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While we acknowledge the broader context of external influences, it was not the focus of this paper to broadly examine the role of the external influences on priority setting at district level.
Participating institutions are presented in Figure 2. The objectives of the project are to strengthen the legitimacy and fairness of priority setting at district level in Tanzania, Zambia and Kenya, and to evaluate potential changes in quality, equity and trust pertaining to health services and interventions.
Their approach highlights the problems of outreach for clinical departments who are at the coal face of priority setting.
First, links between researchers and policy-makers should ideally develop on a long-term basis so that together at the priority setting interface they produce a research agenda that reflects some synthesis between the needs of policy-makers and the perspectives of independent research analysis.
At the research priority setting stage of a translational research project, the amount of developmental uncertainty surrounding the conceived product concepts is usually still enormous.
Our findings indicate that research is needed on how to facilitate priority setting at the national level in low and middle income countries.
Legitimate and fair priority setting at the district and local levels is thus a possible and even necessary addition to the national guidance.
Apart from deciding the funds available for individual hospitals, the central level of Ministry of Health has less influence on the priority setting at health centre and hospital level where the interventions offered to a large extent are determined by self-referral of patients.
Study designed to examine healthcare priority setting processes at a local (clinical commissioning group, CCG) level.
The results show that both the donors and government influence priority setting processes at district level.
Practically, the results show that the priority setting processes at district level are top down and incremental in nature.
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