University of Sharjah, College of Health Sciences, Sharjah, United Arab Emirates.
Nexus International University, College of Graduate and Research, Kampala, Uganda.
Front Public Health. 2020 Nov 16;8:584547. doi: 10.3389/fpubh.2020.584547. eCollection 2020.
The health status of the Sub-Saharan African (SSA) countries is well below that of the rest of the world. Coupled with low per capita income, these countries have agreed and committed themselves to raising their health status equitable standard by addressing United Nations (UN) Sustainability Development Goal number 3 (SDG3) by 2030. Addressing SDG3 requires increased and equitable funding for universal health coverage, healthcare infrastructure, efficient resource allocation, improved priority setting, reduction in corruption, and other strategies. However, what is urgently needed to improve priority setting processes or meaningful health system reform, among other things. There is therefore a need for the exploration of the economic and non-economic (which includes social justice) explicit criteria that ought to form the normative framework for Decision Making. These explicit criteria include efficiency, burden of disease, equality (strict egalitarianism), equity, and explicit criteria. The ultimate aim was to identify explicit values/principles/criteria that can be used to formulate an ideal normative framework to be used to guide decision Making so as to improve SDG3 in SSA. We synthesized selected literature on the normative frameworks for priority setting processes in health in SSA was undertaken, and the explicit criteria which, ought to guide these frameworks were identified. The form of the Social Welfare function and its principles was identified. The framework and its explicit criteria for priority setting in the SSA countries that ought to be adopted in order to improve their SDG3 was identified-Non-Welfarist framework. This framework allows utility, health and other important social values/attributes/principles to enter the normative SWF. It is argued that such a framework ought to be specified empirically and concurrently by the decision-makers and members of the community representatives. Community representatives ought to be recognized as legitimate claimants of the resources determined, and should therefore be allowed to have a role in specifying the arguments in the SWF and what weights to be attached to the stated arguments. This implies that the selection of options in decision-making should focus on maximizing benefit and minimizing the opportunities forgone as stated in the framework.
撒哈拉以南非洲（SSA）国家的健康状况远低于世界其他地区。再加上人均收入低，这些国家已同意并承诺通过解决联合国（UN）可持续发展目标 3（SDG3）来提高其健康公平标准，到 2030 年实现这一目标。实现 SDG3 需要增加和公平分配全民健康覆盖、医疗保健基础设施、有效资源配置、改善重点设置、减少腐败等策略。然而，改善重点设置流程或有意义的卫生系统改革等方面急需明确的标准。因此，需要探索经济和非经济（包括社会正义）明确标准，这些标准应该构成决策的规范框架。这些明确的标准包括效率、疾病负担、平等（严格的平等主义）、公平和明确的标准。最终目的是确定明确的价值观/原则/标准，用于制定理想的规范框架，指导决策，以改善 SSA 的 SDG3。我们综合了有关 SSA 卫生重点设置过程的规范框架的选定文献，并确定了应指导这些框架的明确标准。确定了社会福利函数的形式及其原则。确定了 SSA 国家应采用的优先排序框架及其明确标准，以改善其 SDG3-非福利主义框架。该框架允许效用、健康和其他重要的社会价值观/属性/原则进入规范的 SWF。有人认为，这样的框架应该由决策者和社区代表共同具体规定和实证确定。社区代表应该被视为所确定资源的合法索取者，因此应该被允许在 SWF 中规定论点，并为所提出的论点附加权重。这意味着在决策中选择方案应该侧重于按照框架所述，最大化利益和最小化错失的机会。
