Applying the Strategic Health Purchasing Progress Tracking Framework: Lessons from Nine African Countries
ABSTRACTThe Strategic Purchasing Africa Resource Center (SPARC) developed a framework for tracking strategic purchasing that uses a functional and practical approach to describe, assess, and strengthen purchasing to facilitate policy dialogue within countries. This framework was applied in nine Afri...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-03-01
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| Series: | Health Systems & Reform |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/23288604.2022.2051796 |
| _version_ | 1811173695537807360 |
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| author | Agnes Gatome-Munyua Isidore Sieleunou Edwine Barasa Freddie Ssengooba Kaboré Issa Sabine Musange Otieno Osoro Suzan Makawia Christelle Boyi-Hounsou Eugenia Amporfu Uchenna Ezenwaka |
| author_facet | Agnes Gatome-Munyua Isidore Sieleunou Edwine Barasa Freddie Ssengooba Kaboré Issa Sabine Musange Otieno Osoro Suzan Makawia Christelle Boyi-Hounsou Eugenia Amporfu Uchenna Ezenwaka |
| author_sort | Agnes Gatome-Munyua |
| collection | DOAJ |
| description | ABSTRACTThe Strategic Purchasing Africa Resource Center (SPARC) developed a framework for tracking strategic purchasing that uses a functional and practical approach to describe, assess, and strengthen purchasing to facilitate policy dialogue within countries. This framework was applied in nine African countries to assess their progress on strategic purchasing. This paper summarizes overarching lessons from the experiences of the nine countries. In each country, researchers populated a Microsoft Excel–based matrix using data collected through document reviews and key informant interviews conducted between September 2019 and March 2021. The matrix documented governance arrangements; core purchasing functions (benefits specification, contracting arrangements, provider payment, and performance monitoring); external factors affecting purchasing; and results attributable to the implementation of these purchasing functions. SPARC and its partners synthesized information from the country assessments to draw lessons applicable to strategic purchasing in Africa. All nine countries have fragmented health financing systems, each with distinct purchasing arrangements. Countries have made some progress in specifying a benefit package that addresses the health needs of the most vulnerable groups and entering into selective contracts with mostly private providers that specify expectations and priorities. Progress on provider payment and performance monitoring has been limited. Overall, progress on strategic purchasing has been limited in most of the countries and has not led to large-scale health system improvements because of the persistence of out-of-pocket payments as the main source of health financing and the high degree of fragmentation, which limits purchasing power to allocate resources and incentivize providers to improve productivity and quality of care. |
| first_indexed | 2024-04-10T17:51:21Z |
| format | Article |
| id | doaj.art-ee75c22238fb4fb591614b8d372f402f |
| institution | Directory Open Access Journal |
| issn | 2328-8604 2328-8620 |
| language | English |
| last_indexed | 2024-04-10T17:51:21Z |
| publishDate | 2022-03-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Health Systems & Reform |
| spelling | doaj.art-ee75c22238fb4fb591614b8d372f402f2023-02-02T21:30:22ZengTaylor & Francis GroupHealth Systems & Reform2328-86042328-86202022-03-018210.1080/23288604.2022.2051796Applying the Strategic Health Purchasing Progress Tracking Framework: Lessons from Nine African CountriesAgnes Gatome-Munyua0Isidore Sieleunou1Edwine Barasa2Freddie Ssengooba3Kaboré Issa4Sabine Musange5Otieno Osoro6Suzan Makawia7Christelle Boyi-Hounsou8Eugenia Amporfu9Uchenna Ezenwaka10Department of Health Portfolio Results for Development, P.O.Box 389 - 00621 Nairobi, KenyaDepartment of Health Research, Research for Development International, Yaounde, CameroonHealth Economics Research Unit, KEMRI Wellcome Trust Research Programme, Nairobi, KenyaDepartment of Health Policy Planning & Management, Makerere University School of Public Health, Kampala, UgandaDepartment of Health Research, Recherche pour la Santé et le Développement (RESADE), Ougadougou, Burkina FasoSchool of Public Health, University of Rwanda, Kigali, RwandaDepartment of Economics, University of Dar es Salaam, Dar es Salaam, TanzaniaDepartment of Health System, Policy and Economic Evaluations Ifakara Health Institute, Dar es Salaam, TanzaniaDepartment of Health Research Centre de Recherche en Reproduction Humaine et en Démographie (CERRHUD), Cotonou, BeninDepartment of Economics, Kwame Nkrumah University of Science and Technology, Kumasi, GhanaHealth Policy and Research Group, University of Nigeria, Enugu, NigeriaABSTRACTThe Strategic Purchasing Africa Resource Center (SPARC) developed a framework for tracking strategic purchasing that uses a functional and practical approach to describe, assess, and strengthen purchasing to facilitate policy dialogue within countries. This framework was applied in nine African countries to assess their progress on strategic purchasing. This paper summarizes overarching lessons from the experiences of the nine countries. In each country, researchers populated a Microsoft Excel–based matrix using data collected through document reviews and key informant interviews conducted between September 2019 and March 2021. The matrix documented governance arrangements; core purchasing functions (benefits specification, contracting arrangements, provider payment, and performance monitoring); external factors affecting purchasing; and results attributable to the implementation of these purchasing functions. SPARC and its partners synthesized information from the country assessments to draw lessons applicable to strategic purchasing in Africa. All nine countries have fragmented health financing systems, each with distinct purchasing arrangements. Countries have made some progress in specifying a benefit package that addresses the health needs of the most vulnerable groups and entering into selective contracts with mostly private providers that specify expectations and priorities. Progress on provider payment and performance monitoring has been limited. Overall, progress on strategic purchasing has been limited in most of the countries and has not led to large-scale health system improvements because of the persistence of out-of-pocket payments as the main source of health financing and the high degree of fragmentation, which limits purchasing power to allocate resources and incentivize providers to improve productivity and quality of care.https://www.tandfonline.com/doi/10.1080/23288604.2022.2051796Africahealth purchasingpurchasing frameworkstrategic health purchasingstrategic Health Purchasing Progress Tracking Framework |
| spellingShingle | Agnes Gatome-Munyua Isidore Sieleunou Edwine Barasa Freddie Ssengooba Kaboré Issa Sabine Musange Otieno Osoro Suzan Makawia Christelle Boyi-Hounsou Eugenia Amporfu Uchenna Ezenwaka Applying the Strategic Health Purchasing Progress Tracking Framework: Lessons from Nine African Countries Health Systems & Reform Africa health purchasing purchasing framework strategic health purchasing strategic Health Purchasing Progress Tracking Framework |
| title | Applying the Strategic Health Purchasing Progress Tracking Framework: Lessons from Nine African Countries |
| title_full | Applying the Strategic Health Purchasing Progress Tracking Framework: Lessons from Nine African Countries |
| title_fullStr | Applying the Strategic Health Purchasing Progress Tracking Framework: Lessons from Nine African Countries |
| title_full_unstemmed | Applying the Strategic Health Purchasing Progress Tracking Framework: Lessons from Nine African Countries |
| title_short | Applying the Strategic Health Purchasing Progress Tracking Framework: Lessons from Nine African Countries |
| title_sort | applying the strategic health purchasing progress tracking framework lessons from nine african countries |
| topic | Africa health purchasing purchasing framework strategic health purchasing strategic Health Purchasing Progress Tracking Framework |
| url | https://www.tandfonline.com/doi/10.1080/23288604.2022.2051796 |
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