Contracting out of health care provision

This intervention strategy involves contracting missions, NGOs or private sector organisations to deliver primary health care services and specifying equity and coverage targets in contracts. The Cambodian experience has alimented different papers (Achieving the twin objectives of efficiency and equity: contracting health services in Cambodia, Cambodia: using contracting to reduce inequity in primary health care delivery, Contracting for health: evidence from Cambodia) that demonstrate that government can reach under-served areas or groups or geographically remote areas by utilising the comparative advantage of NGOs to deliver basic health services.

Pre-requisites for this strategy to work include: capacity within government for, and political commitment to, contracting out; national level capacity to monitor contract delivery; NGOs or private sector service delivery organisations with the capacity to fulfil contractual obligations.

Buying results: contracting for health service delivery in developing countries reviews 10 country experiences of contracting services. Whilst the approach has achieved positive results in terms of better health services, the effects of contracting on equity is still under question.