Priority setting for disease outbreaks in Uganda: A case study evaluating the process

Priority setting (PS) and resource allocation during health emergencies are key factors influencing an effective response. However, there is limited understanding of how priorities and resource allocation during disease outbreaks occur and the extent to which these processes are successful. This paper, based on 23 in-depth interviews with policy makers and a review of policy and emergency preparedness documents, used a PS evaluation framework to evaluate PS for disease outbreaks in Uganda. With regard to PS for disease outbreaks in Uganda, we identified a conducive socio-political-economical context, credible institutions, formal participatory prioritisation processes, evidence informed the processes, demonstrated implementation capacity, institutional strengthening and positive health outcomes. Factors that compromised the success of PS included limited resources - especially in between disease outbreaks and unfair processes. Investment in sustaining the established prioritisation infrastructure to oversee preparedness activities between the outbreaks would strengthen the prioritisation process. This should be supported with health system strengthening. The framework enabled us to evaluate some aspects of PS during disease outbreaks. The framework's inability to evaluate all aspects, and reported as opposed to actual PS calls for the integration of evaluation throughout the planning and implementation process to ensure validity and continuous implementation of improvement strategies.