Shelton in the BMJ

Reviewed by Josefien Van Olmen

“The global marketplace of innovation and advocacy for health interventions will continue to be dynamic, turbulent and often passionate”. The author of this ‘analytical paper’ in the BMJ tries to provide a framework to decide on priorities for health interventions in resource limited settings. Framed in such a relative short, very readable paper in a high profile journal, I have not often read something comparable. It is not that Shelton, who works at the US agency for international development, has invented a groundbreaking way of thinking. Although some of his criteria – such as durability and the commercial sector compatibility – are not often mentioned, many of others are commonly accepted principles for priority-setting, reflecting effectiveness, efficiency and acceptability. It is laudable that Sheldon applies his framework to 3 concrete examples, to show the applicability of it. Though his examples are still rather clear-cut, many other – more complex or more comprehensive – interventions, such as availability of emergency obstetric care – are more difficult to appraise according to his scales.

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