Health Systems & Reform Journal Special Issue

Making Progress on Strategic Health Purchasing in Africa

Strategic purchasing involves using evidence and information about population health needs and health provider performance to make decisions about which health services should have priority for public funding (“what to buy”), which providers will provide these services (“from whom to buy”), and how and how much providers will be paid to deliver those services (“how to buy”). Strategic purchasers also allow funds to be used flexibly by frontline providers, while holding them accountable for service delivery results. Strategic purchasing has been recognized as a critical policy approach to improve how limited resources are used to make progress toward universal health coverage (UHC).

This special issue of Health Systems & Reform, titled Making Progress on Strategic Health Purchasing in Africa, is anchored by a framework co-created by SPARC and Africa-based partners. The Strategic Health Purchasing Progress Tracking Framework helps African countries collect and analyze the information they need to make practical policy changes that can make health purchasing more strategic.

Strategic purchasing can be a political issue because it involves resource allocation, but using a framework to understand health purchasing helps depoliticize the discussion and focus on technical solutions to improve resource allocation, increase transparency, and create appropriate incentives for providers. In this issue, we examine the state of knowledge and practice of strategic purchasing in Africa based on the framework and how implementing strategic purchasing approaches can facilitate progress toward UHC.

Strategic Health Purchasing in Nigeria: Investigating Governance and Institutional Capacities within Federal Tax-Funded Health Schemes and the Formal Sector Social Health Insurance Programme

Uchenna Ezenwaka, Agnes Gatome-Munyua, Chikezie Nwankwor, Nkechi Olalere, Nneka Orji, Uchenna Ewelike, Benjamin Uzochukwu & Obinna Onwujekwe

Strengths and Weaknesses of Strategic Health Purchasing for Universal Health Coverage in Rwanda

Stella Umuhoza Matutina, Sabine F. Musange, Alypio Nyandwi, Agnes Gatome-Munyua, Angeline Mumararungu, Regis Hitimana, Alexis Rulisa & Parfait Uwaliraye

Strategic Health Purchasing Progress Mapping: A Spotlight on Ghana’s National Health Insurance Scheme

Eugenia Amporfu. Peter Agyei-Baafour, Anthony Edusei, Jacob Novignon, Eric Arthur

Strategic Purchasing Arrangements in Uganda and Their Implications for Universal Health Coverage

Authors: Elizabeth Ekirapa-Kiracho, Aloysius Ssennyonjo, Cheryl Cashin, Agnes Gatome-Munyua, Nkechi Olalere, Richard Ssempala, Chrispus Mayora, Freddie Ssengooba

The Government Budget: An Overlooked Vehicle for Advancing Strategic Health Purchasing

Authors: Aloysius Ssennyonjo, Otieno Osoro, Freddie Ssengooba, Elizabeth Ekirapa-Kiracho, Chrispus Mayora, Richard Ssempala, Danielle Bloom

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This special issue was led by Results for Development (R4D) as SPARC’s core technical partner, in collaboration with Centre de Recherche en Reproduction Humaine et en Démographie in Benin, Recherche pour la Santé et le Développement in Burkina Faso, Research for Development International in Cameroon, Kwame Nkrumah University of Science and Technology in Ghana, KEMRI Wellcome Trust Research Programme in Kenya, Health Policy Research Group in Nigeria, University of Rwanda School of Public Health, Ifakara Health Institute and University of Dar es Salaam in Tanzania, and Makerere University School of Public Health in Uganda.

