The role of contractual arrangements in improving health sector ...

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Islamic Republic of Iran the product of the experience of industrialized countries’, and its applicability in the context of a developing country such as Islamic Republic of Iran with traditional, religious, fragmented and complex structures, is yet to be determined. At strategic level Justification among top decision-makers about the necessity, importance and usefulness of contracting out; Achieving commitment high-ranked managers and politicians; Providing appropriate, updated and evidence-based legal environment, as well as financial resources, for its successful implementation. At operational level Identification of capable individuals/institutions in private sector as counterpart for contracting; Identification of services purchasable from the private sector; Standardization of delivery of purchasable services; Publicizing necessity for reform in health care/social marketing; Designing and implementing a management information system for recording and evaluating private sector performance; Capacity-building in/empowerment of both the public and private sector, requiring training the right personnel for the purpose of managing contractual arrangements in health services; Capacity-building for teamwork and utilizing other specialties, capacities and capabilities instead of monopolizing reform plans and activities by only one group of professionals (physicians or the others). SOURCES 1. Roberts JM et al. Getting health reform right: a guide to improving performance and equity. Oxford University Press, 2004. 2. Flood MC. International health care reform: a legal, economic and political analysis. London, Routledge, 2000. 3. Palmer N. The use of private-sector contracts for primary health care: theory, evidence and lessons for low-income and middle-income countries. WHO Bulletin, 2000, 78, (6): 821–830. 4. Witter S et al. Health economics for developing countries: a practical guide. BUPA, Macmillan Education Ltd, 2000. 5. Mehryar AH et al. Primary Health Care and Rural Poverty Eradication in the Islamic Republic of Iran. Population Studies and Research Centre for Asia and the Pacific, Working Paper No: 10. 100
Islamic Republic of Iran 6. Shieber JG. (1997), Innovations in Health Care Financing, Proceeding of a World Bank Conference, World Bank Discussion Paper No. 365. 7. Laws and Regulations of MOH and Iran’ s government including: − Article 192 in “Law of the third socio-economic plan 2000-2004”, MPO publications, 2001, Teheran, Iran. − Circular 88, MPO, 2002, Teheran, Iran. 8. Momensaraie M, Pourreza A. The status of economic thinking among hospital managers and decision makers. Journal of School of Public Health, Teheran Medical Sciences University, 2002, 2: 1. 9. Regulations for implementation of Article 192. Teheran, Unit for Health Sector Reform, Ministry of Health and Medical Education, 2003. FURTHER READING Slack K, Savedoff D W. Public purchaser–private provider contracting for health services, examples from Latin America and the Caribbean. Washington, D.C, Inter-American Development Bank, Sustainable Development Department, Technical Papers Series, 2001. McPake B, Hongoro C. Contracting out of clinical services in Zimbabwe, Soc. Sci. Med. 1995, 41(1): 13–24. England R. Contracting and performance management in the health sector: some pointers on how to do it. London, DFDI Health Systems Resource Centre, 2000. McPake B et al. Is the Colombian health system reform improving the performance of public hospitals in Bogota? Health policy and planning, 2003, 18(2). Loevinsohn, B.(?), Practical Issues in Contracting for Primary Health Care Delivery: Lessons from Two Large Projects in Bangladesh, World Bank, USA. Barr D. Research protocol to evaluate the effectiveness of public/private partnerships in enhancing health and welfare systems development. Center for Health Policy, Institute for International Studies, Stanford University, 2004. Jack W. Contracting for health services: an evaluation of recent reforms in Nicaragua. Health policy and planning, 2002, 18(2). 101
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Morocco Draft The role of contractu
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CONTENTS FOREWORD..................
