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Health Policy and Planning Advance Access originally published online on April 5, 2007
Health Policy and Planning 2007 22(3):178-185; doi:10.1093/heapol/czm010
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Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2007; all rights reserved.

Priority setting using multiple criteria: should a lung health programme be implemented in Nepal?

R Baltussen1,2,*, A H A ten Asbroek3, X Koolman3, N Shrestha4, P Bhattarai5,6 and L W Niessen2,4

1Department of Public Health, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
2Institute for Medical Technology Assessment, Erasmus Medical Centre Rotterdam, The Netherlands.
3Department of Social Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands.
4Department of Health Policy and Management, Erasmus Medical Centre Rotterdam, The Netherlands.
5Department of Community Medicine and Family Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
6Nepal Institute of Health Sciences, Kathmandu, Nepal.

* Corresponding author. Department of Public Health, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands. Tel: +31 24 3613235/3119. Fax: +31 24 3619561. E-mail: r.baltussen{at}sg.umcn.nl

Objectives To identify and weigh the various criteria for priority setting, and to assess whether a recently evaluated lung health programme in Nepal should be considered a priority in that country.

Methods Through a discrete choice experiment with 66 respondents in Nepal, the relative importance of several criteria for priority setting was determined. Subsequently, a set of interventions, including the lung health programme, was rank ordered on the basis of their overall performance on those criteria.

Results Priority interventions are those that target severe diseases, many beneficiaries and people of middle-age, have large individual health benefits, lead to poverty reduction and are very cost-effective. Certain interventions in tuberculosis control rank highest. The lung health programme ranks 13th out of 34 interventions.

Conclusion This explorative analysis suggests that the lung health programme is among the priorities in Nepal when taking into account a range of relevant criteria for priority setting. The multi-criteria approach can be an important step forward to rational priority setting in developing countries.

Key Words: Multi-criteria decision analysis, priority setting, rational, Nepal

Accepted for publication 20 February 2007.


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