Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 4 11 2015 11 01 Setting Healthcare Priorities at the Macro and Meso Levels: A Framework for Evaluation 719 732 3096 10.15171/ijhpm.2015.167 EN Edwine Barasa KEMRI Centre for Geographic Medicine Research – Coast, and Welcome Trust Research Programme, Nairobi, Kenya Health Economics Unit, University of Cape Town, Cape Town, South Africa 0000-0001-5793-7177 Sassy Molyneux KEMRI Centre for Geographic Medicine Research – Coast, and Welcome Trust Research Programme, Nairobi, Kenya Centre for Tropical Medicine, University of Oxford, Oxford, UK Mike English KEMRI Centre for Geographic Medicine Research – Coast, and Welcome Trust Research Programme, Nairobi, Kenya Department of Paediatrics, University of Oxford, Oxford, UK Susan Cleary Health Economics Unit, University of Cape Town, Cape Town, South Africa 0000-0002-9071-7958 Journal Article 2015 03 25 Background <br />Priority setting in healthcare is a key determinant of health system performance. However, there is no widely accepted priority setting evaluation framework. We reviewed literature with the aim of developing and proposing a framework for the evaluation of macro and meso level healthcare priority setting practices. <br />  <br />Methods <br />We systematically searched Econlit, PubMed, CINAHL, and EBSCOhost databases and supplemented this with searches in Google Scholar, relevant websites and reference lists of relevant papers. A total of 31 papers on evaluation of priority setting were identified. These were supplemented by broader theoretical literature related to evaluation of priority setting. A conceptual review of selected papers was undertaken. <br />  <br />Results <br />Based on a synthesis of the selected literature, we propose an evaluative framework that requires that priority setting practices at the macro and meso levels of the health system meet the following conditions: (1) Priority setting decisions should incorporate both efficiency and equity considerations as well as the following outcomes; (a) Stakeholder satisfaction, (b) Stakeholder understanding, (c) Shifted priorities (reallocation of resources), and (d) Implementation of decisions. (2) Priority setting processes should also meet the procedural conditions of (a) Stakeholder engagement, (b) Stakeholder empowerment, (c) Transparency, (d) Use of evidence, (e) Revisions, (f) Enforcement, and (g) Being grounded on community values. <br />  <br />Conclusion <br />Available frameworks for the evaluation of priority setting are mostly grounded on procedural requirements, while few have included outcome requirements. There is, however, increasing recognition of the need to incorporate both consequential and procedural considerations in priority setting practices. In this review, we adapt an integrative approach to develop and propose a framework for the evaluation of priority setting practices at the macro and meso levels that draws from these complementary schools of thought. https://www.ijhpm.com/article_3096_60792d855cd8a912a97711f91a1f155c.pdf