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.

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