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Health Policy Plan. 2015 Apr;30(3):345-55. doi: 10.1093/heapol/czu020. Epub 2014 Apr 15.

Priority setting in HIV/AIDS control in West Java Indonesia: an evaluation based on the accountability for reasonableness framework.

Author information

1
Department of Primary and Community Care, Radboud University Medical Center, Geert Grooteplein Noord No. 21, 6525 EZ Nijmegen, The Netherlands, Medical Research Unit, Faculty of Medicine, Padjadjaran University, Jalan Eijkman No. 28, 40161 Bandung, Indonesia, Department of Economics, Faculty of Economics, Padjadjaran University, Jalan Dipatiukur No. 35, 40132 Bandung, Indonesia and Department of Public Health, Faculty of Medicine, Padjadjaran University, Jalan Eyckman No. 38, 40161 Bandung, Indonesia Department of Primary and Community Care, Radboud University Medical Center, Geert Grooteplein Noord No. 21, 6525 EZ Nijmegen, The Netherlands, Medical Research Unit, Faculty of Medicine, Padjadjaran University, Jalan Eijkman No. 28, 40161 Bandung, Indonesia, Department of Economics, Faculty of Economics, Padjadjaran University, Jalan Dipatiukur No. 35, 40132 Bandung, Indonesia and Department of Public Health, Faculty of Medicine, Padjadjaran University, Jalan Eyckman No. 38, 40161 Bandung, Indonesia Noor.Tromp@radboudumc.nl.
2
Department of Primary and Community Care, Radboud University Medical Center, Geert Grooteplein Noord No. 21, 6525 EZ Nijmegen, The Netherlands, Medical Research Unit, Faculty of Medicine, Padjadjaran University, Jalan Eijkman No. 28, 40161 Bandung, Indonesia, Department of Economics, Faculty of Economics, Padjadjaran University, Jalan Dipatiukur No. 35, 40132 Bandung, Indonesia and Department of Public Health, Faculty of Medicine, Padjadjaran University, Jalan Eyckman No. 38, 40161 Bandung, Indonesia.
3
Department of Primary and Community Care, Radboud University Medical Center, Geert Grooteplein Noord No. 21, 6525 EZ Nijmegen, The Netherlands, Medical Research Unit, Faculty of Medicine, Padjadjaran University, Jalan Eijkman No. 28, 40161 Bandung, Indonesia, Department of Economics, Faculty of Economics, Padjadjaran University, Jalan Dipatiukur No. 35, 40132 Bandung, Indonesia and Department of Public Health, Faculty of Medicine, Padjadjaran University, Jalan Eyckman No. 38, 40161 Bandung, Indonesia Department of Primary and Community Care, Radboud University Medical Center, Geert Grooteplein Noord No. 21, 6525 EZ Nijmegen, The Netherlands, Medical Research Unit, Faculty of Medicine, Padjadjaran University, Jalan Eijkman No. 28, 40161 Bandung, Indonesia, Department of Economics, Faculty of Economics, Padjadjaran University, Jalan Dipatiukur No. 35, 40132 Bandung, Indonesia and Department of Public Health, Faculty of Medicine, Padjadjaran University, Jalan Eyckman No. 38, 40161 Bandung, Indonesia.

Abstract

BACKGROUND:

Indonesia has insufficient resources to adequately respond to the HIV/AIDS epidemic, and thus faces a great challenge in prioritizing interventions. In many countries, such priority setting processes are typically ad hoc and not transparent leading to unfair decisions. Here, we evaluated the priority setting process in HIV/AIDS control in West Java province against the four conditions of the accountability for reasonableness (A4R) framework: relevance, publicity, appeals and revision, and enforcement.

METHODS:

We reviewed government documents and conducted semi-structured qualitative interviews based on the A4R framework with 22 participants of the 5-year HIV/AIDS strategy development for 2008-13 (West Java province) and 2007-11 (Bandung).

RESULTS:

We found that criteria for priority setting were used implicitly and that the strategies included a wide range of programmes. Many stakeholders were involved in the process but their contribution could be improved and particularly the public and people living with HIV/AIDS could be better engaged. The use of appeal and publicity mechanisms could be more transparent and formally stated. Public regulations are not yet installed to ensure fair priority setting.

CONCLUSIONS:

To increase fairness in HIV/AIDS priority setting, West Java should make improvements on all four conditions of the A4R framework.

KEYWORDS:

Accountability for reasonableness; HIV/AIDS control; Indonesia; priority setting

PMID:
24740708
DOI:
10.1093/heapol/czu020
[Indexed for MEDLINE]

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