Table 1 Parameters for evaluating priority setting with corresponding indicators and means of verification
Parameters of successful priority setting | Objectively Verifiable Indicators (OVI) | Means of Verification (MOV) | |
|---|---|---|---|
Contextual Factors | Conducive political, economic, social and cultural context | Relevant contextual factors that may impact priority setting | Follow up intermittent interviews with local stakeholders, systematic longitudinal observations, relevant reports, media reports. |
Pre-requisites | Political will | Degree to which the politicians support the set priorities | Follow up intermittent interviews with local stakeholders, systematic longitudinal observations, relevant reports, media reports. |
Resources | Budgetary and human resource allocation to the health sector | National budget documents | |
Legitimate and credible institutions | Degree to which the priority setting institutions can set priorities, public confidence in the institution | Stakeholder and public interviews | |
Incentives | Material and financial incentives | National budget documents | |
The priority setting process | Stakeholder participation | Number of stakeholders participating, number of opportunities each stakeholder gets to express opinions | Observation at meetings/minutes of meetings, media reports, special reports |
Use of clear priority setting process/tool/methods | Documented priority setting process and/or use of priority setting framework | Observation at meetings/minutes of meetings, media reports, special reports | |
Use of explicit relevant priority setting criteria | Documented/articulated criteria | Observation at meetings/minutes of meetings, media reports, special reports | |
Use of evidence | Number of times available data is resourced/number of studies commissioned/existing strategies to collect relevant data | Observation at meetings/minutes of meetings, media reports, special reports | |
Reflection of public values | Number and type of members from the general public represented, how they are selected, number of times they get to express their opinion, proportion of decisions reflecting public values, documented strategy to enlist public values, number of studies commissioned to elicit public values | Observation at meetings/minutes of meetings, study reports, meeting minutes and strategic plans | |
Publicity of priorities and criteria | Number of times decisions and rationales appear in public documents | Media reports | |
Functional mechanisms for appealing the decision | Number of decisions appealed, number of decisions revised | Observations at meetings/minutes at [of] meetings, media reports, special reports | |
Functional mechanisms for enforcement | Number of cases of failure to adhere to priority-setting process reported | Observation at meetings/minutes of meetings, media reports, special reports | |
Efficiency of the priority setting process | Proportion of meeting time spent on priority setting, number of decisions made on time | Observation at meetings/minutes of meetings, annual budget documents, health system reports | |
Decreased dissentions | Number of complaints from stakeholders | Meeting minutes, media reports | |
Allocation of resources according to priorities | Degree of alignment of resource allocation and agreed upon priorities, times budget is re-allocated from less prioritized to high prioritized areas, stakeholder satisfaction with the decisions | Annual budget reports, evaluation documents | |
Decreased resource wastage/misallocation | Proportion of budget unused | Budget documents, evaluation reports | |
Improved internal accountability/reduced corruption | Number of publicized resource allocation decisions | Evaluation reports, stakeholder interviews, media reports | |
Increased stakeholder understanding, satisfaction and compliance with the priority setting process | Number of stakeholders attending meetings, number of complaints from stakeholders, percentage of stakeholders that can articulate the concepts used in priority setting and appreciate the need for priority setting | Observation at meetings/minutes of meetings, special reports, stakeholder satisfaction survey, media reports, stakeholder interviews, evaluation reports | |
Implementation of the set priorities | Improved internal accountability/reduced corruption | Number of publicized resource allocation decisions | Evaluation reports, stakeholder interviews, media reports |
Strengthening of the priority setting institution | Indicators relating to increased efficiency, use of data, quality of decisions and appropriate resource allocation, percentage of stakeholders with the capacity to set priorities | Training reports, evaluation reports, budget documents | |
Impact on institutional goals and objectives | Percentage of institutional objectives met that are attributed to the priority setting process | Evaluation reports, special studies | |
Priority setting outcomes | Impact on health policy and practice | Changes in health policy to reflect identified priorities | Policy documents |
Achievement of health system goals -improved population health -reduction in health inequalities -fair financial contribution -responsive health care system | Percent reduction in DALYs, percent reduction of the gap between the lower and upper quintiles, percentage of poor populations spending more than 50% of their income on health care, percentage of users who report satisfaction with the healthcare system | Ministry of Health documents, Demographic and Health Surveys, commissioned studies | |
Improved financial and political accountability | Number of publicized financial resource allocation decisions, number of corruption instances reported, percentage of the public reporting satisfaction with the process | Reports, media reports, interviews with stakeholders | |
Increased investment in the health sector and strengthening of the health care system | Proportion increase in the health budget, proportion increase in the retention of health workers, percentage of the public reporting satisfaction with the health care system | National budget allocation documents |