Priority setting for disease outbreaks in Uganda: A case study evaluating the process

ABSTRACT

Priority setting (PS) and resource allocation during health emergencies are key factors influencing an effective response. However, there is limited understanding of how priorities and resource allocation during disease outbreaks occur and the extent to which these processes are successful. This paper, based on 23 in-depth interviews with policy makers and a review of policy and emergency preparedness documents, used a PS evaluation framework to evaluate PS for disease outbreaks in Uganda. With regard to PS for disease outbreaks in Uganda, we identified a conducive socio-political-economical context, credible institutions, formal participatory prioritisation processes, evidence informed the processes, demonstrated implementation capacity, institutional strengthening and positive health outcomes. Factors that compromised the success of PS included limited resources – especially in between disease outbreaks and unfair processes. Investment in sustaining the established prioritisation infrastructure to oversee preparedness activities between the outbreaks would strengthen the prioritisation process. This should be supported with health system strengthening. The framework enabled us to evaluate some aspects of PS during disease outbreaks. The framework’s inability to evaluate all aspects, and reported as opposed to actual PS calls for the integration of evaluation throughout the planning and implementation process to ensure validity and continuous implementation of improvement strategies.

KEYWORDS:

• Priority setting
• evaluation
• disease outbreaks
• low income countries
• Uganda

Acknowledgements

The authors acknowledge the contribution made by Brendan Kwesiga who participated in the data collection and Emmy Arnold who contributed to the data analysis. This study would not have been possible without the participation of all the respondents.

Ethics

The study was reviewed by the relevant research ethics boards. All respondents provided signed consent.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The study was funded by the Canadian Institutes for Health Research [Grant# 10558616].