Table 5. Evaluating the Introduction of HPV and PCV Using the Parameters of Successful Priority Setting .

Immediate Parameter of Successful Priority Setting	HPV	PCV
Efficiency of the priority-setting process	Impossible to determine	Impossible to determine
Allocation of resources according to priorities	Although identified as a priority, HPV was not originally identified as a high priority in HSSIP II.	Identified as a priority in the HSSIP II.
Stakeholder participation	Participation of key stakeholders such as MoH staff and district officers limited	Same as HPV
Use of clear priority setting process/tool/methods	No explicit framework or process used	No explicit framework or process used
Use of Evidence	Evidence from pilot project in 2 districts and several feasibility studies used	Evidence from sentinel surveillance reports and commissioned studies used
Use of explicit and relevant priority setting criteria	Burden of disease, equity used	Burden of disease and cost-effectiveness used
Publicity of priorities and criteria	Media reports about benefits of vaccines, launching of vaccines, however public not informed of exact decision-making processes	Same as HPV
Functional mechanisms for appealing the decisions	None recorded	Same as HPV
Functional mechanisms for enforcement	None recorded	Same as HPV
Fairer priority setting process (a) relevance (b) publicity (c) revisions (d) enforcement	Less fair than for PCV	Fairer than for HPV
Reflection of public values	Impossible to determine	Same as HPV
Increased public awareness of priority setting	Impossible to determine	Same as HPV
Increased public confidence in and acceptance of decisions	Impossible to determine	Same as HPV
Delayed Parameter of Successful Priority Setting
Increased stakeholder understanding, satisfaction and compliance with the priority setting process
(a) Stakeholder understanding	Limited understanding especially at district level	Clearer since they followed due process of implementing HSSIP identified priorities
(b) Stakeholder satisfaction	Dissatisfaction with the introduction of HPV when it was not part of the original plan	General satisfaction since PCV was part of the original HSSIP plan
(c) Stakeholder compliance	Sense that compliance had deteriorated, especially that of donors	Same as HPV
Decreased dissentions	Other than media reports of complaints related to vaccines running out in districts, no complaints recorded	Same as HPV
Decreased resource wastage	Impossible to determine	Same as HPV
Improved internal accountability/reduced corruption	Institutional transparency low since criteria for prioritization thought to be irrelevant	Transparency better but still lacking because of lack of consultative process
Strengthening of the priority setting institution	See strengthening of the healthcare system	See strengthening of the health care system
Impact on institutional goals and objectives	See achievement of health system goals	See achievement of health system goals
Impact on health policy and practice	No impact on health policy but impact on practice since changes in vaccine schedule	Same as HPV
Achievement of health system goals	Contributed to goal of reducing mortality and morbidity	Same as HPV
Improved financial and political accountability	Financial accountability appears to be met for HPV	Respondents reported one instance where the resources where misappropriated but it was rectified. More stringent accountability mechanisms have been instituted
Increased investment in the health sector and strengthening of the health care system	Contextual issues weakened capacity to successfully engage in priority setting	Same as HPV

Abbreviations‏: HPV, Human Papilloma Virus; PCV, pneumococcal conjugate vaccine; HSSIP, Health Sector Strategic and Investment Plan; MoH, Ministry of Health.