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Decentralized health care priority setting in Tanzania: Evaluating against the accountability for reasonableness framewo

Outline of the presentation. BackgroundThe REACT Project in TanzaniaObjective of The StudyStudy area

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Decentralized health care priority setting in Tanzania: Evaluating against the accountability for reasonableness framewo

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    1. Decentralized health care priority setting in Tanzania: Evaluating against the accountability for reasonableness framework Stephen Maluka PhD Candidate, MA (DS) Umea International School of Public Health (UISPH)- Sweden & Institute of Development Studies, University of Dar Es Salaam, Tanzania 1 Wednesday, August 08, 2012 Priorities 2010: Boston, USA

    2. Outline of the presentation Background The REACT Project in Tanzania Objective of The Study Study area & Methods Findings Conclusion 2 Wednesday, August 08, 2012 Priorities 2010: Boston, USA

    3. Background What is Priority Setting (PS)? The process of making decisions on how resources should be distributed among competing programmes/ or patients. Why priority Setting Resources are always limited. BIG GAP btn demands, neeeds & available resources. 3 Wednesday, August 08, 2012 Priorities 2010: Boston, USA

    4. Background Cont…….. Others Challenges to PS in LDCs (Tanzania) Lack of credible information & credible methods to deal with the trade-off decisions (Kapiriri & Martin, 2007). Few systematic and formal processes for decision making. Corruption. PS by CHANCE not by CHOICE (Steen, 2003). 4 Wednesday, August 08, 2012 Priorities 2010: Boston, USA

    5. Background cont… Discipline specific approaches to PS (Sibbald, Singer, Upshur & Martin, 2009). 5 Wednesday, August 08, 2012 Priorities 2010: Boston, USA

    6. Background cont....... Accountability for Reasonableness (A4R). A4R focus on the Fairness & Legitimacy of the PS process. AFR thus provides structure to the process of PS. A Fair Priority Setting Process should meet 4 Conditions. 6 Wednesday, August 08, 2012 Priorities 2010: Boston, USA

    7. Four Conditions for Fairness (Daniels & Sabin, 2002, p. 45) 7 Wednesday, August 08, 2012 Priorities 2010: Boston, USA

    8. The REACT Project in Tanzania Began in 2006 at the district level in 3 African countries (Tanzania, Kenya and Zambia) in the context of REACT. REACT-Response to Accountable priority setting for Trust in health system. No empirical evidence on its relevance in the LMICs. In Tanzania intervention began in 2008. End of the project December 2010. 8 Wednesday, August 08, 2012 Priorities 2010: Boston, USA

    9. How is A4R Implemented in the District? DEI Approach (Byskov et al. 2009) 9

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