IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v96y2013icp241-249.html
   My bibliography  Save this article

Strengthening district health service management and delivery through internal contracting: Lessons from pilot projects in Cambodia

Author

Listed:
  • Khim, Keovathanak
  • Annear, Peter Leslie

Abstract

Following a decade of piloting different models of contracting, in mid-2009 the Cambodian Ministry of Health began to test a form of ‘internal contracting’ for health care delivery in selected health districts (including hospitals and health centers) contracted by the provincial health department as Special Operating Agencies (SOAs) and provided with greater management autonomy. This study assesses the internal contracting approach as a means for improving the management of district health services and strengthening service delivery. While the study may contribute to the emerging field now known as performance-based financing, the lessons deal more broadly with the impact of management reform and increased autonomy in contrast to traditional public sector line-management and budgeting. Carried out during 2011, the study was based on: (i) a review of the literature and of operational documents; (ii) primary data from semi-structured key informant interviews with 20 health officials in two provinces involved in four SOA pilot districts; and (iii) routine data from the 2011 SOA performance monitoring report. Five prerequisites were identified for effective contract management and improved service delivery: a clear understanding of roles and responsibilities by the contracting parties; implementation of clear rules and procedures; effective management of performance; effective monitoring of the contract; and adequate and timely provision of resources. Both the level and allocation of incentives and management bottlenecks at various levels continue to impede implementation. We conclude that, in contracted arrangements like these, the clear separation of contracting functions (purchasing, commissioning, monitoring and regulating), management autonomy where responsibilities are genuinely devolved and accepted, and the provision of resources adequate to meet contract demands are necessary conditions for success.

