Lebanon - What is GIS - World Health Organization
Lebanon - What is GIS - World Health Organization
Lebanon - What is GIS - World Health Organization
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<strong>Lebanon</strong> Role of contractual arrangements in improving health system performance<br />
attitudes, practices by contracting partners, and areas where data needs to be collected, become<br />
important in itself and th<strong>is</strong> has been the approach taken here.<br />
Many of the major determinants of health lie outside the health sector. Choices and<br />
contents of contractual arrangements are directly affected by the positions of regulating bodies<br />
(i.e. government) on the relevance of broad determinants to health and health sector<br />
performance. Such determinants are rarely reflected, however, in d<strong>is</strong>cussions of contractual<br />
arrangements. Analyzing contractual arrangements in light of sociopolitical determinants<br />
requires understanding of the performance of the Lebanese economy and social and political<br />
organization. While such a broad analys<strong>is</strong> may be beyond our focus, they constitute the context<br />
within which contractual arrangements must be understood. As such, an attempt must be made to<br />
bring these perspectives in d<strong>is</strong>cussions of contractual arrangements. The Report attempts to do so<br />
in a modest way.<br />
If “health sector” <strong>is</strong> interpreted broadly to mean “health system”, then contractual<br />
arrangements must be evaluated in a much broader context. Th<strong>is</strong> would necessitate evaluation of<br />
how contractual arrangements relate not only to health care delivery but also to performance of<br />
other, broader, components of the health system, such as nutrition and basic social services.<br />
Because th<strong>is</strong> endeavour <strong>is</strong> potentially complex and very wide in scope, limited reference <strong>is</strong> made<br />
to health system <strong>is</strong>sues beyond care delivery.<br />
While there are opportunities to improve the use of contractual arrangements as a tool,<br />
recommendations for so doing cannot be separated from the broader <strong>is</strong>sues of health sector<br />
reform in <strong>Lebanon</strong>. A detailed consideration of health sector reform in <strong>Lebanon</strong> <strong>is</strong> beyond the<br />
focus of th<strong>is</strong> report. However, an attempt <strong>is</strong> made to contextualize recommendations for<br />
improving use of contractual arrangements in relation to previously made recommendations for<br />
health sector reform in <strong>Lebanon</strong>.<br />
Considering the sheer number and breadth of contractual arrangements in <strong>Lebanon</strong>, there<br />
are multiple ways of classifying and summarizing these arrangements. Th<strong>is</strong> can be done<br />
according to which agency <strong>is</strong> involved (e.g. MOPH or NSSF), contracted party (e.g. hospitals,<br />
primary care centres, or other parties), types of service provided (e.g. hospitalization versus<br />
outpatient services), or other criteria. In th<strong>is</strong> Report, an attempt was made to provide insights into<br />
contractual arrangements from different angles to enhance understanding of the complexity of<br />
the <strong>is</strong>sues. A mixed approach <strong>is</strong> taken in which contracts are briefly mentioned according to the<br />
different governmental agencies involved, while case studies investigate specific aspects of<br />
service delivery.<br />
Finally, an attempt <strong>is</strong> made to proceed beyond identification of problems into recognizing<br />
aspects of good performance and opportunities for improving performance.