Bridging the equity gap in maternal and child health: Health systems research is needed to improve implementation

doi:10.1136/bmj.331.7520.844

BMJ 2005;331:844 (8 October), doi:10.1136/bmj.331.7520.844

Letter

Bridging the equity gap in maternal and child health

Health systems research is needed to improve implementation

The first 150 words of the full text of this article appear below.

EDITOR—As an adviser to district health managers on prioritysetting, I am concerned with the constant return to a call formore research on cost effectiveness as the solution to improvedimplementation of health services in developing countries.¹Cost effectiveness information is useful, but it is far fromadequate when a district health manager needs to make a decisionand include stakeholders for priority setting.

To know if one intervention against malaria is more cost effectivethan another against HIV/AIDS, is for all practical purposesuseless information to a district policy maker. This type ofinformation is only really useful when they have to choose betweentwo interventions tackling the same challenge. The districthealth manager is up against a range of stakeholders, all withdiffering values and criteria for setting priorities. Cost effectivenessis only one of them.² Unless they have tools to also measureand include . . . [Full text of this article]