Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
C
URRENT
O
PINION
Priority setting in otolaryngology practices
in Zimbabwe
Clemence Chidziva
a,b
and Nyarai D. Soko
b,c
Purpose of review
This article describes priority setting in otorhinolaryngology healthcare services in Zimbabwe. It aims to
initiate discussion on priority setting among otorhinolaryngologists working in African countries.
Recent findings
The WHO reports that most developed countries have formal processes in place for the collection and
analysis of information that is used in priority setting in healthcare services. However, many resource-
limited nations lack well-defined processes for priority setting. Information surrounding priority setting in
otorhinolaryngology in particular is scarce.
Summary
Priority setting refers to the distribution of limited resources among competing programmes and patient or
patient groups in an equitable and just manner. A dearth of information on priority setting in
otorhinolaryngology exists. This silence is more pronounced in African settings. Despite the myriad of
challenges facing many African countries, formal guidelines for priority setting are rare. Priority setting
therefore is often haphazard and unplanned. We therefore recommend agility in bringing together
otorhinolaryngology stakeholders in an effort to initiate dialogue and come up with formal processes that
will collect information that will lead to provision of guidelines in priority setting.
Keywords
otorhinolaryngology, priority setting, rationing care, resources, Zimbabwe
INTRODUCTION
Health systems globally have an uphill task in meet-
ing the needs of patients on a backdrop of limited or
even dwindling resources [1,2]. Disease burden,
especially in developing nations, tends to be larger
than the ability of health systems to adequately
provide much-needed healthcare in adequate
amounts [2]. Limited resources therefore pose a
dilemma about which patient is treated first and
how each patient is treated. Health services are
forced into priority setting in order to stretch resour-
ces. Priority setting, also called ‘rationing’ or
‘resource allocation’ [3], is fundamental in deliver-
ing healthcare to any population. Priority setting in
healthcare services refers to the distribution of
resources among competing programmes and
patient or patient groups [4]. Priority setting could
be seen to answer the question, who gets what and at
whose expense [5].
Well-developed and implemented priority set-
ting guidelines have the advantages of enhancing
budgeting and management of scarce resources [6];
they provide channels for the involvement of
necessary stakeholders [7] and keep the public
informed. They can also enable equitable service
delivery [8]. However, priority setting can be per-
ceived as a decision regarding which patient is
treated first and which patient gets what type of
treatment [9], potentially affecting doctor–patient
relationships. Priority setting may also open chan-
nels for manipulation of health systems [9,10]. The
fundamental goal of priority setting in healthcare is
to ensure equitable distribution of services includ-
ing treatment and management of all individuals.
Ideally, priority setting should be based on the view
that all individuals have an intrinsic value regardless
of their ethnic background, age, sex, religion, socio-
economic status, level of functionality, place of
residence or even relationship status [9].
a
Department of Surgery, Faculty of Sciences, University of Zimbabwe,
b
Audiomax Clinic, Baines Avenue and
c
Department of Biochemistry,
Faculty of Science, University of Zimbabwe, Harare, Zimbabwe
Correspondence to Clemence Chidziva, Department of Surgery, Faculty
of Medicine, University of Zimbabwe, Harare 0000, Zimbabwe.
Tel: +263772135657; e-mail: cchidziva@audiomaxclinic.com
Curr Opin Otolaryngol Head Neck Surg 2019, 27:207–211
DOI:10.1097/MOO.0000000000000537
1068-9508 Copyright ß 2019 Wolters Kluwer Health, Inc. All rights reserved. www.co-otolaryngology.com
REVIEW