Searching for Essential Health Services in Low- and Middle-Income Countries: A Review of Recent Studies on Health Priorities

The main focus of this paper is the application of explicit criteria to set health priorities in lending projects and sector work. It draws lessons from 24 studies undertaken in low- and middle-income countries from 1993 to 1996. The paper describes the main characteristics of the studies, assesses their technical quality and policy relevance, and summarizes the first two stages which culminated with the publication of the 1993 World Development Report: Investing in Health (World Bank 1993). The paper is organized into six chapters: Chapter I summarizes the logic behind setting health priorities and briefly reviews their antecedents through explicit criteria. Chapter II describes the main characteristics of the studies. Chapters III and IV focus on the evaluation of information, methods and indicators to set priorities and design packages of essential health services. Chapter V reports on the main disease priorities and the results of cost effectiveness analyzes. Finally, and lastly, Chapter VI identifies research and development needs to improve future studies.