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

The role of contractual arrangements in improving health sector performance
Table 3. Assessment of an intervention with contractual arrangements
Country Project/programme
selected
Non-clinical services
Bahrain Contracting out of
non-clinical services
Morocco Contracting out of
maintenance in
hospitals
Syrian Arab
Republic
Contracting out of
maintenance in
hospitals
Primary care services
Afghanistan Contracting out of
PHC services
Egypt Contracting through
Family Health Fund
Islamic
Republic of
Iran
Contracting out by
medical universities
Lebanon Contracting out of
primary care services
Purchaser Provider Contract
Intervention
MOH Private sector Maintenance of
medical equipment
SEGMA
Hospital
Centres
Private
providers
MOH Private
providers
MOH
Donor
agencies
International
and national
NGOs
MOH District
provider
organizations,
private
providers
Medical
Universities
Private
providers
Non-clinical
services: catering,
security gardening,
bandage
Maintenance and
cleaning of
hospitals in three
governorates
Delivery of basic
pack age of health
services
Package of primary
health care services
Variable – 45
clinical and 10
non-clinical
services
MOH NGOs Primary care
service package
26
Population
covered
Payment methods Performance
indicators
Not applicable Block payments
made on quarterly
instalments
Not applicable 10%–40% of
annual budget
Not applicable Agreed payment
made quarterly
16.5 million Capitation at US$
4.5 as the cost of
BPHS
Five pilot
governorates
covering 5.0
million
Not clearly
defined
Fee-for-service
Some piloting with
capitation
Block payment
Cost–volume
contracts
50% eligible Reimbursement on
fee-for-service
Standards of
service stipulated
in contract
Not well defined
Indicators related
to timeliness and
quality of cleaning
Based on BPHS
Monitoring
system unclear
11 monitoring
indicators
Elaborate system
of performance
evaluation,
None specified