Health planning and health priority setting: a mixed-methods toolkit

Abstract

Health planning is the backbone of every health system, including at different geographical levels. From the international level with the Sustainable Development Goals to a National Health Plan and Local Health Plans, the process of defining objectives, strategies and then implementing has been very heterogeneous. It is also really tied to the process of priority setting. In fact, the definition of health priorities, with finite resources but growing needs, requires quantitative instruments, public involvement, and multi-criteria. These frameworks include the impact on the burden of disease for informed and transparent governance. Among the methods available, Programme Budgeting and Marginal Analysis (PBMA) stands out for its ability to guide decisions with a strong economic basis. This is based on a budgetary analysis, but also on the budget impact of interventions or policies that necessarily use the burden of disease for this analysis. To enable change and improve health, it is essential to understand the impact that any intervention or policy will have on the target population and, at a macro level, on population health, which can be done through metrics such as DALYs. However, the economic rationale for marginal analysis and consideration of opportunity costs is essential. Nevertheless, it is also necessary to consider the trade-off between efficiency and equity. And this is where the main disadvantage of using only the burden of disease emerges. There should be no competition between diseases based on their prevalence, considering rare diseases to be less critical, even though their magnitude is one possible point of prioritization in health. In this workshop, we will explore how health planning, burden of disease and priority setting can be integrated into mixed-method frameworks that can and define health policies.