ArticleInternational journal for equity in health2012
Challenges to fair decision-making processes in the context of health care services: a qualitative assessment from Tanzania.
Article in International journal for equity in health, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 4 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 4 syntheses or guidelines pooled it, 65 citations in OpenAlex.
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- Assessing the interactions of people and policy-makers in social participation for health: an inventory of participatory governance measures from a rapid systematic literature review.International journal for equity in health · 2023Pooled it
- Synergies, strengths and challenges: findings on community capability from a systematic health systems research literature review.BMC health services research · 2016Pooled it
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- Developing the improved Community Health Fund in Tanzania: was it a fair process?Health policy and planning · 2023Article
- How does power shape district health management team responsiveness to public feedback in low- and middle-income countries: an interpretive synthesis.Health policy and planning · 2023Article
- How is inclusiveness in health systems research priority-setting affected when community organizations lead the process?Health policy and planning · 2022Article
- Exploring the obesity concerns of British Pakistani women living in deprived inner-city areas: A qualitative study.Health expectations : an international journal of public participation in health care and health policy · 2022Article
- Designing and Implementing Deliberative Processes for Health Technology Assessment: A Good Practices Report of a Joint HTAi/ISPOR Task Force.International journal of technology assessment in health care · 2022Article
- Designing and Implementing Deliberative Processes for Health Technology Assessment: A Good Practices Report of a Joint HTAi/ISPOR Task Force.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2022Article
- The functionality of health facility governing committees and their associated factors in selected primary health facilities implementing direct health facility financing in Tanzania: A mixed-method study.Health science reports · 2022Article
- Participation in primary health care through community-level health committees in Sub-Saharan Africa: a qualitative synthesis.BMC public health · 2022Review
- Achieving inclusive research priority-setting: what do people with lived experience and the public think is essential?BMC medical ethics · 2021Article
- Sharing power in global health research: an ethical toolkit for designing priority-setting processes that meaningfully include communities.International journal for equity in health · 2021Article
- What should community organisations consider when deciding to partner with researchers? A critical reflection on the Zilla Budakattu Girijana Abhivrudhhi Sangha experience in Karnataka, India.Health research policy and systems · 2020Article
- Developing a toolkit for engagement practice: sharing power with communities in priority-setting for global health research projects.BMC medical ethics · 2020Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFair processes in decision making need the involvement of stakeholders who can discuss issues and reach an agreement based on reasons that are justifiable and appropriate in meeting people's needs. In Tanzania, the policy of decentralization and the health sector reform place an emphasis on community participation in making decisions in health care. However, aspects that can influence an individual's opportunity to be listened to and to contribute to discussion have been researched to a very limited extent in low-income settings. The objective of this study was to explore challenges to fair decision-making processes in health care services with a special focus on the potential influence of gender, wealth, ethnicity and education. We draw on the principle of fairness as outlined in the deliberative democratic theory.
methodsThe study was carried out in the Mbarali District of Tanzania. A qualitative study design was used. In-depth interviews and focus group discussion were conducted among members of the district health team, local government officials, health care providers and community members. Informal discussion on the topics was also of substantial value.
resultsThe study findings indicate a substantial influence of gender, wealth, ethnicity and education on health care decision-making processes. Men, wealthy individuals, members of strong ethnic groups and highly educated individuals had greater influence. Opinions varied among the study informants as to whether such differences should be considered fair. The differences in levels of influence emerged most clearly at the community level, and were largely perceived as legitimate.
conclusionsExisting challenges related to individuals' influence of decision making processes in health care need to be addressed if greater participation is desired. There is a need for increased advocacy and a strengthening of responsive practices with an emphasis on the right of all individuals to participate in decision-making processes. This simultaneously implies an emphasis on assuring the distribution of information, training and education so that individuals can participate fully in informed decision making.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.