TY - JOUR
T1 - Adjustments in purchasing arrangements to support the COVID-19 health sector response
T2 - Evidence from eight middle-income countries
AU - Parmar, Divya
AU - Mathauer, Inke
AU - Bloom, Danielle
AU - Dkhimi, Fahdi
AU - Abuosi, Aaron Asibi
AU - Chen, Dorothee
AU - Chukwuma, Adanna
AU - de Claro, Vergil
AU - Comsa, Radu
AU - Domingo, Albert Francis
AU - Doroshenko, Olena
AU - Gong, Estelle
AU - Goroshko, Alona
AU - Nketiah-Amponsah, Edward
AU - Lylozian, Hratchia
AU - Nkangu, Miriam
AU - Onwujekwe, Obinna
AU - Obikeze, Obioma
AU - Pattnaik, Anooj
AU - Rivillas, Juan Carlos
AU - Tapkigen, Janet
AU - Vîlcu, Ileana
AU - Wang, Huihui
AU - Co, Pura Angela Wee
N1 - Funding Information:
A part of this work was supported by funding received by the World Health Organization from the Canadian government to work on COVID-19. Some other part of this work was funded through the Bill & Melinda Gates Foundation through the Strategic Purchasing for Primary Health Care (SP4PHC) grant. Acknowledgements
Publisher Copyright:
© World Health Organization, 2024.
PY - 2024/3/1
Y1 - 2024/3/1
N2 - The COVID-19 pandemic has triggered several changes in countries' health purchasing arrangements to accompany the adjustments in service delivery in order to meet the urgent and additional demands for COVID-19 related services. However, evidence on how these adjustments have played out in low- and middle-income countries is scarce. This paper provides a synthesis of a multi-country study of the adjustments in purchasing arrangements for the COVID-19 health sector response in eight middle-income countries (Armenia, Cameroon, Ghana, Kenya, Nigeria, Philippines, Romania and Ukraine).We use secondary data assembled by country teams, as well as applied thematic analysis to examine the adjustments made to funding arrangements, benefits packages, provider payments, contracting, information management systems, and governance arrangements as well as related implementation challenges. Our findings show that all countries in the study adjusted their health purchasing arrangements to varying degrees. While the majority of countries expanded their benefit packages and several adjusted payment methods to provide selected COVID-19 services, only half could provide these services free of charge. Many countries also streamlined their processes for contracting and accrediting health providers, thereby reducing administrative hurdles. In conclusion, it was important for the countries to adjust their health purchasing arrangements so that they could adequately respond to the COVID-19 pandemic, but in some countries financing challenges resulted in issues with equity and access. However, it is uncertain whether these adjustments can and will be sustained over time, even where they have potential to contribute to making purchasing more strategic to improve efficiency, quality and equitable access in the long run.
AB - The COVID-19 pandemic has triggered several changes in countries' health purchasing arrangements to accompany the adjustments in service delivery in order to meet the urgent and additional demands for COVID-19 related services. However, evidence on how these adjustments have played out in low- and middle-income countries is scarce. This paper provides a synthesis of a multi-country study of the adjustments in purchasing arrangements for the COVID-19 health sector response in eight middle-income countries (Armenia, Cameroon, Ghana, Kenya, Nigeria, Philippines, Romania and Ukraine).We use secondary data assembled by country teams, as well as applied thematic analysis to examine the adjustments made to funding arrangements, benefits packages, provider payments, contracting, information management systems, and governance arrangements as well as related implementation challenges. Our findings show that all countries in the study adjusted their health purchasing arrangements to varying degrees. While the majority of countries expanded their benefit packages and several adjusted payment methods to provide selected COVID-19 services, only half could provide these services free of charge. Many countries also streamlined their processes for contracting and accrediting health providers, thereby reducing administrative hurdles. In conclusion, it was important for the countries to adjust their health purchasing arrangements so that they could adequately respond to the COVID-19 pandemic, but in some countries financing challenges resulted in issues with equity and access. However, it is uncertain whether these adjustments can and will be sustained over time, even where they have potential to contribute to making purchasing more strategic to improve efficiency, quality and equitable access in the long run.
UR - http://www.scopus.com/inward/record.url?scp=85185833960&partnerID=8YFLogxK
U2 - 10.1093/heapol/czad121
DO - 10.1093/heapol/czad121
M3 - Article
C2 - 38261999
SN - 0268-1080
VL - 39
SP - 213
EP - 223
JO - Health policy and planning
JF - Health policy and planning
IS - 2
M1 - czad121
ER -