Strategic purchasing of high-priority services is a critical part effective spending to advance UHC goals. Available conceptual frameworks for strategic have facilitated high-level advocacy and policy dialogue, they framed research analytical work describe understand countries' arrangements. What has been missing framework approach that combines the framing with practical guidance assess in sufficient detail inform policy.This paper presents tracking progress purchasing: Health Purchasing...

This paper emphasizes the importance of orienting health system reforms to address underlying system-level performance problems. Too often in practice, objective-orientation that is stressed frameworks gets lost relation policies or schemes are promoted without plausible linkages actual objectives reforms. The can also get subsumed by political agendas disconnected, even detract from, people's needs. There three core attributes objective-oriented reform: (i) problem-oriented; (ii) consistent...

In this commentary, two members of the technical teams that led Kenyan health reforms reflect on progress made in country's journey toward universal coverage during President Uhuru Kenyatta's second term (2017 to 2022). The authors discuss how key decisions were while balancing multiple considerations such as: maintaining fidelity achieve objectives, accounting for context previous reforms, and making necessary trade-offs between political pressures. They share three lessons, contextualized...

The Strategic Purchasing Africa Resource Center (SPARC) developed a framework for tracking strategic purchasing that uses functional and practical approach to describe, assess, strengthen facilitate policy dialogue within countries. This was applied in nine African countries assess their progress on purchasing. paper summarizes overarching lessons from the experiences of In each country, researchers populated Microsoft Excel–based matrix using data collected through document reviews key...

In the context of scarce resources and increasing health care costs, strategic purchasing is viewed as a key mechanism to spur countries' progress toward universal coverage (UHC), by using limited more effectively. We applied Strategic Health Purchasing Progress Tracking Framework examine arrangements in three financing schemes Rwanda—the Community Based Insurance (CBHI) scheme, Rwanda Social Security Board (RSSB) medical performance-based (PBF). Data were collected from secondary primary...

To make progress toward universal health coverage (UHC), most countries need to commit more public resources health. However, can also by using available effectively. Health purchasing, one of the financing functions systems, is transfer pooled funds providers deliver covered services. Purchasers be either passive or strategic in how they these funds. Strategic purchasing deliberately directing priority populations, interventions, and services, actively creating incentives so are used...

For Nigeria to make progress on its commitment universal health coverage, additional public funding will be required. But more resources alone not enough. Government spending must efficient and effective, through strategic purchasing-a critical policy tool. Studies purchasing in Nigeria's financing schemes are limited, however. This study examines the arrangements funded by federal budget Formal Sector Social Health Insurance Programme (FSSHIP) within National Scheme. We adopted a...

Following the devastating 1994 Genocide, Government of Rwanda and its citizens have worked relentlessly to rebuild country reassemble a strong health system. Immediately after genocide, global development partners sought swiftly provide aid support address urgent system needs. However, inadequate coordination influx resulted in duplicated efforts inefficient sector management. In 1998, Central Public Investments External Finance Bureau undertook monitoring evaluation donor-funded projects...

Several purchasing arrangements coexist in Uganda, creating opportunities for synergy but also leading to conflicting incentives and inefficiencies resource allocation functions. This paper analyzes the key health care functions Uganda implications of various universal coverage (UHC). The data this were collected through a document review stakeholder dialogue. analysis was guided by Strategic Health Purchasing Progress Tracking Framework created Africa Resource Center (SPARC) its technical...

Primary care facilities' autonomy and the factors that influence it are understudied. Direct facility financing (DFF) is gaining popularity in low- middle-income countries as a modality to finance primary facilities. Tanzania has introduced DFF with objectives of streamlining resource allocation, fostering fiscal decentralization, granting health facilities for enhanced service readiness responsiveness. This study aims contribute evidence on execute funds influencing this autonomy.

Cross-programmatic inefficiencies are duplications or misalignments that arise from undue fragmentation of health systems by vertical programs. Identifying and addressing the root causes cross-programmatic in a system can ensure more efficient use resources to make progress toward Universal Health Coverage. This paper examines related governance financing state Anambra southeast Nigeria. Data were collected 38 in-depth interviews four focus group discussions analyzed thematically. The...

Ethiopia has made great strides in improving population health but sustaining system and improvements the current fiscal environment is challenging. Provider payment, as a function of purchasing, tool to use limited resources better. This study describes design implementation Ethiopia's provider payment mechanisms (PPMs) how they influence objectives contribute universal coverage goals. The research team adapted framework analytical tools Joint Learning Network for Universal Health Coverage...

The promise of contributory health insurance to generate additional, self-sustaining funding for the sector has not been achieved in many low- and lower-middle-income countries. Instead, found exacerbate inequities access care because entitlements are linked contributions. For these countries with schemes, separate institutional arrangements revenue collection purchasing, that operate alongside budget-funded other financing it is usually politically or technically feasible reverse eliminate...

Strategic purchasing means deliberately directing health funds to priority populations, interventions, and services. This is done by actively creating incentives so funding used equitably efficiently aligned with population needs. a complex policy area fraught challenging technical, institutional, political issues. Policy makers practitioners are an important source of tacit knowledge—experiential knowledge that context specific gained over time. Collaborative learning, through which group...

Embodied in the goals of universal health coverage (UHC) are societal norms about ethics, equity, solidarity, and social justice. As African countries work toward UHC, it is important for their governments to use all available resources, knowledge, networks continue bring this goal closer reality populations. The Strategic Purchasing Africa Resource Center (SPARC) was established 2018 as a "go-to" source Africa-based expertise strategic purchasing, which critical policy tool making more...