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Misunderstandings and ambiguities in strategic purchasing in low‐ and middle‐income countries

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  • Elisabeth Paul
  • Garrett W. Brown
  • Valéry Ridde

Abstract

Strategic purchasing is branded as an approach that is necessary for progress towards universal health coverage. While we agree that publicly purchased health services should respond to society's needs and patient expectations, and thus generally endorse strategic purchasing, here we would like to explore two emerging concerns within current discussions in low‐ and middle‐income countries. First, there exists a great deal of misunderstanding and conceptual unclarity, within practitioner groups, around the concept of strategic purchasing and what instruments it incorporates. Second, there is a growing trend to regularly fuse strategic purchasing into a performance‐based financing (PBF) discourse in ways that increasingly blur their distinctive properties and policy orientations, while perhaps too easily obfuscating potential tensions. We believe the discourse on strategic purchasing would benefit from better conceptual clarity by dissociating and prioritising its two objectives, namely: priority should be given to needs‐based allocation of resources, while rewarding performance is a subsequent concern. We argue there is a need for a more thoroughgoing conceptual and empirical re‐examination of strategic purchasing's priorities, its link with PBF, as well as for a wider evidence‐base on what strategic purchasing tools exist and which are most appropriate for diverse contexts.

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  • Elisabeth Paul & Garrett W. Brown & Valéry Ridde, 2020. "Misunderstandings and ambiguities in strategic purchasing in low‐ and middle‐income countries," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(5), pages 1001-1008, September.
  • Handle: RePEc:bla:ijhplm:v:35:y:2020:i:5:p:1001-1008
    DOI: 10.1002/hpm.3019
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    References listed on IDEAS

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    1. Zawora Rita Zizien & Catherine Korachais & Philippe Compaoré & Valéry Ridde & Vincent De Brouwere, 2019. "Contribution of the results‐based financing strategy to improving maternal and child health indicators in Burkina Faso," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 111-129, January.
    2. Alexander S. Preker & John C. Langenbrunner, 2005. "Spending Wisely : Buying Health Services for the Poor," World Bank Publications - Books, The World Bank Group, number 7449.
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    1. Montás, Marie C. & Klasa, Katarzyna & van Ginneken, Ewout & Greer, Scott L., 2022. "Strategic purchasing and health systems resilience: Lessons from COVID-19 in selected European countries," Health Policy, Elsevier, vol. 126(9), pages 853-864.

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