Contracting for the Delivery of Community Health Services : A Review of Global Experience
To achieve the health-related Millennium Development Goals, it will be necessary to improve the delivery of health services, particularly to poor people. One proposed approach to improving both coverage and quality of care is to contract with NGOs...
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| Format: | Working Paper |
| Language: | English en_US |
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World Bank, Washington, DC
2013
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| Online Access: | http://documents.worldbank.org/curated/en/2004/09/5620866/contracting-delivery-community-health-services-review-global-experience http://hdl.handle.net/10986/13621 |
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okr-10986-136212021-04-23T14:03:09Z Contracting for the Delivery of Community Health Services : A Review of Global Experience Loevinsohn, Benjamin Harding, April ACCOUNTABILITY ADVOCACY ALLOCATIVE EFFICIENCY ANTENATAL CARE BASIC HEALTH BASIC HEALTH SERVICES CHILD HEALTH COMMUNITY DEVELOPMENT COMMUNITY HEALTH COMMUNITY HEALTH SERVICES CONTRACTED SERVICES DEATHS DECISIONMAKING ECONOMICS ECONOMIES OF SCALE EMERGENCIES FAMILY PLANNING FINANCIAL MANAGEMENT GOVERNMENT POLICIES HEALTH CARE HEALTH CARE CENTERS HEALTH CARE FINANCING HEALTH CARE SERVICES HEALTH CARE SYSTEMS HEALTH EXPENDITURES HEALTH INFORMATION HEALTH INFORMATION SYSTEMS HEALTH INSURANCE HEALTH POLICY HEALTH SECTOR HEALTH SERVICE DELIVERY HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEMS HEALTH WORKERS HOSPITAL AUTONOMY HOSPITAL CARE HOSPITAL MANAGEMENT HOSPITAL SERVICES HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES IMMUNIZATION IMMUNIZATION COVERAGE IMMUNIZATION RATES INCOME INPATIENT CARE INTERVENTION JOURNALS LESSONS LEARNED LOW-INCOME COUNTRIES MALNUTRITION MANAGEMENT CONTRACT MANAGEMENT CONTRACTS MANAGERS MEDICAL EQUIPMENT NONGOVERNMENTAL ORGANIZATIONS NONPROFIT ORGANIZATIONS NUTRITION PHYSICIANS PRIMARY CARE PRIMARY HEALTH CARE PRIMARY HEALTH CARE SERVICES PRIVATE SECTOR PROMOTING HEALTH PUBLIC HEALTH PUBLIC SECTOR QUALITY OF CARE RADIO REFORMS REPRODUCTIVE HEALTH SANCTIONS SERVICE DELIVERY SERVICES DELIVERY SEX WORKERS SUPERVISION TUBERCULOSIS VACCINATION WEIGHT WORKERS To achieve the health-related Millennium Development Goals, it will be necessary to improve the delivery of health services, particularly to poor people. One proposed approach to improving both coverage and quality of care is to contract with NGOs or other non-state entities to deliver health services. This paper reviews experiences with contracting in which some coherent form of evaluation was carried out, using at least before and after, or controlled evaluation designs. Ten examples of contracting with NGOs were found and from these studies, it appears that in developing countries, contracting with non-state providers to deliver primary health or nutrition services can be very effective and that improvements can be rapid. These results were found in a variety of services and settings. Six of the ten studies compared contractor performance to government provision of the same services and all six found that the contractors achieved better results. There are a number of concerns about contracting that have been raised, including scale, cost, sustainability and contract management. Scaling up appears not to be a problem. Four of the examples studied involved populations of many millions of beneficiaries. On the issue of cost, four of the studies found that NGOs performed better even when provided the same resources as the public sector. Of the nine studies with three or more years of elapsed experience, seven have been continued and expanded. Contract management was seen as a significant issue in at least three of the examples reviewed, however, it did not prevent contractors in those instances from being successful. Based on the success thus far, health services contracting appears to improve service delivery and may help achieve the MDGs. The approach should be carefully expanded in developing countries using large scale pilots initially. Future efforts at contracting should include rigorous evaluations. 2013-05-29T15:16:17Z 2013-05-29T15:16:17Z 2004-09 http://documents.worldbank.org/curated/en/2004/09/5620866/contracting-delivery-community-health-services-review-global-experience http://hdl.handle.net/10986/13621 English en_US Health, Nutrition and Population (HNP) discussion paper; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Working Paper Publications & Research |
| repository_type |
Digital Repository |
| institution_category |
Foreign Institution |
| institution |
Digital Repositories |
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World Bank Open Knowledge Repository |
| collection |
World Bank |
| language |
English en_US |
| topic |
