Salient stakeholders: Using the salience stakeholder model to assess stakeholders’ influence in healthcare priority setting

Stakeholders play an important role in health priority setting, and their roles have been discussed in the literature, mainly in relationship to their power. An emerging body of literature is focusing on the legitimacy of the stakeholders. Using the case of the Uganda health system, the overall aim of this paper is to assess the utility of the salience stakeholder analysis framework in identifying the most salient stakeholders in health-care priority setting. Methods: This was a qualitative case study involving 57 key informant interviews with national and district level policy makers and a review of policy documents. Interview data were analyzed using QSR NVivo10 qualitative data analysis software. Analysis was guided by the salience stakeholder analysis framework. Findings: Among the eight groups of stakeholders identified by the respondents, the politicians were found to be the most salient stakeholders. However, stakeholders' salience varied depending on the type of decision, the nature of health issue and how and who tabled the health issue. Conclusion: The salience stakeholder analysis framework, originating from the business management and political science disciplines, provided a more comprehensive stakeholder analysis by supporting the concurrent consideration of power, legitimacy and urgency in stakeholder analysis for health care priority setting.