Provider Purchasing and Contracting for Health Services_The Case

esource use within designated priorities. Furthermore, adherence to financial and accounting
systems is an aspect that is said be of significant focus in the assessment process and in
monitoring of the contractual agreements.
Quality Assurance and Accreditation. It was explained that, initially, all forms of contracts—
public to public and public to private—were intended to be overseen by the regulation of
minimum standards that would be the benchmark for quality assurance. The standards would
be used to assess contracted institutions, which would then be graded or accredited on the
basis of the level of quality for funding and determination of the type of services the
institutions or districts were able to provide. However, from the discussions and data
collected, it is evident that this relatively useful and innovative approach has not been used
extensively. Apart from the mission and mine facilities, very few private hospitals and clinics
are accredited in Zambia.
8. Partnerships between the Public Sector and Private For-Profit Providers
In spite of the limited contracting arrangements between the public and private for-profit
providers, partnerships have been developed among these players. The partnerships relate to
curative and prevention programs for specific diseases. These are discussed below:
Partnerships specific to malaria, TB, and HIV/AIDS programs
The government has recognized the enormous potential that the private sector can contribute
to case detection and treatment of TB, malaria, and HIV cases. These diseases are among the
top 10 causes of mortality and morbidity in Zambia. In a bid to reduce the incidence and
prevalence of these diseases, the government has entered into partnerships with the private
for-profit providers and industrial hospitals. The main objective of the partnerships in
curative services is to ensure that the private sector adheres to the national treatment
guidelines by making appropriate health services accessible to all citizens.
In all cases, the treatment of TB is free in Zambia. One of the objectives of the National TB
Programme is to ensure uninterrupted supply of quality-assured anti-TB drugs and laboratory
reagents throughout the country for treatment of TB patients. To promote adherence and
improve treatment outcomes, the four fixed-dose combinations has been introduced in all
nine provinces and has been extended to some private for-profit health providers.
This arrangement is made possible through the anti-TB drug supplies that are secured through
GDF by the Ministry of Health. In this partnership, the Ministry of Health gives free TB
drugs to selected private for-profit and industrial health facilities. Under the partnerships, the
contracted facilities are in turn supposed to provide free treatment to the public. They are
supposed to charge consultancy fees only. According to the Ministry of Health and some
respondents in private facilities, the private partners are supposed provide the government
with information on the utilization of these drugs.
Regarding malaria, interviewees at the Ministry of Health stated in 2003 that the government
revised the national malaria treatment policy. The aim of the policy is to provide access to
more effective treatment for malaria. The new policy introduced the use of artemisinin-based
combination therapy for uncomplicated malaria. The respondents further noted that the
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