ACCOUNTABILITY ADVOCACY ALLOCATIVE EFFICIENCY ANTENATAL CARE BASIC HEALTH BASIC HEALTH SERVICES CHILD HEALTH COMMUNITY DEVELOPMENT COMMUNITY HEALTH COMMUNITY HEALTH SERVICES CONTRACTED SERVICES DEATHS DECISIONMAKING ECONOMICS ECONOMIES OF SCALE EMERGENCIES FAMILY PLANNING FINANCIAL MANAGEMENT GOVERNMENT POLICIES HEALTH CARE HEALTH CARE CENTERS HEALTH CARE FINANCING HEALTH CARE SERVICES HEALTH CARE SYSTEMS HEALTH EXPENDITURES HEALTH INFORMATION HEALTH INFORMATION SYSTEMS HEALTH INSURANCE HEALTH POLICY HEALTH SECTOR HEALTH SERVICE DELIVERY HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEMS HEALTH WORKERS HOSPITAL AUTONOMY HOSPITAL CARE HOSPITAL MANAGEMENT HOSPITAL SERVICES HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES IMMUNIZATION IMMUNIZATION COVERAGE IMMUNIZATION RATES INCOME INPATIENT CARE INTERVENTION JOURNALS LESSONS LEARNED LOW-INCOME COUNTRIES MALNUTRITION MANAGEMENT CONTRACT MANAGEMENT CONTRACTS MANAGERS MEDICAL EQUIPMENT NONGOVERNMENTAL ORGANIZATIONS NONPROFIT ORGANIZATIONS NUTRITION PHYSICIANS PRIMARY CARE PRIMARY HEALTH CARE PRIMARY HEALTH CARE SERVICES PRIVATE SECTOR PROMOTING HEALTH PUBLIC HEALTH PUBLIC SECTOR QUALITY OF CARE RADIO REFORMS REPRODUCTIVE HEALTH SANCTIONS SERVICE DELIVERY SERVICES DELIVERY SEX WORKERS SUPERVISION TUBERCULOSIS VACCINATION WEIGHT WORKERS |
| spellingShingle |
ACCOUNTABILITY ADVOCACY ALLOCATIVE EFFICIENCY ANTENATAL CARE BASIC HEALTH BASIC HEALTH SERVICES CHILD HEALTH COMMUNITY DEVELOPMENT COMMUNITY HEALTH COMMUNITY HEALTH SERVICES CONTRACTED SERVICES DEATHS DECISIONMAKING ECONOMICS ECONOMIES OF SCALE EMERGENCIES FAMILY PLANNING FINANCIAL MANAGEMENT GOVERNMENT POLICIES HEALTH CARE HEALTH CARE CENTERS HEALTH CARE FINANCING HEALTH CARE SERVICES HEALTH CARE SYSTEMS HEALTH EXPENDITURES HEALTH INFORMATION HEALTH INFORMATION SYSTEMS HEALTH INSURANCE HEALTH POLICY HEALTH SECTOR HEALTH SERVICE DELIVERY HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEMS HEALTH WORKERS HOSPITAL AUTONOMY HOSPITAL CARE HOSPITAL MANAGEMENT HOSPITAL SERVICES HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES IMMUNIZATION IMMUNIZATION COVERAGE IMMUNIZATION RATES INCOME INPATIENT CARE INTERVENTION JOURNALS LESSONS LEARNED LOW-INCOME COUNTRIES MALNUTRITION MANAGEMENT CONTRACT MANAGEMENT CONTRACTS MANAGERS MEDICAL EQUIPMENT NONGOVERNMENTAL ORGANIZATIONS NONPROFIT ORGANIZATIONS NUTRITION PHYSICIANS PRIMARY CARE PRIMARY HEALTH CARE PRIMARY HEALTH CARE SERVICES PRIVATE SECTOR PROMOTING HEALTH PUBLIC HEALTH PUBLIC SECTOR QUALITY OF CARE RADIO REFORMS REPRODUCTIVE HEALTH SANCTIONS SERVICE DELIVERY SERVICES DELIVERY SEX WORKERS SUPERVISION TUBERCULOSIS VACCINATION WEIGHT WORKERS Loevinsohn, Benjamin Harding, April Contracting for the Delivery of Community Health Services : A Review of Global Experience |
| relation |
Health, Nutrition and Population (HNP)
discussion paper; |
| description |
To achieve the health-related Millennium
Development Goals, it will be necessary to improve the
delivery of health services, particularly to poor people.
One proposed approach to improving both coverage and quality
of care is to contract with NGOs or other non-state entities
to deliver health services. This paper reviews experiences
with contracting in which some coherent form of evaluation
was carried out, using at least before and after, or
controlled evaluation designs. Ten examples of contracting
with NGOs were found and from these studies, it appears that
in developing countries, contracting with non-state
providers to deliver primary health or nutrition services
can be very effective and that improvements can be rapid.
These results were found in a variety of services and
settings. Six of the ten studies compared contractor
performance to government provision of the same services and
all six found that the contractors achieved better results.
There are a number of concerns about contracting that have
been raised, including scale, cost, sustainability and
contract management. Scaling up appears not to be a problem.
Four of the examples studied involved populations of many
millions of beneficiaries. On the issue of cost, four of the
studies found that NGOs performed better even when provided
the same resources as the public sector. Of the nine studies
with three or more years of elapsed experience, seven have
been continued and expanded. Contract management was seen as
a significant issue in at least three of the examples
reviewed, however, it did not prevent contractors in those
instances from being successful. Based on the success thus
far, health services contracting appears to improve service
delivery and may help achieve the MDGs. The approach should
be carefully expanded in developing countries using large
scale pilots initially. Future efforts at contracting should
include rigorous evaluations. |
| format |
Publications & Research :: Working Paper |
| author |
Loevinsohn, Benjamin Harding, April |
| author_facet |
Loevinsohn, Benjamin Harding, April |
| author_sort |
Loevinsohn, Benjamin |
| title |
Contracting for the Delivery of Community Health Services : A Review of Global Experience |
| title_short |
Contracting for the Delivery of Community Health Services : A Review of Global Experience |
| title_full |
Contracting for the Delivery of Community Health Services : A Review of Global Experience |
| title_fullStr |
Contracting for the Delivery of Community Health Services : A Review of Global Experience |
| title_full_unstemmed |
Contracting for the Delivery of Community Health Services : A Review of Global Experience |
| title_sort |
contracting for the delivery of community health services : a review of global experience |
| publisher |
World Bank, Washington, DC |
| publishDate |
2013 |
| url |
http://documents.worldbank.org/curated/en/2004/09/5620866/contracting-delivery-community-health-services-review-global-experience http://hdl.handle.net/10986/13621 |
| _version_ |
1764424146853298176 |