An empirical study of health planning in Latin America and Africa

Abstract

This study analyzes the impact which underlying social and economic forces have on the objectives of health planning and the techniques employed in resource allocation decisions in the health sector. Data drawn from twenty-seven countries are used to analyze the interaction between social and economic forces, the health planning process and ultimate resource allocation decisions in the health sector. The first issue studied is the objective function of the health sector for countries in Latin America and Africa. Subsequent planning techniques employed, types of data gathered and the focus of analysis and, of course, political commitment to implementation are all ultimately predicated on the underlying objective functions. Next, a brief review of various methodologies used by health planners is presented and the way in which these methodologies have been used in Latin America and Africa is analyzed with particular reference to the influence of a country's general socio-economic mileau on (a) the objective function enunciated by health planners and (b) the types of methodologies employed as resource allocation tools. A case study of Tanzania's health planning process since the 1967 Arusha declaration is presented. The study analyzes Tanzania's changed health care priorities and the consistency of these with the country's general economic development thrust. The final section of the paper summarizes the empirical analyses and discusses the ways in which health planning may be a channel through which a more systematic process of decision making can be incorporated into general economic development in developing countries. The issue of political commitment to implementation of the outcomes of the health planning process is highlighted.