What’s Getting in the Way of Fairer National Priority Setting for Universal Health Coverage?

A woman in a bright yellow dress holds a baby in a colorful blue shirt. Both are smiling.
A woman and child in Rwanda. (Photo: USAID)

Through the LHSS-JLN learning exchange, health practitioners from Bangladesh, Lao PDR, Malaysia, Philippines, Rwanda, South Africa, and Thailand are sharing successful country experiences and promising practices to institutionalize explicit national priority-setting processes for health.

The learning exchange is a forum for interested countries to share promising practices, problem-solve, and generate lessons that can be adapted for different country contexts. Participants are gaining a greater understanding of enabling factors, barriers, and practical steps they can take to advance the institutionalization of explicit priority setting as part of strategic planning for the health sector. A report due for release later in 2022 will sum up what they learned.

A shared vision for an institutionalized, explicit process

At their first meeting in December 2021, learning exchange participants developed a shared understanding of what an institutionalized, explicit process for setting national health priorities looks like. They agreed that such a process is inclusive and fair, transparent and accountable, informed by evidence, and realistic (Figure 1).

A circular blue graphic divided into four sections in which the four key defining features of institutionalized, explicit priority setting are described.
Figure 1. Consensus definition of institutionalized, explicit priority setting

Moving towards institutionalizing an explicit national priority-setting process

The participants agreed on four categories of factors that need to be in place to create an enabling environment for priority setting:

A table that describes the four factors that influence institutionalization of explicit national priority-setting processes, in terms of their ability to inhibit or enable.
Figure 2. Factors that influence institutionalization of explicit national priority-setting processes

What comes next?

Of the challenges and complexities countries face, learning exchange participants prioritized two areas for joint learning: 1) stakeholder engagement, and 2) impact on plans and budgets. In future meetings, they will continue to validate and add depth to this framework. They’ll discuss how to reduce the inhibiting factors and develop a more enabling environment for setting fairer national health priorities that will help countries make faster progress towards universal health coverage and better health for all.

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LHSS Project

LHSS Project

USAID’s Local Health System Sustainability Project helps countries achieve sustainable, self-financed health systems that offer quality health care for all.