Suggested Citation

  • Khim, Keovathanak & Annear, Peter Leslie, 2013. "Strengthening district health service management and delivery through internal contracting: Lessons from pilot projects in Cambodia," Social Science & Medicine, Elsevier, vol. 96(C), pages 241-249.
    • Handle: RePEc:eee:socmed:v:96:y:2013:i:c:p:241-249
    DOI: 10.1016/j.socscimed.2013.02.029
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953613001111
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2013.02.029?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Marko Vujicic & Kelechi Ohiri & Susan Sparkes, 2009. "Working in Health : Financing and Managing the Public Sector Health Workforce," World Bank Publications - Books, The World Bank Group, number 2621.
    2. Ssengooba, Freddie & McPake, Barbara & Palmer, Natasha, 2012. "Why performance-based contracting failed in Uganda – An “open-box” evaluation of a complex health system intervention," Social Science & Medicine, Elsevier, vol. 75(2), pages 377-383.
    3. Miller, Grant & Luo, Renfu & Zhang, Linxiu & Sylvia, Sean & Shi, Yaojiang & Foo, Patricia & Zhao, Qiran & Martorell, Reynaldo & Medina, Alexis & Rozelle, Scott, 2012. "Effectiveness of provider incentives for anaemia reduction in rural China: a cluster randomised trial," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 345, pages 1-10.
    4. Guinness, Lorna, 2011. "What can transaction costs tell us about governance in the delivery of large scale HIV prevention programmes in southern India?," Social Science & Medicine, Elsevier, vol. 72(12), pages 1939-1947, June.
    5. Basinga, Paulin & Gertler, Paul J. & Binagwaho, Agnes & Soucat, Agnes L.B. & Sturdy, Jennifer R. & Vermeersch, Christel M.J., 2010. "Paying primary health care centers for performance in Rwanda," Policy Research Working Paper Series 5190, The World Bank.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Bertone, Maria Paola & Jowett, Matthew & Dale, Elina & Witter, Sophie, 2019. "Health financing in fragile and conflict-affected settings: What do we know, seven years on?," Social Science & Medicine, Elsevier, vol. 232(C), pages 209-219.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Singh, Neha S. & Kovacs, Roxanne J. & Cassidy, Rachel & Kristensen, Søren R. & Borghi, Josephine & Brown, Garrett W., 2021. "A realist review to assess for whom, under what conditions and how pay for performance programmes work in low- and middle-income countries," Social Science & Medicine, Elsevier, vol. 270(C).
    2. Sameh El-Saharty & Susan Powers Sparkes & Helene Barroy & Karar Zunaid Ahsan & Syed Masud Ahmed, 2015. "The Path to Universal Health Coverage in Bangladesh," World Bank Publications - Books, The World Bank Group, number 21633.
    3. Christopher H. Herbst & Monique Vledder & Karen Campbell & Mirja Sjöblom & Agnes Soucat, 2011. "The Human Resources for Health Crisis in Zambia : An Outcome of Health Worker Entry, Exit, and Performance within the National Health Labor Market," World Bank Publications - Books, The World Bank Group, number 5938.
    4. Alzúa, María Laura & Katzkowicz, Noemí, 2021. "Pay for performance for prenatal care and newborn health: Evidence from a developing country," World Development, Elsevier, vol. 141(C).
    5. Lewis, Maureen & Pettersson, Gunilla, 2009. "Governance in health care delivery : raising performance," Policy Research Working Paper Series 5074, The World Bank.
    6. Lohmann, Julia & Houlfort, Nathalie & De Allegri, Manuela, 2016. "Crowding out or no crowding out? A Self-Determination Theory approach to health worker motivation in performance-based financing," Social Science & Medicine, Elsevier, vol. 169(C), pages 1-8.
    7. Darin Christensen & Oeindrila Dube & Johannes Haushofer & Bilal Siddiqi & Maarten Voors, 2021. "Building Resilient Health Systems: Experimental Evidence from Sierra Leone and The 2014 Ebola Outbreak," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 136(2), pages 1145-1198.
    8. Singh, Prakarsh & Masters, William A., 2017. "Impact of caregiver incentives on child health: Evidence from an experiment with Anganwadi workers in India," Journal of Health Economics, Elsevier, vol. 55(C), pages 219-231.
    9. Gertler, Paul & Giovagnoli, Paula & Martinez, Sebastian, 2014. "Rewarding provider performance to enable a healthy start to life : evidence from Argentina's Plan Nacer," Policy Research Working Paper Series 6884, The World Bank.
    10. Nicholas Wilson, 2015. "Can Disease-Specific Funding Harm Health? in the Shadow of HIV/AIDS Service Expansion," Demography, Springer;Population Association of America (PAA), vol. 52(5), pages 1671-1700, October.
    11. James Andreoni & Michael Callen & Karrar Hussain & Muhammad Yasir Khan & Charles Sprenger, 2023. "Using Preference Estimates to Customize Incentives: An Application to Polio Vaccination Drives in Pakistan," Journal of the European Economic Association, European Economic Association, vol. 21(4), pages 1428-1477.
    12. Arimoto, Yutaka & 有本, 寛 & Kurata, Masamitsu, 2017. "Adoption of Management Practices in the Public Sector of Bangladesh," Discussion Paper Series 654, Institute of Economic Research, Hitotsubashi University.
    13. Hongyan Liu & Yaojiang Shi & Emma Auden & Scott Rozelle, 2018. "Anxiety in Rural Chinese Children and Adolescents: Comparisons across Provinces and among Subgroups," IJERPH, MDPI, vol. 15(10), pages 1-14, September.
    14. Dominic Haazen, 2012. "Making Health Financing Work for Poor People in Tanzania," World Bank Publications - Books, The World Bank Group, number 2240.
    15. Kleiman-Weiner, Max & Luo, Renfu & Zhang, Linxiu & Shi, Yaojiang & Medina, Alexis & Rozelle, Scott, 2013. "Eggs versus chewable vitamins: Which intervention can increase nutrition and test scores in rural China?," China Economic Review, Elsevier, vol. 24(C), pages 165-176.
    16. Berry, James & Mehta, Saurabh & Mukherjee, Priya & Ruebeck, Hannah & Shastry, Gauri Kartini, 2021. "Crowd-out in school-based health interventions: Evidence from India’s midday meals program," Journal of Public Economics, Elsevier, vol. 204(C).
    17. International Food Policy Research Institute (IFPRI), 2016. "Global Nutrition Report 2016: From Promise to Impact: Ending Malnutrition by 2030," IFPRI books, International Food Policy Research Institute (IFPRI), number 978-0-89629-584-1.
    18. Jessica Goldberg & Mario Macis & Pradeep Chintagunta, 2023. "Incentivized Peer Referrals for Tuberculosis Screening: Evidence from India," American Economic Journal: Applied Economics, American Economic Association, vol. 15(1), pages 259-291, January.
    19. Martin Chalkley & Andrew J. Mirelman & Luigi Siciliani & Marc Suhrcke & Peter Berman, 2020. "Paying for Performance for Health Care in Low- and Middle-Income Countries: An Economic Perspective," World Scientific Book Chapters, in: Paul Revill & Marc Suhrcke & Rodrigo Moreno-Serra & Mark Sculpher (ed.), Global Health Economics Shaping Health Policy in Low- and Middle-Income Countries, chapter 6, pages 157-190, World Scientific Publishing Co. Pte. Ltd..
    20. Nava Ashraf & Oriana Bandiera & Edward Davenport & Scott S. Lee, 2020. "Losing Prosociality in the Quest for Talent? Sorting, Selection, and Productivity in the Delivery of Public Services," American Economic Review, American Economic Association, vol. 110(5), pages 1355-1394, May.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:96:y:2013:i:c:p:241-249. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.