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Rudan et al.'s [ 37 ] essay on evidence-based priority setting for healthcare and research presents the available tools for priority setting that could be used by policymakers in low-resource settings.
This included development of simple and complex exposure and hazard tools for priority setting which draw maximally and efficiently on available data to systematically identify substances that are highest priorities in relation to their potential to cause adverse effects on the general population.
Reviews of various tools for priority setting exist elsewhere in the literature [ 6, 7].
These decision makers have been bombarded over the past decade by technically-based tools for priority setting that they felt were insufficient, opaque, did not include relevant people, and did not take into account relevant values.
We call for a shift away from present tools for priority setting – that tend to focus on single criteria for priority setting – towards transparent and systematic approaches that take into account all relevant criteria simultaneously.
Knowledge about what weight is actually given to the key criteria in decisions concerning different health conditions and interventions could be useful in the process of developing tools for priority setting and drawing up guidelines that are perceived as useful in PHC.
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This is not a major drawback since the EHP was designed and costed by government as a tool for priority setting and to be funded by both government and partners through a SWAp.
Similar to the governmental toxicological benchmarks, the biomonitoring guidance values, such as the biomonitoring equivalent determined for benzene, are risk management tools used for priority setting, identifying additional research needs and evaluating if exposure to a particular chemical needs to be controlled (Hays et al., 2012).
The software incorporates the district health account (DHA) tool under MOHSW which is required for priority setting, targeting resources to interventions addressing the largest share of burden of disease (BOD) and producing graphics and summaries of CCHP (MoHSW, 2007a).
We recommend making the tool part of the integrated MCDA A4R approach for priority setting in health as proposed by Baltussen et al. [ 16], however local capacity should be present or established to facilitate such a complete process.
Hospital administrators, constrained by budget restrictions and confronted by increasing demand, find it a particularly difficult challenge to maintain services and quality, while controlling costs; decision makers (or leaders) lack guidance and information for priority setting and are unaware of priority setting tools available to them [ 2- 4].
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