Strengthening district health service management and delivery through internal contracting
Lessons from pilot projects in Cambodia
Bibliographic Data
| ID | 4794432 |
|---|---|
| Authors | Keovathanak Khim (0000-0002-8604-0323, The University of Melbourne), Peter Annear (0000-0001-7887-8292, The University of Melbourne), Peter Leslie Annear |
| Year | 2013 |
| Volume | 96 |
| Pages | 241-249 |
| Publication date | 2013-11-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Social Science & Medicine (JOURNAL) |
| Journal identifiers | ISSN: 0277-9536 • E-ISSN: 1873-5347 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.socscimed.2013.02.029 |
| PMID | 23489889 |
| OpenAlex | W2062939907 |
| Language | EN |
| Citations received | 6 |
| References cited | 21 |
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
Autonomy · Business · Economics · Incentive · Operations management · Political science · Public relations · Purchasing · Service (business · Service delivery framework · Global Maternal and Child Health · Health Systems, Economic Evaluations, Quality of Life · Healthcare Systems and Reforms · Marketing
Are health workers motivated by income? Job motivation of Cambodian primary health workers implementing performance-based financing
Implementation of free maternal and child healthcare policies
Transaction Costs for Delivering HIV&Aids Prevention Services in Uganda
Opening the ‘black box’ of performance-based financing in low- and lower middle-income countries
Challenges and opportunities in addressing social determinants of child health in Cambodia
Health financing in fragile and conflict-affected settings
Development Beyond Neoliberalism?
Improving immunisation coverage in rural India
Buying results? Contracting for health service delivery in developing countries
From old public administration to new public management
Effect on maternal and child health services in Rwanda of payment to primary health-care providers for performance
Performance incentives for global health
The effectiveness of contracting-out primary health care services in developing countries
A Public Management for All Seasons
Why performance-based contracting failed in Uganda - An "open-box" evaluation of a complex health system intervention
What can transaction costs tell us about governance in the delivery of large scale HIV prevention programmes in southern India
| Citations per year | 0.6 |
|---|---|
| Citation span | 2016 - 2024 (9) |
| Highly cited | No |