# Health Project Prioritization in Meta, Colombia, Using Anp-Dematel
## 6 Conclusions  
This article employed a Multicriteria Decision-Making (MCDM) approach--integrating ANP and DEMATEL--to prioritize health projects in Meta. The replacement of Puerto Gait's healthcare center (A05) was ranked highest, followed by the expansion of Acacias' municipal hospital (A04) and the creation of an emergency regulation center. Correlation analysis revealed a strong link between hospital expansion and reduced unmet basic needs, highlighting the interplay between social determinants and healthcare infrastructure. The high consistency in expert rankings underscores the robustness of the ANP-DEMATEL model.  
A relevant methodological limitation identified in this study is the partial disconnect between the highest-weighted criterion (C4.1: reduction of the population with Unmet Basic Needs) and the evaluated alternatives, which do not explicitly address it. Although the ANP-DEMATEL model captured indirect influences between criteria--thereby reflecting some of the impact of alternatives such as A05 and A04 on improving structural conditions--this lack of direct alignment between strategic objectives and proposed actions may affect the interpretation of results. It is recommended that future applications reinforce the conceptual correspondence between high-priority criteria and selected projects through an intermediate portfolio validation stage. This experience demonstrates the utility of the ANP-DEMATEL approach not only for modeling interdependencies but also for revealing potential gaps between strategic intent and the technical execution of decisions.  
Sensitivity analysis confirmed the stability of results under a 10% variation in weight assignments, reinforcing the methodology's reliability for public health planning. From a policy standpoint, integrated resource allocation--prioritizing accessibility and equity--is essential. Stakeholder inclusion enhances transparency, though a key limitation was the limited availability of some experts. We recommend replicating this approach in other Colombian regions to assess broader applicability. Further methodological refinements could combine MCDM with cost-benefit analysis and predictive modeling for healthcare infrastructure planning.  
These priorities, validated through the participation of 42 institutional stakeholders and formally shared with them, provide a strategic roadmap to guide public health investment in Meta. They are expected to optimize the social return on allocated resources and reduce structural inequities in access to essential services.  
(CRediT taxonomy): A.L.-C.: Conceptualization, Methodology, Software, Validation, Formal Analysis, Investigation, Resources, Data Curation, Writing--Original Draft, Visualization, Project Administration, Funding Acquisition. S.G.-R.: Conceptualization, Validation, Writing--Review and Editing, Supervision, Funding Acquisition. All authors have read and agreed to the published version of the manuscript.  
This research was funded by Universidad de los Llanos, project number C09-F05-016-2021. The APC was funded by Universidad de los Llanos.  
This non-interventional study adhered to the ethical principles of the Declaration of Helsinki (1975, revised in 2013). As no personal or clinical data were collected, formal ethical review was waived.  
Informed Consent Statement: Informed consent was obtained from all subjects involved in the study, and principles of voluntariness, anonymity, and confidentiality were strictly followed.  
The data supporting this study are available from the corresponding author upon reasonable request.  
The authors declare no conflicts of interest.