Priority Setting in Low Income Countries: The Roles and Legitimacy of Development Assistance Partners

Priority setting presents one of the biggest challenges policy makers in low-income countries have to deal with on a daily basis. Extreme lack of resources in these contexts introduces non-state stakeholders whose priorities may not necessarily reflect the national priorities. This raises concerns about the legitimacy of the non-state stakeholders' involvement in priority setting. To date, the meagre literature on priority setting in low-income countries has not focused on the question of the legitimacy of the non-state stakeholders, specifically, the development partners. This article fills this gap in the literature. We provide an overview of some of the health sector priority setting approaches, of relevance to low-income countries, including the processes, the stakeholders and their roles, and the priority setting challenges. These factors are explored, in-depth, using the case of Uganda. The sources of legitimacy of development assistance partners' involvement in priority setting is assessed based on current literature on sources of legitimacy and legitimacy in priority setting. The article concludes that both the government and development assistance partners need to work together to foster and maintain their legitimacy through; having fair priority setting processes with wide representation of all relevant stakeholders, explicit priority setting processes and a balance of decision making powers with commitment to accountability and transparency.