Broadly, strategic purchasing is the efficient use of limited resources to deliver maximum health outcomes for everyone. It involves the use of information to make purchasing decisions, including what to buy, who to buy from and how to pay. Strategic purchasing explores ways to provide quality healthcare services to priority populations, especially the most vulnerable and needy, using limited resources. Burkina Faso has made progress in strategic health purchasing in its Gratuité program and community-based health insurance (CBHI) schemes by prioritizing services through explicit benefit packages, contracting with providers, and introducing output-based provider payment that links payment to service delivery objectives. Various forms of provider performance monitoring are used, and Gratuité involves national and international nongovernmental organizations in auditing provider claims for accountability and transparency. This Twitter chat will explore Burkina Faso’s progress and challenges, and recommendations made to improve strategic purchasing in light of the current status of purchasing functions in the country.