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Overview
Fair Choices on the Path to UHC – In Times of Change (2026–2030) is a flagship initiative of the Ministry of Health, Revolutionary Government of Zanzibar. The project is implemented through the Zanzibar Health Research Institute (ZAHRI) and supported by NORAD through the Bergen Centre for Ethics and Priority Setting (BCEPS), University of Bergen.
The project aims to institutionalize fair, transparent, and evidence-informed priority setting within Zanzibar’s health financing reforms. Its purpose is to ensure that scarce health resources are allocated equitably, efficiently, and sustainably in line with Zanzibar’s Universal Health Coverage (UHC) commitments.
Rather than treating priority setting as a one-time technical exercise, the project builds durable institutional systems that embed economic evidence, ethical frameworks, and stakeholder engagement into routine government decision-making.
Project objectives
What we're working toward.
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Supporting the design, revision, and implementation of the Zanzibar Essential Health Care Package (ZEHCP).
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Institutionalizing the use of the FairChoices tool for economic and equity analysis in national planning.
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Building long-term national capacity in health economics, research, and policy translation (including PhD and Master’s level training).
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Aligning priority setting with Zanzibar’s Health Financing Strategy, including public health insurance reform and strategic purchasing.
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Integrating FairChoices analytics into routine systems, including linkage with DHIS2 through the Health Management Information System (HMIS).
Roadmap
The project roadmap.
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Phase 1
Activity 1: Policy Engagement and Institutional Development
Establishing structured priority-setting processes within government institutions, engaging policymakers and stakeholders, and embedding FairChoices analytics into routine decision-making systems for sustainable institutional capacity.
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Phase 2
Activity 2: Research and Training Capacity Building
Development of national research capacity in health economics and priority setting, including PhD and Master’s level training programs, research mentorship, and institutional strengthening for sustainable analytical capabilities within Zanzibar’s health system.
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Phase 3
Activity 3: Data and Analytics
Integrating FairChoices analytics into routine systems, including linkage with DHIS2 through the Health Management Information System (HMIS), to support evidence-based priority setting and resource allocation.
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Phase 4
Activity 4: Policy Alignment and Sustainability Support
Aligning priority setting with Zanzibar’s Health Financing Strategy, supporting the design and revision of the Zanzibar Essential Health Care Package (ZEHCP), and ensuring public health insurance reform and strategic purchasing integration.
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Phase 5
Activity 5: Compliance and Operational Controls Support
Establishing robust compliance frameworks and operational controls to ensure transparent, accountable, and efficient implementation of priority-setting processes across all project activities.