Health decision making in low income countries

11 August 2010

An analysis article in the British Medical Journal discusses the importance of relating health spending to local needs in low income countries. The authors consider difficulties that low income countries face when it comes to assessing their health needs and initiatives that could help local decision and policy making [Chalkidou et al . (2010) BMJ 341:c3651].

The authors state that in many countries decisions are still driven by historical norms, priorities of foreign donors and lobbying pressures. As such many countries lack the mechanisms and capabilities for making decisions about their own health needs and developing services accordingly. This is further compounded by the lack of local data, technical expertise and institutions to contribute to needs assessments. The authors suggest that a way forward would be through an international support service involving organisations involved in decision making. They suggest that organisations such as NICE, NHS Global and the Thai Health Intervention and Technology Assessment Programme (HITAP) may be able to lend support to local decision makers by working in collaboration or sharing experiences with them.

The importance of developing services according to local needs in low and middle income countries has been recognised by the PHG Foundation, which is already engaged in a major project to tackle birth defects. This includes a newly developed toolkit to help developing countries (where this group of conditions account for a significant proportion of child deaths and ongoing disability) assess their health needs and develop basic services to prevent and care for this these conditions.

The aim is to provide governments and their health partners with the tools and data to build the evidence base and make the case for the development of services to tackle birth defects in their populations. Importantly, this includes options to take into account not only epidemiological, logistical and economic concerns but also ethical issues, which may also vary widely between different countries and regions.

The toolkit is to be piloted in different international locations over the coming two years, and the PHG Foundation is working with the World Health Organization (WHO) and other supporters to and drive forward concerted global efforts to share expertise and resources in order to reduce the suffering associated with birth defects.


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