This is also important in terms of revisions and appeals as a greater number of champions within the political arena will ensure that processes are transparent and that changes in any one party will not render the entire process vulnerable.
While stakeholders in Mbarali district widely appreciated the importance of the revision and appeals condition, they also expressed their concern about the applicability and feasibility of it.
Experiences from other contexts suggest that if carried out correctly, the revision and appeals condition can close the gap between decision-makers and those affected by the policies, and engage a broader range of stakeholders in the process of deliberation [ 30].
Some reproductive health-related activities may have also been missed due to human error; if activities were not mentioned in the proposal or were subsumed under vague descriptions due to political sensitivities; or if modifications were made beyond what was captured in appeals revision processes.
Respondents expressed the need for fair, clear, explicit, and more responsive mechanisms for appeals and revisions.
For example, in Chile, a country with a history of dictatorship and military rule, a government culture that discourages disagreement impeded the implementation of an appeals and revisions process (Valdebenito et al. 2009).
The challenges of achieving the appeals and revisions condition pointed out by stakeholders in the district should not be surprising, given the socio-political conditions and traditions in which the A4R framework is implemented.
This process of revision based on appeal must include explicit mechanisms for revising decisions based on emerging issues or arguments.
The studies captured in this review, therefore, endeavoured to evaluate priority setting processes against the four conditions of AFR such as relevance, publicity, appeals and revision and enforcement.
In applying frameworks for fair resource allocation, implementing mechanisms for appeal and revisions [ 37] would also give practitioners the opportunity to bring experience from clinical practice to bear on prioritization.
The managers of the hospital need to develop and publicize participatory guidelines for appealing and revisions, and communicate decisions and reasons in response to appeals.
