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Updated: Sep 19, 2025

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A 10-Step Method for Fair Priority-Setting Processes: A Qualitative Case Study from Zanzibar.

Omar Mwalim1,2, Sanaa Said2,3, Subira Suleiman1,4

  • 1Ministry of Health, Zanzibar, Tanzania.

Health Systems and Reform
|June 18, 2025
PubMed
Summary
This summary is machine-generated.

This study introduces a 10-step method for fair priority setting in health systems, ensuring transparent and inclusive decision-making for essential health services, especially in resource-limited settings.

Keywords:
Healthcare systemdecision-makinghealth equityhealth prioritiesstakeholder engagement

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Area of Science:

  • Health Policy and Systems Research
  • Global Health
  • Health Economics

Background:

  • Global health systems grapple with resource scarcity, demanding systematic and equitable methods for prioritizing essential health services.
  • Limited practical guidance exists for establishing transparent and inclusive priority-setting processes.

Purpose of the Study:

  • To present a 10-step method for designing fair priority-setting processes for essential health care packages.
  • To demonstrate the method's application in revising the Zanzibar Essential Health Care Package (2019-2022).

Main Methods:

  • A 10-step structured approach was developed, emphasizing stakeholder involvement, transparency, and deliberation.
  • The method includes roadmap development, management, criteria selection, intervention identification, financing, evidence generation, analytics, prioritization, implementation, and M&E.
  • Consensus-building workshops were used to determine priority-setting criteria, including cost-effectiveness, budget impact, disease burden, equity, and political acceptability.

Main Results:

  • The 10-step method provides pragmatic, context-specific guidance for resource-limited settings.
  • Key criteria for priority setting in Zanzibar included cost-effectiveness, budget impact, disease burden, equity, and political/public acceptability.
  • The process fostered inclusivity, trust, and legitimacy in the Essential Health Care Package revision.

Conclusions:

  • The 10-step method offers a valuable tool for policymakers to design and implement fair and inclusive priority-setting processes for essential health services.
  • This approach helps bridge the gap between global frameworks and local implementation in diverse health system contexts.