Global Health Priorities
Bedside rationing and priority setting

Resource scarcity requires difficult choices in Ethiopia

Nine out of ten physicians have regretted their choice of profession due to lack of resources and difficult rationing dilemmas.

picture of doctor at his desk
Resource scarcity requires difficult choices for physicians.

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In a new paper recently published in BMC Health Services Research, Frehiwot Berhane Defaye and collegues have done a survey of Ethiopian physicians' experiences of bedside rationing. Defaye is a PhD candidate in the Global Health Priorities Research Group and main author of the paper, where also associate professor Ingrid Miljeteig and professor Ole Frithjof Norheim contributed.

The main findings from the survey was that rationing dilemmas due to resource scarcity are very common. 99% of the participants claimed that scarcity of resources required them to make difficult choices. Two out of three physicians restricted treatment to patients for the benefit of other patients who could gain more from the treatment. Limited availability of referrals to surgery, specialists and ICU beds, prescriptions of drugs and hospital beds were most frequently experienced on a daily or weekly basis.

Over half of the physicians experienced adverse consequences for their patients on a weekly basis due to limited resources in the health care system, and more than one third of the physicians regreted their choice of profession because of this scarcity.

The work of Defaye and collegues is important in the Ethiopian setting, as studies on clinical priority setting and bedside rationing have mainly been done in an high-income setting. The article is part of a larger project on this subject, called 'Values at the Bedside in Ethiopia'. The research groupwarmly congratulate.


Defaye, F., D. Desalegn, M. Danis, S. Hurst, Y. Berhane, O. Norheim and I. Miljeteig (2015). "A survey of Ethiopian physicians' experiences of bedside rationing: extensive resource scarcity, tough decisions and adverse consequence BMC Health Services Research 15(1): 467.