How countries cope with competing demands and expectations: perspectives of different stakeholders on priority setting and resource allocation for health in the era of HIV and AIDS.
Identifieur interne : 000315 ( PubMed/Curation ); précédent : 000314; suivant : 000316How countries cope with competing demands and expectations: perspectives of different stakeholders on priority setting and resource allocation for health in the era of HIV and AIDS.
Auteurs : Françoise Jenniskens [Pays-Bas] ; Georges Tiendrebeogo ; Anne Coolen ; Lucie Blok ; Seni Kouanda ; Fuseini Sataru ; Andriamampianina Ralisimalala ; Victor Mwapasa ; Mbela Kiyombo ; David PlummerSource :
- BMC public health [ 1471-2458 ] ; 2012.
Descripteurs français
- KwdFr :
- MESH :
- organisation et administration : Priorités en santé, Rationnement des services de santé.
- Afrique subsaharienne, Besoins et demandes de services de santé, Groupes focalisés, Humains, Infections à VIH, Recherche qualitative.
English descriptors
- KwdEn :
- MESH :
- geographic : Africa South of the Sahara.
- organization & administration : Health Care Rationing, Health Priorities.
- therapy : HIV Infections.
- Focus Groups, Health Services Needs and Demand, Humans, Qualitative Research.
Abstract
Health systems have experienced unprecedented stress in recent years, and as yet no consensus has emerged as to how to deal with the multiple burden of disease in the context of HIV and AIDS and other competing health priorities. Priority setting is essential, yet this is a complex, multifaceted process. Drawing on a study conducted in five African countries, this paper explores different stakeholders' perceptions of health priorities, how priorities are defined in practice, the process of resource allocation for HIV and Health and how different stakeholders perceive this.
DOI: 10.1186/1471-2458-12-1071
PubMed: 23231820
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wicri:level="1"><nlm:affiliation>Royal Tropical Institute, Amsterdam, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Royal Tropical Institute, Amsterdam</wicri:regionArea></affiliation></author><author><name sortKey="Tiendrebeogo, Georges" sort="Tiendrebeogo, Georges" uniqKey="Tiendrebeogo G" first="Georges" last="Tiendrebeogo">Georges Tiendrebeogo</name></author><author><name sortKey="Coolen, Anne" sort="Coolen, Anne" uniqKey="Coolen A" first="Anne" last="Coolen">Anne Coolen</name></author><author><name sortKey="Blok, Lucie" sort="Blok, Lucie" uniqKey="Blok L" first="Lucie" last="Blok">Lucie Blok</name></author><author><name sortKey="Kouanda, Seni" sort="Kouanda, Seni" uniqKey="Kouanda S" first="Seni" last="Kouanda">Seni Kouanda</name></author><author><name sortKey="Sataru, Fuseini" sort="Sataru, Fuseini" uniqKey="Sataru F" first="Fuseini" last="Sataru">Fuseini Sataru</name></author><author><name sortKey="Ralisimalala, Andriamampianina" sort="Ralisimalala, Andriamampianina" uniqKey="Ralisimalala A" first="Andriamampianina" last="Ralisimalala">Andriamampianina Ralisimalala</name></author><author><name sortKey="Mwapasa, Victor" sort="Mwapasa, Victor" uniqKey="Mwapasa V" first="Victor" last="Mwapasa">Victor Mwapasa</name></author><author><name sortKey="Kiyombo, Mbela" sort="Kiyombo, Mbela" uniqKey="Kiyombo M" first="Mbela" last="Kiyombo">Mbela Kiyombo</name></author><author><name sortKey="Plummer, David" sort="Plummer, David" uniqKey="Plummer D" first="David" last="Plummer">David Plummer</name></author></analytic><series><title level="j">BMC public health</title><idno type="eISSN">1471-2458</idno><imprint><date when="2012" type="published">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Africa South of the Sahara</term><term>Focus Groups</term><term>HIV Infections (therapy)</term><term>Health Care Rationing (organization & administration)</term><term>Health Priorities (organization & administration)</term><term>Health Services Needs and Demand</term><term>Humans</term><term>Qualitative Research</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Afrique subsaharienne</term><term>Besoins et demandes de services de santé</term><term>Groupes focalisés</term><term>Humains</term><term>Infections à VIH ()</term><term>Priorités en santé (organisation et administration)</term><term>Rationnement des services de santé (organisation et administration)</term><term>Recherche qualitative</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Africa South of the Sahara</term></keywords><keywords scheme="MESH" qualifier="organisation et administration" xml:lang="fr"><term>Priorités en santé</term><term>Rationnement des services de santé</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Health Care Rationing</term><term>Health Priorities</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Focus Groups</term><term>Health Services Needs and Demand</term><term>Humans</term><term>Qualitative Research</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Afrique subsaharienne</term><term>Besoins et demandes de services de santé</term><term>Groupes focalisés</term><term>Humains</term><term>Infections à VIH</term><term>Recherche qualitative</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Health systems have experienced unprecedented stress in recent years, and as yet no consensus has emerged as to how to deal with the multiple burden of disease in the context of HIV and AIDS and other competing health priorities. Priority setting is essential, yet this is a complex, multifaceted process. Drawing on a study conducted in five African countries, this paper explores different stakeholders' perceptions of health priorities, how priorities are defined in practice, the process of resource allocation for HIV and Health and how different stakeholders perceive this.