Strategic Purchasing in Healthcare

Several millions of people experience financial hardship after accessing medical care through out-of-pocket payments and catastrophic health spending in low-middle-income settings. As a result, a renewed campaign to implement policy reforms will offer some financial protection in healthcare utilisation. Despite the many research findings in less developed geopolitical regions, there is still inadequate attention to effectively prioritising, building consensus, and balancing policy and health politics towards universal health coverage (UHC). The growing concerns garnered multidisciplinary researchers from the UK, US, East, Western and South Africa to seek to understand the issues therein. Strategic purchasing (SP) in healthcare has been a timely approach, tool, and guiding principle towards achieving universal health coverage. Indeed, low-middle-income countries have multiple challenges relating to 1) government stewardship; 2) information management systems; 3) health benefits package design; 4) patient empowerment and provider accountability arrangements; 5) provider payment methods; 6) political economy; and 7) the management and alignment of tensions between these elements. These dimensions have more significant implications on functional healthcare delivery machinery and financing pathways mainly to ensure quality, affordable and efficient healthcare delivery.

Strategic initiatives in this direction were the work of RESYST (Resilient and Responsive Health Systems) consortium in Kenya, Nigeria, Thailand, Vietnam. The study revealed critical factors influencing system functionality. Following this, we have adopted the Sanderson et al. theoretical framework [see Sanderson, J., Lonsdale, C., & Mannion, R. (2019). What’s needed to develop strategic purchasing in healthcare? Policy lessons from a realist review] to understand the varied geopolitical and contextual factors hinging on health system performance improvement and provider payment mechanisms. Based on these reforms, the current project on “Strategic purchasing in healthcare” aims to systematically review and synthesise the evidence from middle-income countries (MICs) for enhanced health policy decisions. We aim to offer lessons for efficient, quality, improved financial protection, and equitable distribution of health services in MICs. We also aim to highlight strategic purchasing mechanisms in ten countries as case studies - Ghana, Kenya, Iran, Vietnam, Philippines, Mexico, Thailand, Nigeria, China and Indonesia. The Research leader is Joshua Sumankuuro. Tel: 050 007 2754; Email: joshsumankuuro@gmail.com