Using burden of disease information for health planning in developing countries: the experience from Uganda.
Given the growing interest in both the use of evidence in planning and in using the burden of disease measure (BOD) and cost-effectiveness analysis, we explored health planners' perception of the usefulness of the BOD in priority setting and planning in developing countries, using Uganda as an example. An exploratory qualitative approach involving in-depth interviews with key policy makers in health at district and national levels was employed. Interviews were supplemented with a review of relevant documents. Analysis involved identification of key concepts from the interviews. Concepts were grouped into categories, namely, the appeal of quantitative data, data limitations, opaque methodology, planning as a political process and opportunity costs. These form the basis of this article. We found that the BOD study results have been used as the basis for the national health policy and in defining the contents of the national essential health care package. The quantification and ranking of disease burden is appreciated by politicians and used for advocacy, resource mobilization and re-allocation. The results have also provided information for priority setting and strategic planning. Limitations to its use included poor understanding of the methodology, poor quality of data in-puts, low involvement of stakeholders, inability of the methodology to capture key non-economic issues, and the costs of carrying out the study. There is commitment, by Ugandan planners to using evidence in priority setting. Since this was an exploratory study, there is a need for more studies in developing countries to document their experiences with the use of evidence, and specifically, the BOD approach in planning and priority setting. Such information would contribute to further synthesis of the approach.
Department of Public Health and Primary Health Care, Centre for International Health, University of Bergen, Ulriksdal 8c, N-5009, Bergen, Norway. lydia.kapiriri@student.uib.no <lydia.kapiriri@student.uib.no>
Lydia
L
Kapiriri
Ole Frithjof
OF
Norheim
Kristian
K
Heggenhougen
D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003906:Developing Countries; D006285:Health Planning / Q000379:methods* / Q000458:organization & administration; D006291:Health Policy; D006292:Health Priorities; D006801:Humans; D007407:Interviews as Topic; D010934:Planning Techniques; D011050:Policy Making; D011057:Politics; D011634:Public Health; D036301:Qualitative Research; D040841:Resource Allocation; D012945:Social Values; D014454:Uganda