Abstract:
Background: Successful priority setting is increasingly known to be an important aspect in achieving better family
planning, maternal, newborn and child health (FMNCH) outcomes in developing countries. However, far too little
attention has been paid to capturing and analysing the priority setting processes and criteria for FMNCH at district
level. This paper seeks to capture and analyse the priority setting processes and criteria for FMNCH at district level
in Tanzania. Specifically, we assess the FMNCH actor’s engagement and understanding, the criteria used in decision
making and the way criteria are identified, the information or evidence and tools used to prioritize FMNCH
interventions at district level in Tanzania.
Methods: We conducted an exploratory study mixing both qualitative and quantitative methods to capture and
analyse the priority setting for FMNCH at district level, and identify the criteria for priority setting. We purposively
sampled the participants to be included in the study. We collected the data using the nominal group technique
(NGT), in-depth interviews (IDIs) with key informants and documentary review. We analysed the collected data
using both content analysis for qualitative data and correlation analysis for quantitative data.
Results: We found a number of shortfalls in the district’s priority setting processes and criteria which may lead to
inefficient and unfair priority setting decisions in FMNCH. In addition, participants identified the priority setting
criteria and established the perceived relative importance of the identified criteria. However, we noted differences
exist in judging the relative importance attached to the criteria by different stakeholders in the districts.
Conclusions: In Tanzania, FMNCH contents in both general development policies and sector policies are well
articulated. However, the current priority setting process for FMNCH at district levels are wanting in several aspects
rendering the priority setting process for FMNCH inefficient and unfair (or unsuccessful). To improve district level
priority setting process for the FMNCH interventions, we recommend a fundamental revision of the current FMNCH
interventions priority setting process. The improvement strategy should utilize rigorous research methods
combining both normative and empirical methods to further analyze and correct past problems at the same time
use the good practices to improve the current priority setting process for FMNCH interventions. The suggested
improvements might give room for efficient and fair (or successful) priority setting process for FMNCH
interventions.