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">23231820</PMID><DateCreated><Year>2013</Year><Month>01</Month><Day>21</Day></DateCreated><DateCompleted><Year>2013</Year><Month>03</Month><Day>14</Day></DateCompleted><DateRevised><Year>2017</Year><Month>02</Month><Day>20</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2458</ISSN><JournalIssue CitedMedium="Internet"><Volume>12</Volume><PubDate><Year>2012</Year><Month>Dec</Month><Day>11</Day></PubDate></JournalIssue><Title>BMC public health</Title><ISOAbbreviation>BMC Public Health</ISOAbbreviation></Journal><ArticleTitle>How countries cope with competing demands and expectations: perspectives of different stakeholders on priority setting and resource allocation for health in the era of HIV and AIDS.</ArticleTitle><Pagination><MedlinePgn>1071</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/1471-2458-12-1071</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Health systems have experienced unprecedented stress in recent years, and as yet no consensus has emerged as to how to deal with the multiple burden of disease in the context of HIV and AIDS and other competing health priorities. Priority setting is essential, yet this is a complex, multifaceted process. Drawing on a study conducted in five African countries, this paper explores different stakeholders' perceptions of health priorities, how priorities are defined in practice, the process of resource allocation for HIV and Health and how different stakeholders perceive this.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A sub-analysis was conducted of selected data from a wider qualitative study that explored the interactions between health systems and HIV and AIDS responses in five sub-Saharan countries (Burkina Faso, the Democratic Republic of Congo, Ghana, Madagascar and Malawi). Key background documents were analysed and semi-structured interviews (n = 258) and focus group discussions (n = 45) were held with representatives of communities, health personnel, decision makers, civil society representatives and development partners at both national and district level.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Health priorities were expressed either in terms of specific health problems and diseases or gaps in service delivery requiring a strengthening of the overall health system. In all five countries study respondents (with the exception of community members in Ghana) identified malaria and HIV as the two top health priorities. Community representatives were more likely to report concerns about accessibility of services and quality of care. National level respondents often referred to wider systemic challenges in relation to achieving the Millennium Development Goals (MDGs). Indeed, actual priority setting was heavily influenced by international agendas (e.g. MDGs) and by the ways in which development partners were supporting national strategic planning processes. At the same time, multi-stakeholder processes were increasingly used to identify priorities and inform sector-wide planning, whereby health service statistics were used to rank the burden of disease. However, many respondents remarked that health system challenges are not captured by such statistics.In all countries funding for health was reported to fall short of requirements and a need for further priority setting to match actual resource availability was identified. Pooled health sector funds have been established to some extent, but development partners' lack of flexibility in the allocation of funds according to country-generated priorities was identified as a major constraint.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Although we found consensus on health priorities across all levels in the study countries, current funding falls short of addressing these identified areas. The nature of external funding, as well as programme-specific investment, was found to distort priority setting. There are signs that existing interventions have had limited effects beyond meeting the needs of disease-specific programmes. A need for more comprehensive health system strengthening (HSS) was identified, which requires a strong vision as to what the term means, coupled with a clear strategy and commitment from national and international decision makers in order to achieve stated goals. Prospective studies and action research, accompanied by pilot programmes, are recommended as deliberate strategies for HSS.