Abstract

The conditions under which organisations operate in the twenty-first century environment have become complex owing to a number of factors. Most organisations are forced to operate on serious budget shortfalls, a situation which has necessitated prioritising activities. The health sector is no exception. In line with this, the Ministry of Health (MoH) in Malawi adopted the process of priority setting in its hospitals so as to ensure efficiency and effectiveness in the distribution of resources. This study evaluated the extent to which the process of priority setting at Zomba Central Hospital, ZCH, adheres to ethical requirements. Specifically, it examined the degree to which the priority setting practices at this hospital can be said to be ethically justified by comparing the practices against the tenets in the ethical framework known as accountability for reasonableness (A4R). To attain its objectives, the study employed a qualitative case study research design where data was collected through in-depth interviews, focus group discussions (FDGs) and document reviews. The study identified three priority setting processes that are practised at ZCH, namely; planning and budgeting, medicine selection, and nurse allocation. The study revealed that priority setting practices at ZCH contain some ethical aspects that are in tandem with the A4R framework. However, the processes do not completely adhere to the requirements of the accountability for reasonableness when setting its priorities. The study, therefore, concludes that the A4R framework is indispensable in both examining ethical aspects of priority settings as well as in averting problems arising from a weak ethical base. It also reflects on areas for further research, to enhance strategies that can help inculcate ethical culture in the Malawian health delivery system.

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School	: School of Arts, Communication and Design
Issued Date	: 2019

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