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Priority-setting for Reproductive Health Services at the Council Level In the Context of Health Sector Reforms in Tanzania

Cresencia A Masawe

Abstract

Priority-setting has become an important component of health sector reforms (HSRs) seeking to achieve improved health outcomes. However, limited studies have focused on analysing priority-setting processes and the criteria used for resource allocation for sexual and reproductive health services (SRH) at the council level in Tanzania. This study aims at providing a better understanding of the factors affecting SRH prioritisation at council levels. Explicitly, it documents the priority-setting process and expounds whether there is harmonisation or discrepancy between national and local priorities. The study was qualitative in nature, collecting data through interviews with key informants, focus group discussions (FGDs) with members of the Health Facility Governing Committee (HFGC), and a review of relevant documents. The findings show that HSRs in Tanzania support prioritization of SRH although the process is influenced by central directives. The study also found that the priority-setting process is underdeveloped and hardly involve SRH advocates. The study argues that SRH priorities need protection within the reformed health system, as such challenging the current priority-setting mechanism that uses disease ranking as the main criteria for setting council health priorities. For HSRs to provide a chance to improve SRH status, there is a need to ensure that the provision of, and access to, essential SRH services such as reproductive system cancer screening, fertility, among others, are inclusive. Thus, a needs-driven priority-setting that embraces bottom-up approach with the inclusion of SRH advocates and experts is recommended.

Keywords

health system reform, priority-setting, sexual and reproductive health services, Tanzania

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References

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