Editor: Michael Reich

Guest Editors: Agnes Gatome-Munyua, Cheryl Cashin HSR Journal Team: Eddie Spofford, Rebekah Smith Support Team: Naomi Gaspard

Copyeditor: Ina Chang

Design Team: RRD Design (Rebecca Richards-Diop, Jessica Stone-Weaver)

Video Abstracts: Wynne Greenwood

Communications: David Mitine, Johnattan Garcia, Kelly Toves, Heather Luca

Health Systems & Reform Special Issue Contributors List

 

Author Name

Organization

  

Agnes Gatome-Munyua

Results for Development (R4D), Kenya

  

Cheryl Cashin

Results for Development (R4D), US

  

Isidore Sieleunou

Research for Development International Cameroon

  

Sory Orokia

Recherche pour la Santé et le Développement (RESADE), Burkina Faso

  

Edwine Barasa

Health Economics Research Unit, KEMRI Wellcome Trust Research Programme, Kenya

  

Freddie Ssengooba

Makerere University School of Public Health, Uganda

  

Issa Kaboré

Recherche pour la Santé et le Développement (RESADE), Burkina Faso

  

Sabine Musange

University of Rwanda School of Public Health, Rwanda

  

Otieno Osoro

University of Dar es Salaam, Tanzania

  

Suzan Makawia

Ifakara Health Institute, Tanzania

  

Christelle Boyi

Centre de Recherche en Reproduction Humaine et en Démographie (CERRHUD), Benin

  

Eugenia Amporfu

Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

  

Uchenna Ezenwaka

Health Policy and Research Group, University of Nigeria, Enugu Campus, Nigeria

  

Charlemagne Tapsoba

Recherche pour la Santé et le Développement (RESADE), Burkina Faso

  

S. Pierre Yameogo

Secrétariat Technique en charge de la Couverture Sanitaire Universelle (ST/CSU) au Ministère de la Santé du Burkina Faso

  

Parfait Uwaliraye

Ministry of Health, Rwanda

  

Regis Hitimana

Rwanda Social Security Board, Rwanda

  

Danielle Bloom

World Bank, Canada

  

Elizabeth Ekirapa-Kiracho

Makerere University School of Public Health, Uganda

  

Aloysius Ssennyonjo

Makerere University School of Public Health, Uganda

  

Richard Ssempala

Makerere University School of Public Health, Uganda

  

Chrispus Mayora

Makerere University School of Public Health, Uganda

  

Joël Arthur Kiendrébéogo

Department of Public Health, University Joseph Ki-Zerbo, Ouagadougou, Burkina Faso; Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany; Recherche pour la Santé et le Développement,  (RESADE), Burkina Faso

  

Yamba Kafando

Recherche pour la Santé et le Développement (RESADE), Burkina Faso

  

Chikezie Nwankwor

Faculty of Health Sciences and Technology, University of Nigeria Enugu Campus, Nigeria

  

Nkechi Olalere

Ministry of Health, Nigeria

  

Nneka Orji

   

Uchenna Ewelike

National Health Insurance Scheme (NHIS),  Nigeria

  

Benjamin Uzochukwu

Health Policy Research Group, College of Medicine, University of Nigeria Enugu Campus, Nigeria

  

Obinna Onwujekwe

Health Policy and Research Group, University of Nigeria, Enugu Campus, Nigeria

  

Stella Umuhoza Matutina

University of Rwanda School of Public Health, Rwanda

  

Alypio Nyandwi

Africa Population and Health Research Centre (APHRC), Kenya

  

Peter Agyei-Baafour

Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

  

Anthony Edusei

Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

  

Jacob Novignon

Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

  

Eric Arthur

Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

  

Dennis Waithaka

Health Economics Research Unit, KEMRI Wellcome Trust Research Programme, Kenya

  

Fred Matovu

Makerere University School of Public Health, Uganda

  

Evelyn Kabia

Health Economics Research Unit, KEMRI Wellcome Trust Research Programme, Kenya

  

Jacob Kazungu

Health Economics Research Unit, KEMRI Wellcome Trust Research Programme, Kenya

  

Prince Agwu

Health Policy Research Group, University of Nigeria, Nigeria

  

Nathaniel Otoo

Results for Development (R4D), Ghana

  

George Kimathi

Amref Health Africa, Kenya

  

 

      

 

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