aim of this report was to analyse if a new methodology, namely the Multi-Criteria Decision Analysis (MCDA) combined with a Discrete Choice Experiment (DCE), is a better methodology for priority setting in developing countries than the ones used before. Thus, a review of rational and transparent approaches in health priority setting in developing countries from 2006-2008 was performed and a critical analysis of the theory and experience of the multi criteria decision analysis done. The review showed that developing country priority setting approaches are still in their infancy. Each of the methods tested proved to be feasible but all are subject to substantial methodological improvements. Another finding was that it is not possible to conclude that the MCDA-DCE method is a better methodology. The main reason for that is that so far solely exploratory research results are available which do not give enough evidence for its real world superiority .In addition, MCDA approaches do not resolve all the underlying problems in health system strengthening in developing countries like having incomplete or inaccurate data or the problems of fair distribution of health outcomes. They do, however, at least ensure that decisions can be made about the right things. [Author, p. 4]
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Health care systems throughout the world face crisis of quality, financing and sustainability. These pressures have led governments to look for more efficient and equitable ways to allocate public resources. Especially in developing countries, public finances are far from sufficient to provide a comprehensive set of essential health services. The aim of this report was to analyse if a new methodology, namely the Multi-Criteria Decision Analysis (MCDA) combined with a Discrete Choice Experiment (DCE), is a better methodology for priority setting in developing countries than the ones used before. Thus, a review of rational and transparent approaches in health priority setting in developing countries from 2006-2008 was performed and a critical analysis of the theory and experience of the multi criteria decision analysis done. The review showed that developing country priority setting approaches are still in their infancy. Each of the methods tested proved to be feasible but all are subject to substantial methodological improvements. Another finding was that it is not possible to conclude that the MCDA-DCE method is a better methodology. The main reason for that is that so far solely exploratory research results are available which do not give enough evidence for its real world superiority .In addition, MCDA approaches do not resolve all the underlying problems in health system strengthening in developing countries like having incomplete or inaccurate data or the problems of fair distribution of health outcomes. They do, however, at least ensure that decisions can be made about the right things. [Author, p. 4]