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Jenniskens</LastName><ForeName>Françoise</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Royal Tropical Institute, Amsterdam, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tiendrebeogo</LastName><ForeName>Georges</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>Coolen</LastName><ForeName>Anne</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Blok</LastName><ForeName>Lucie</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Kouanda</LastName><ForeName>Seni</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Sataru</LastName><ForeName>Fuseini</ForeName><Initials>F</Initials></Author><Author ValidYN="Y"><LastName>Ralisimalala</LastName><ForeName>Andriamampianina</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Mwapasa</LastName><ForeName>Victor</ForeName><Initials>V</Initials></Author><Author ValidYN="Y"><LastName>Kiyombo</LastName><ForeName>Mbela</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Plummer</LastName><ForeName>David</ForeName><Initials>D</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2012</Year><Month>12</Month><Day>11</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Public Health</MedlineTA><NlmUniqueID>100968562</NlmUniqueID><ISSNLinking>1471-2458</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Health Policy Plan. 2010 Nov;25 Suppl 1:i21-31</RefSource><PMID Version="1">20966105</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Global Health. 2008 Sep 16;4:8</RefSource><PMID Version="1">18796148</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Health Policy Plan. 2009 Jul;24(4):239-52</RefSource><PMID Version="1">19491291</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lancet. 2009 Sep 5;374(9692):783-4</RefSource><PMID Version="1">19733777</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lancet. 2004 Sep 4-10;364(9437):900-6</RefSource><PMID Version="1">15351199</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Health Policy Plan. 2010 Nov;25 Suppl 1:i1-3</RefSource><PMID Version="1">20966104</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lancet. 2009 Jun 20;373(9681):2137-69</RefSource><PMID Version="1">19541040</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>PLoS Med. 2010;7(12):e1000385</RefSource><PMID Version="1">21203584</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Bull World Health Organ. 2004 May;82(5):346-53</RefSource><PMID Version="1">15298225</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Bull World Health Organ. 1994;72(3):429-45</RefSource><PMID Version="1">8062401</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lancet. 2008 Sep 13;372(9642):917-27</RefSource><PMID Version="1">18790315</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Cost Eff Resour Alloc. 2006 Aug 21;4:14</RefSource><PMID Version="1">16923181</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lancet. 2009 Nov 14;374(9702):1674; author reply 1675-6</RefSource><PMID Version="1">19914508</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Acquir Immune Defic Syndr. 2009 Nov;52 Suppl 1:S45-8</RefSource><PMID Version="1">19858938</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lancet. 2009 Feb 7;373(9662):508-15</RefSource><PMID Version="1">19150128</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D017954" MajorTopicYN="N" Type="Geographic">Africa South of the Sahara</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017144" MajorTopicYN="N">Focus Groups</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015658" MajorTopicYN="N">HIV Infections</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015276" MajorTopicYN="N">Health Care Rationing</DescriptorName><QualifierName UI="Q000458" MajorTopicYN="Y">organization & administration</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006292" MajorTopicYN="N">Health Priorities</DescriptorName><QualifierName UI="Q000458" MajorTopicYN="Y">organization & administration</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006301" MajorTopicYN="Y">Health Services Needs and Demand</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D036301" MajorTopicYN="N">Qualitative Research</DescriptorName></MeshHeading></MeshHeadingList><OtherID Source="NLM">PMC3549279</OtherID></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2012</Year><Month>07</Month><Day>03</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2012</Year><Month>11</Month><Day>13</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2012</Year><Month>12</Month><Day>13</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2012</Year><Month>12</Month><Day>13</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2013</Year><Month>3</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">23231820</ArticleId><ArticleId IdType="pii">1471-2458-12-1071</ArticleId><ArticleId IdType="doi">10.1186/1471-2458-12-1071</ArticleId><ArticleId IdType="pmc">PMC3549279</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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