Using burden of disease information for health planning in developing countries: the experience from Uganda
Using burden of disease information for health planning in developing countries: the experience from Uganda
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DOI：
10.1016/s0277-9536(02)00246-0
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发表时间：
2003-06-01
影响因子：
5.4
通讯作者：
Heggenhougen, K
中科院分区：
文献类型：
--
作者：
Kapiriri, L;Norheim, OF;Heggenhougen, K
鉴于人们对在规划中使用证据以及使用疾病负担测量（BOD）和成本效益分析的兴趣日益浓厚，我们以乌干达为例，探讨了卫生规划人员对BOD在发展中国家确定优先事项和规划中的有用性的看法。采用了一种探索性质的方法，包括对地区和国家各级卫生领域的主要决策者进行深入访谈。面谈的同时还审查了有关文件。分析包括从访谈中识别关键概念。概念分为几类，即数量数据的吸引力、数据限制、不透明的方法、作为政治进程的规划和机会成本。这些构成了本文的基础。我们发现，BOD研究结果已被用作国家卫生政策和确定国家基本卫生保健一揽子计划内容的基础。疾病负担的量化和排名受到政治家的赞赏，并用于宣传、资源调动和重新分配。调查结果还为确定优先事项和战略规划提供了资料。其使用的限制包括对方法的理解不足、输入的数据质量差、利益攸关方的参与程度低、方法无法捕捉关键的非经济问题以及开展研究的成本。乌干达规划人员承诺在确定优先事项时使用证据。由于这是一项探索性研究，有必要在发展中国家进行更多的研究，以记录它们利用证据的经验，特别是在规划和确定优先事项方面采用按需出版方法。这些资料将有助于进一步综合这一办法。2003爱思唯尔科学有限公司版权所有。
Given the growing interest in both the use of evidence in planning and in using the burden of disease measure (BOD) and cost-effectiveness analysis, we explored health planners' perception of the usefulness of the BOD in priority setting and planning in developing countries, using Uganda as an example.An exploratory qualitative approach involving in-depth interviews with key policy makers in health at district and national levels was employed. Interviews were supplemented with a review of relevant documents. Analysis involved identification of key concepts from the interviews. Concepts were grouped into categories, namely, the appeal of quantitative data, data limitations, opaque methodology, planning as a political process and opportunity costs. These form the basis of this article.We found that the BOD study results have been used as the basis for the national health policy and in defining the contents of the national essential health care package. The quantification and ranking of disease burden is appreciated by politicians and used for advocacy, resource mobilization and re-allocation. The results have also provided information for priority setting and strategic planning. Limitations to its use included poor understanding of the methodology, poor quality of data in-puts, low involvement of stakeholders, inability of the methodology to capture key non-economic issues, and the costs of carrying out the study. There is commitment, by Ugandan planners to using evidence in priority setting. Since this was an exploratory study, there is a need for more studies in developing countries to document their experiences with the use of evidence, and specifically, the BOD approach in planning and priority setting. Such information would contribute to further synthesis of the approach. (C) 2003 Elsevier Science Ltd. All rights reserved.