Contracting-In Management to Strengthen Publicly Financed Primary Health Services--The Experience of Punjab, Pakistan

OBJECTIVES: In response to low utilization of primary health services in rural areas, the Government of Punjab contracted with a local non-governmental organization (NGO) to manage the basic health units in one district. METHODS: To evaluate the performance of the contractor, health facility surveys...

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Main Authors: Loevinsohn, B., Haq, I. U., Couffinhal, A., Pande, A.
Format: Journal Article
Language:EN
Published: 2012
Subjects:
Online Access:http://hdl.handle.net/10986/5105
id okr-10986-5105
recordtype oai_dc
spelling okr-10986-51052021-04-23T14:02:21Z Contracting-In Management to Strengthen Publicly Financed Primary Health Services--The Experience of Punjab, Pakistan Loevinsohn, B. Haq, I. U. Couffinhal, A. Pande, A. Adolescent Adult Contracts Data Collection Female Government financing Humans Male Middle Aged Organizational Case Studies Pakistan Primary Health Care Young Adult OBJECTIVES: In response to low utilization of primary health services in rural areas, the Government of Punjab contracted with a local non-governmental organization (NGO) to manage the basic health units in one district. METHODS: To evaluate the performance of the contractor, health facility surveys, household surveys, and routinely collected information were used to compare the experimental district (Rahim Yar Khan, RYK) with a contiguous and equally poor district (Bahawalpur, BWP). RESULTS: The evaluation found that contracting led to more than a 50% increase in out-patient visits in RYK compared to BWP. There was also increased satisfaction of the community with health services. Technical quality of care was equally poor in both districts and contracting also had little effect on the coverage of preventive services. The latter was likely the result of the NGO not being given managerial responsibility over vaccinators and other community health workers. CONCLUSIONS: Despite methodological limitations, this study found that contracting in management achieved important goals at the same cost to the Government, implying a large increase in efficiency. Contracting in management worked reasonably well in this context and has now been significantly expanded. The approach provides a plausible means for large-scale improvements of poorly performing primary health care systems. 2012-03-30T07:31:18Z 2012-03-30T07:31:18Z 2009 Journal Article Health Policy 0168-8510 http://hdl.handle.net/10986/5105 EN http://creativecommons.org/licenses/by-nc-nd/3.0/igo World Bank Journal Article Pakistan
repository_type Digital Repository
institution_category Foreign Institution
institution Digital Repositories
building World Bank Open Knowledge Repository
collection World Bank
language EN
topic Adolescent
Adult
Contracts
Data Collection
Female
Government financing
Humans
Male
Middle Aged
Organizational Case Studies
Pakistan
Primary Health Care
Young Adult
spellingShingle Adolescent
Adult
Contracts
Data Collection
Female
Government financing
Humans
Male
Middle Aged
Organizational Case Studies
Pakistan
Primary Health Care
Young Adult
Loevinsohn, B.
Haq, I. U.
Couffinhal, A.
Pande, A.
Contracting-In Management to Strengthen Publicly Financed Primary Health Services--The Experience of Punjab, Pakistan
geographic_facet Pakistan
relation http://creativecommons.org/licenses/by-nc-nd/3.0/igo
description OBJECTIVES: In response to low utilization of primary health services in rural areas, the Government of Punjab contracted with a local non-governmental organization (NGO) to manage the basic health units in one district. METHODS: To evaluate the performance of the contractor, health facility surveys, household surveys, and routinely collected information were used to compare the experimental district (Rahim Yar Khan, RYK) with a contiguous and equally poor district (Bahawalpur, BWP). RESULTS: The evaluation found that contracting led to more than a 50% increase in out-patient visits in RYK compared to BWP. There was also increased satisfaction of the community with health services. Technical quality of care was equally poor in both districts and contracting also had little effect on the coverage of preventive services. The latter was likely the result of the NGO not being given managerial responsibility over vaccinators and other community health workers. CONCLUSIONS: Despite methodological limitations, this study found that contracting in management achieved important goals at the same cost to the Government, implying a large increase in efficiency. Contracting in management worked reasonably well in this context and has now been significantly expanded. The approach provides a plausible means for large-scale improvements of poorly performing primary health care systems.
format Journal Article
author Loevinsohn, B.
Haq, I. U.
Couffinhal, A.
Pande, A.
author_facet Loevinsohn, B.
Haq, I. U.
Couffinhal, A.
Pande, A.
author_sort Loevinsohn, B.
title Contracting-In Management to Strengthen Publicly Financed Primary Health Services--The Experience of Punjab, Pakistan
title_short Contracting-In Management to Strengthen Publicly Financed Primary Health Services--The Experience of Punjab, Pakistan
title_full Contracting-In Management to Strengthen Publicly Financed Primary Health Services--The Experience of Punjab, Pakistan
title_fullStr Contracting-In Management to Strengthen Publicly Financed Primary Health Services--The Experience of Punjab, Pakistan
title_full_unstemmed Contracting-In Management to Strengthen Publicly Financed Primary Health Services--The Experience of Punjab, Pakistan
title_sort contracting-in management to strengthen publicly financed primary health services--the experience of punjab, pakistan
publishDate 2012
url http://hdl.handle.net/10986/5105
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