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The role of contractual arrangement
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Islamic Republic of Iran care (incr
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Afghanistan AFGHANISTAN 37
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Current health services delivery Af
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Afghanistan with the staff of the M
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Afghanistan 3) Greater emphasis cou
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Afghanistan Table 2. Implementation
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Provider Strengths Afghanistan •
Page 49 and 50: Bahrain BAHRAIN
Page 51 and 52: Bahrain services to be contracted-o
Page 53 and 54: Bahrain claiming under them respect
Page 55 and 56: Financing Bahrain There is a clear
Page 57 and 58: Bahrain receipt of the invoice. The
Page 59 and 60: Bahrain RESULTS AND DISCUSSION: CAS
Page 61 and 62: Bahrain The competitive bidding pro
Page 63 and 64: Bahrain 11. SMC Cleaning Services C
Page 65 and 66: INTRODUCTION Egypt The health secto
Page 67 and 68: Egypt are governed by their own set
Page 69 and 70: Egypt One of the key objectives of
Page 71 and 72: Egypt Is the legal framework robust
Page 73 and 74: Egypt The opportunity for the HSRP
Page 75 and 76: Egypt The Research Unit includes Fa
Page 77 and 78: Egypt How was the nongovernmental o
Page 79 and 80: Egypt How did the approved list of
Page 81 and 82: Egypt districts, where private and
Page 83 and 84: Egypt Annex 1 Contract copy between
Page 85 and 86: Egypt deposit the fees of opening n
Page 87 and 88: Islamic Republic of Iran ISLAMIC RE
Page 89 and 90: INTRODUCTION Islamic Republic of Ir
Page 91 and 92: Islamic Republic of Iran OVERVIEW O
Page 93 and 94: Delivery Facility Health House Sour
Page 95 and 96: Islamic Republic of Iran PBSC invol
Page 97 and 98: Islamic Republic of Iran authoritie
Page 99: Islamic Republic of Iran From an ad
Page 103 and 104: Medical Sciences University Islamic
Page 105 and 106: Jordan JORDAN
Page 107 and 108: INTRODUCTION Jordan This study docu
Page 109 and 110: Jordan hospital beds in Jordan. In
Page 111 and 112: Jordan health education programmes.
Page 113 and 114: Jordan Benefits by health subsystem
Page 115 and 116: Jordan Table 2. Summary of health e
Page 117 and 118: Jordan ASSESSMENT OF OVERALL CAPACI
Page 119 and 120: Jordan attract foreign investment,
Page 121 and 122: Jordan businesses efficiently. The
Page 123 and 124: Expected risks and incentives Minis
Page 125 and 126: Jordan Table 4. Profile of contract
Page 127 and 128: Fee-for-service contracts Royal Med
Page 129 and 130: Jordan King Abdullah Hospital (KAH)
Page 131 and 132: Strengths Jordan • Provides acces
Page 133 and 134: Jordan • The minimum charge scale
Page 135 and 136: Jordan The main reasons behind the
Page 137 and 138: Jordan • Interviews with the Mini
Page 139 and 140: Jordan • This type of contracting
Page 141 and 142: Jordan CONCLUSIONS AND RECOMMENDATI
Page 143 and 144: Jordan 3. Prospective payment mecha
Page 145 and 146: Jordan Annex 1 CONTRACT/AGREEMENT A
Page 147 and 148: Lebanon LEBANON
Page 149 and 150: Lebanon at their disposal for regul
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Research methods and data sources L
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Lebanon and local municipalities. E
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Lebanon Table 1. Contractual arrang
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Lebanon Table 3. Costs of contractu
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Lebanon performance or mechanisms f
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Lebanon Overall, the contracts allo
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Lebanon belong to the Ministry of S
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Lebanon Perhaps the more obvious di
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Lebanon quality of care in the cont
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Lebanon Correcting this imbalance b
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Lebanon could be a first step towar
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Lebanon Table 5. Scorecard of contr
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Lebanon support for wide reform and
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Lebanon Sabri B et al. Health secto
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INTRODUCTION Morocco During the pas
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Morocco A contractual arrangement i
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Morocco services, as the administra
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Morocco The programme budget is lik
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Morocco According to his Act, each
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Morocco The number of patients curr
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Morocco facilities and the technica
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Morocco Evaluation of the subcontra
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Morocco Annex 2 EVALUATION OF THE E
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Chefchaouen Reassignment of agents,
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Ain Seb. Hay Moh. S. B. Zenata El F
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Pakistan PAKISTAN
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Pakistan To improve the health stat
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Pakistan the government grants a co
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Pakistan The relevant documents wer
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Pakistan Table 1. Examples of contr
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Pakistan Each contract generally sp
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Pakistan services. The specialized
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Pakistan Case study: contractual ar
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Pakistan used in the project to col
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Pakistan GFATM support, and a Natio
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RECOMMENDATIONS Pakistan 1. Conduct
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Pakistan Annex 1 GUIDELINES FOR DIS
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Pakistan Question Discussion points
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INTRODUCTION Tunisia The health ins
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Tunisia hospital facilities may be
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Tunisia the regulations of the mutu
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Tunisia pocket household expenditur
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Tunisia The Tunisian health strateg
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Table 2. Distribution of agreements
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Tunisia Coverage of MRI procedures
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under the agreements, 1995-2004 Tun
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Tunisia Table 5. Beneficiaries (BEN
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Tunisia The National Pension and So
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Tunisia Table 8 shows an increase i
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Tunisia to the private sector. The
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CONCLUSIONS Tunisia Three closely i
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