An assessment of priority setting process and its implication on availability of emergency obstetric care services in Malindi District, Kenya

Nyandieka, L; Kombe, Yeri; Ng’ang’a, Zipporah; Byskov, Jens; Njeru, Mercy Karimi

doi:10.11604/pamj.2015.22.156.7296

Cited by 8 publications

(11 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are limited mechanisms of incorporating community values in the planning and budgeting processes. This finding is consistent with studies done in both HICs and LMICs . According to communitarian claims, it is not enough to just subject the community to the decisions made, they should be involved to the extent of determining how resources are allocated .…”

Section: Discussionsupporting

confidence: 89%

Describing and evaluating healthcare priority setting practices at the county level in Kenya

Waithaka

Tsofa

Kabia

et al. 2018

Health Planning & Management

View full text Add to dashboard Cite

SummaryBackgroundHealthcare priority setting research has focused at the macro (national) and micro (patient level), while there is a dearth of literature on meso‐level (subnational/regional) priority setting practices. In this study, we aimed to describe and evaluate healthcare priority setting practices at the county level in Kenya.MethodsWe used a qualitative case study approach to examine the planning and budgeting processes in 2 counties in Kenya. We collected the data through in‐depth interviews of senior managers, middle‐level managers, frontline managers, and health partners (n = 23) and document reviews. We analyzed the data using a framework approach.FindingsThe planning and budgeting processes in both counties were characterized by misalignment and the dominance of informal considerations in decision making. When evaluated against consequential conditions, efficiency and equity considerations were not incorporated in the planning and budgeting processes. Stakeholders were more satisfied and understood the planning process compared with the budgeting process. There was a lack of shifting of priorities and unsatisfactory implementation of decisions. Against procedural conditions, the planning process was more inclusive and transparent and stakeholders were more empowered compared with the budgeting process. There was ineffective use of data, lack of provisions for appeal and revisions, and limited mechanisms for incorporating community values in the planning and budgeting.ConclusionCounty governments can improve the planning and budgeting processes by aligning them, implementing a systematic priority setting process with explicit resource allocation criteria, and adhering to both consequential and procedural aspects of an ideal priority setting process.

show abstract

Section: Discussionsupporting

confidence: 89%

Describing and evaluating healthcare priority setting practices at the county level in Kenya

Waithaka

Tsofa

Kabia

et al. 2018

Health Planning & Management

View full text Add to dashboard Cite

show abstract

“…There was, however, a general consensus that the guidelines limited the ability of regions to set their own priorities ( Bukachi et al ., 2014 ; Gibson et al ., 2006 ; Maluka et al ., 2010a ; Maluka, 2011 ; Nyandieka et al ., 2015 ; Robinson et al ., 2012 ). For example, Nyandieka et al (2015) on assessment of priority setting implications on emergency obstetrics care (EMOC) found that Malindi district in Kenya, had limited freedom in setting priorities as the process is largely dependent on national level guidelines. In Mbarali district in Tanzania, Maluka et al (2010a) found that when district priorities conflicted with national priorities in the planning and budgeting process, the national priorities took precedence.…”

Section: Resultsmentioning

confidence: 99%

Evaluating healthcare priority setting at the meso level: A thematic review of empirical literature

Waithaka¹,

Tsofa²,

Barasa³

2018

Wellcome Open Res

View full text Add to dashboard Cite

Decentralization of health systems has made Background sub-national/regional healthcare systems the backbone of healthcare delivery. These regions are tasked with the difficult responsibility of determining healthcare priorities and resource allocation amidst scarce resources. We aimed to review empirical literature that evaluated priority setting practice at the meso (sub-national) level of health systems.: We systematically searched PubMed, ScienceDirect and Google Methods scholar databases and supplemented these with manual searching for relevant studies, based on the reference list of selected papers. We only included empirical studies that described and evaluated, or those that only evaluated priority setting practice at the meso-level. A total of 16 papers were identified from LMICs and HICs. We analyzed data from the selected papers by thematic review.: Few studies used systematic priority setting processes, and all but Results one were from HICs. Both formal and informal criteria are used in priority-setting, however, informal criteria appear to be more perverse in LMICs compared to HICs. The priority setting process at the meso-level is a top-down approach with minimal involvement of the community. Accountability for reasonableness was the most common evaluative framework as it was used in 12 of the 16 studies. Efficiency, reallocation of resources and options for service delivery redesign were the most common outcome measures used to evaluate priority setting.: Our study was limited by the fact that there are very few empirical Limitations studies that have evaluated priority setting at the meso-level and there is likelihood that we did not capture all the studies.: Improving priority setting practices at the meso level is crucial to Conclusions strengthening health systems. This can be achieved through incorporating and adapting systematic priority setting processes and frameworks to the context where used, and making considerations of both process and outcome measures during priority setting and resource allocation.

show abstract

“…Ministry of Health (MoH) guidelines for health management committees [33] provide for participation in health planning process through representation of community members in order for them to represent community interests. The said representation has been found to be inadequate, as perceived by some of the in-charges of health facilities in Malindi [34]. Besides most community members do not know their representatives and do not discuss their needs before the representatives attend meetings to represent them.…”

Section: Discussionmentioning

confidence: 99%

“…One strategy suggested in the annual operations plan (AOP) [37] was to sensitize community through barazas, a strategy that is usually carried out by calling community meetings under the local administration to address emerging issues in the community. One of the weaknesses of this strategy is that usually the men send their wives to such meetings to represent them [34], thus leaving out the very people targeted by the health planners.…”

Section: Discussionmentioning

confidence: 99%

Male Involvement in Maternal Health Planning Key to Utilization of Skilled Birth Services in Malindi Subcounty, Kenya

Nyandieka

Njeru

Ng’ang’a

et al. 2016

Advances in Public Health

Self Cite

View full text Add to dashboard Cite

Background.In Malindi, rural populations face challenges in accessing skilled birth services. Consequently, the majority of women deliver at home and only seek help when they have complications. This paper reports part findings from a study conducted to assess health priority setting process and its implication on availability, access, and use of emergency obstetric care services in Malindi.Methods. The study utilized qualitative methods to collect data from health personnel and maternal health stakeholders including community members. Source and method triangulation was used to strengthen the credibility of study findings. Data was categorized manually into themes around issues relating to utilization of skilled birth services discussed in this paper.Findings. Various barriers to utilization of skilled birth services were cited. However, most were linked tomwenye(the husband) who decides on the place of birth for the wife.Conclusion.Husbands are very influential in regard to decisions on skilled birth service utilization in this community. Their lack of involvement in maternal health planning may contribute as a barrier to utilization of skilled care by pregnant women. There is need to address themwenyefactor in an attempt to mitigate some of the barriers cited for nonutilization of skilled birth services.

show abstract

An assessment of priority setting process and its implication on availability of emergency obstetric care services in Malindi District, Kenya

Cited by 8 publications

References 25 publications

Describing and evaluating healthcare priority setting practices at the county level in Kenya

Describing and evaluating healthcare priority setting practices at the county level in Kenya

Evaluating healthcare priority setting at the meso level: A thematic review of empirical literature

Male Involvement in Maternal Health Planning Key to Utilization of Skilled Birth Services in Malindi Subcounty, Kenya

Contact Info

Product

Resources

About