Evidence map›Paper›PMID 40531826›Full record

ArticleHealth systems and reform2025

A 10-Step Method for Fair Priority-Setting Processes: A Qualitative Case Study from Zanzibar.

Omar Mwalim, Sanaa Said, Subira Suleiman, Fatma Bakar, Haji Khamis, Dhameera Mohammed, Zuhura Amour, Omar Mussa, Abdulmajid Jecha, Abdul-Latif Haji and 5 more

Abstract read
In one paragraph

Article in Health systems and reform, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Omar MwalimMinistry of Health, Zanzibar, Tanzania.ORCID 0000-0002-0791-1937
Sanaa SaidBergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Subira SuleimanMinistry of Health, Zanzibar, Tanzania.
Fatma BakarMinistry of Health, Zanzibar, Tanzania.
Haji KhamisMinistry of Health, Zanzibar, Tanzania.
Dhameera MohammedMinistry of Health, Zanzibar, Tanzania.
Zuhura AmourMinistry of Health, Zanzibar, Tanzania.
Omar MussaMinistry of Health, Zanzibar, Tanzania.
Abdulmajid JechaOffice of Chief Government Statistician, Zanzibar, Tanzania.
Abdul-Latif HajiMinistry of Health, Zanzibar, Tanzania.
Ole F NorheimBergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Ingrid MiljeteigBergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Austen DavisBergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Peter HangomaBergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Kjell Arne JohanssonBergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Health systems worldwide face challenges in managing resource scarcity, necessitating systematic and fair approaches to prioritize essential health services. Practical guidance on structuring transparent and inclusive priority setting processes remains limited. This paper presents a 10-step method for designing fair priority-setting processes, demonstrated through the revision of the Zanzibar Essential Health Care Package (2019-2022). The 10-step method provides pragmatic and context-specific guidance, bridging the gap between global frameworks and local implementation in resource-limited settings. These 10 steps build upon recognized and accepted conditions and principles for health priorities and include: (1) development of a roadmap, (2) establishment of management, (3) selection of criteria for priority setting, (4) identification of candidate interventions, (5) formulation of financing strategies, (6) evidence generation, (7) employment of analytics, (8) setting priorities, (9) implementation arrangement, and (10) monitoring and evaluation to track implementation. The core team guided each step based on three fundamental principles-stakeholder involvement, transparency, and structured deliberation. In Zanzibar, consensus-building workshops were held to determine the criteria for setting priorities: cost-effectiveness, budget impact, disease burden, and equity. Political/public acceptability emerged as an additional criterion due to the challenges associated with including abortion services. Financial risk protection was deemed significant but was instead incorporated into the implementation and health financing plans. The core team offered preliminary training sessions on health priorities to stakeholders. This structured 10-step method encourages participation and inclusivity of marginalized groups usually excluded from such discussions, trust, and legitimacy in Essential Health Care Package processes, thereby providing policymakers with a tool for improvement.

Indexed as

Health PrioritiesCost-Benefit AnalysisHumansQualitative ResearchTanzaniadecision-makingHealthcare systemhealth equityhealth prioritiesstakeholder engagement

Identifiers

PMID40531826
PMCPMC12312743

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.