Nijmegen International Center for Health Systems Research and Education, Radboud University, Nijmegen, The Netherlands.
BMC Womens Health. 2011 Oct 21;11:46. doi: 10.1186/1472-6874-11-46.
Successful priority setting is increasingly known to be an important aspect in achieving better family planning, maternal, newborn and child health (FMNCH) outcomes in developing countries. However, far too little attention has been paid to capturing and analysing the priority setting processes and criteria for FMNCH at district level. This paper seeks to capture and analyse the priority setting processes and criteria for FMNCH at district level in Tanzania. Specifically, we assess the FMNCH actor's engagement and understanding, the criteria used in decision making and the way criteria are identified, the information or evidence and tools used to prioritize FMNCH interventions at district level in Tanzania.
We conducted an exploratory study mixing both qualitative and quantitative methods to capture and analyse the priority setting for FMNCH at district level, and identify the criteria for priority setting. We purposively sampled the participants to be included in the study. We collected the data using the nominal group technique (NGT), in-depth interviews (IDIs) with key informants and documentary review. We analysed the collected data using both content analysis for qualitative data and correlation analysis for quantitative data.
We found a number of shortfalls in the district's priority setting processes and criteria which may lead to inefficient and unfair priority setting decisions in FMNCH. In addition, participants identified the priority setting criteria and established the perceived relative importance of the identified criteria. However, we noted differences exist in judging the relative importance attached to the criteria by different stakeholders in the districts.
In Tanzania, FMNCH contents in both general development policies and sector policies are well articulated. However, the current priority setting process for FMNCH at district levels are wanting in several aspects rendering the priority setting process for FMNCH inefficient and unfair (or unsuccessful). To improve district level priority setting process for the FMNCH interventions, we recommend a fundamental revision of the current FMNCH interventions priority setting process. The improvement strategy should utilize rigorous research methods combining both normative and empirical methods to further analyze and correct past problems at the same time use the good practices to improve the current priority setting process for FMNCH interventions. The suggested improvements might give room for efficient and fair (or successful) priority setting process for FMNCH interventions.
在发展中国家，成功的优先排序被越来越多地认为是实现更好的计划生育、孕产妇、新生儿和儿童健康（FMNCH）结果的一个重要方面。然而，在捕捉和分析地区一级 FMNCH 的优先排序过程和标准方面，关注的远远不够。本文旨在捕捉和分析坦桑尼亚地区一级 FMNCH 的优先排序过程和标准。具体来说，我们评估了 FMNCH 行为者的参与和理解、决策中使用的标准以及确定标准的方式、在坦桑尼亚地区一级优先排序 FMNCH 干预措施中使用的信息或证据和工具。
我们采用混合定性和定量方法的探索性研究来捕捉和分析地区一级 FMNCH 的优先排序，并确定优先排序的标准。我们有目的地选择参与者参加研究。我们使用名义团体技术（NGT）、与主要利益攸关方的深入访谈（IDIs）和文献审查收集数据。我们使用内容分析法对定性数据进行分析，使用相关分析对定量数据进行分析。
我们发现该地区在优先排序过程和标准方面存在一些不足，这可能导致 FMNCH 中的决策效率低下和不公平。此外，参与者确定了优先排序标准，并确定了所确定标准的感知相对重要性。然而，我们注意到不同利益相关者在判断标准的相对重要性方面存在差异。
在坦桑尼亚，FMNCH 内容在一般发展政策和部门政策中都有明确规定。然而，目前地区一级 FMNCH 的优先排序过程在几个方面都存在不足，使得 FMNCH 的优先排序过程效率低下且不公平（或不成功）。为了改进地区一级 FMNCH 干预措施的优先排序过程，我们建议对当前的 FMNCH 干预措施优先排序过程进行根本性修订。改进策略应利用规范性和实证性方法相结合的严格研究方法，同时分析和纠正过去的问题，利用良好的实践改进当前的 FMNCH 干预措施优先排序过程。建议的改进措施可能为 FMNCH 干预措施的有效和公平（或成功）的优先排序过程提供空间。
