Health Care Patterns and Planning in Developing Countries

By Rais Akhtar | Go to book overview

is that for each criterion, the options available can be ranked from best to worst. It is clear that at this stage, there is plenty of scope for wide participation. The various interest groups can state which criteria they feel should be included.


Weighting Criteria

Decisions have to be made as to how to weight criteria--which "experiments" to choose in the examples discussed. This is the stage at which there is great scope for conflict between groups. Different interest groups will want to put different weights on the various criteria. Which interest groups should be included in deciding on the weighting of criteria and how controversies between such groups should be resolved are problems that will have to be solved differently in each particular situation. Trade-offs will have to be made and how this is done is a highly political question.

The framework outlined in this chapter does not, then, remove conflict and controversy from the planning procedure. What it does is to encourage the clarification of the costs and benefits of the alternatives and so enable decisions to be made in the light of a more informed debate. It also allows for the input of various groups at an early stage and throughout the planning procedure. The final decision need not rest on the power of a single interest group, nor on an intuitive assessment of the most acceptable outcome; rather, a consensus can be generated from the explicity stated preferences of many groups whose interests might otherwise be simply seen as being incompatible and hence not capable of inclusion in the same planning process.


REFERENCES

Askew I and Massam B. 1986. A procedure for evaluating the location of rural health care facilities in developing countries. Occasional Paper No. 2. Exeter, UK: Institute of Population Studies, University of exeter

Bennett V, Eaton D and Church R. 1982. "Selecting sites for rural health workers" Soc Sci Med 16:63-72

Blumenfeld S. 1985. Operations research methods: a general approach in primary health care. Chevy Chase, MA, USA:PRICOR

Joseph A and Phillips D. 1984. Accessibility and utilization: geographic perspectives on health care delivery. London: Harper and Row

de Kadt E. 1983. "'Community participation for health: the case of Latin America'" In Morley D, Rohde J and Williams G (eds) Practising Health for All. Oxford, UK: Oxford University Press

Massam B. 1980. Spatial search: applications to planning problems in the public sector. Oxford: Pergamon Press

Reid R, Ruffing K and Smith H. 1986. "Managing medical supply logistics among health workers in Ecuador" Soc Sci Med 22:9-14

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