Contracting for the Delivery of Community Health Services : A Review of Global Experience

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collection.link.221
https://openknowledge.worldbank.org/handle/10986/12995
collection.name.221
Health, Nutrition and Population (HNP) Discussion Papers
dc.contributor.author
Loevinsohn, Benjamin
dc.contributor.author
Harding, April
dc.date.accessioned
2013-05-29T15:16:17Z
dc.date.available
2013-05-29T15:16:17Z
dc.date.issued
2004-09
dc.date.lastModified
2021-04-23T14:03:09Z
dc.description.abstract
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.
en
dc.identifier
http://documents.worldbank.org/curated/en/2004/09/5620866/contracting-delivery-community-health-services-review-global-experience
dc.identifier.uri
http://hdl.handle.net/10986/13621
dc.language
English
dc.language.iso
en_US
dc.publisher
World Bank, Washington, DC
dc.relation.ispartofseries
Health, Nutrition and Population (HNP) discussion paper;
dc.rights
CC BY 3.0 IGO
dc.rights.holder
World Bank
dc.rights.uri
http://creativecommons.org/licenses/by/3.0/igo/
dc.subject
ACCOUNTABILITY
dc.subject
ADVOCACY
dc.subject
ALLOCATIVE EFFICIENCY
dc.subject
ANTENATAL CARE
dc.subject
BASIC HEALTH
dc.subject
BASIC HEALTH SERVICES
dc.subject
CHILD HEALTH
dc.subject
COMMUNITY DEVELOPMENT
dc.subject
COMMUNITY HEALTH
dc.subject
COMMUNITY HEALTH SERVICES
dc.subject
CONTRACTED SERVICES
dc.subject
DEATHS
dc.subject
DECISIONMAKING
dc.subject
ECONOMICS
dc.subject
ECONOMIES OF SCALE
dc.subject
EMERGENCIES
dc.subject
FAMILY PLANNING
dc.subject
FINANCIAL MANAGEMENT
dc.subject
GOVERNMENT POLICIES
dc.subject
HEALTH CARE
dc.subject
HEALTH CARE CENTERS
dc.subject
HEALTH CARE FINANCING
dc.subject
HEALTH CARE SERVICES
dc.subject
HEALTH CARE SYSTEMS
dc.subject
HEALTH EXPENDITURES
dc.subject
HEALTH INFORMATION
dc.subject
HEALTH INFORMATION SYSTEMS
dc.subject
HEALTH INSURANCE
dc.subject
HEALTH POLICY
dc.subject
HEALTH SECTOR
dc.subject
HEALTH SERVICE DELIVERY
dc.subject
HEALTH SERVICES
dc.subject
HEALTH STATUS
dc.subject
HEALTH SYSTEM
dc.subject
HEALTH SYSTEMS
dc.subject
HEALTH WORKERS
dc.subject
HOSPITAL AUTONOMY
dc.subject
HOSPITAL CARE
dc.subject
HOSPITAL MANAGEMENT
dc.subject
HOSPITAL SERVICES
dc.subject
HOSPITALS
dc.subject
HUMAN DEVELOPMENT
dc.subject
HUMAN RESOURCES
dc.subject
IMMUNIZATION
dc.subject
IMMUNIZATION COVERAGE
dc.subject
IMMUNIZATION RATES
dc.subject
INCOME
dc.subject
INPATIENT CARE
dc.subject
INTERVENTION
dc.subject
JOURNALS
dc.subject
LESSONS LEARNED
dc.subject
LOW-INCOME COUNTRIES
dc.subject
MALNUTRITION
dc.subject
MANAGEMENT CONTRACT
dc.subject
MANAGEMENT CONTRACTS
dc.subject
MANAGERS
dc.subject
MEDICAL EQUIPMENT
dc.subject
NONGOVERNMENTAL ORGANIZATIONS
dc.subject
NONPROFIT ORGANIZATIONS
dc.subject
NUTRITION
dc.subject
PHYSICIANS
dc.subject
PRIMARY CARE
dc.subject
PRIMARY HEALTH CARE
dc.subject
PRIMARY HEALTH CARE SERVICES
dc.subject
PRIVATE SECTOR
dc.subject
PROMOTING HEALTH
dc.subject
PUBLIC HEALTH
dc.subject
PUBLIC SECTOR
dc.subject
QUALITY OF CARE
dc.subject
RADIO
dc.subject
REFORMS
dc.subject
REPRODUCTIVE HEALTH
dc.subject
SANCTIONS
dc.subject
SERVICE DELIVERY
dc.subject
SERVICES DELIVERY
dc.subject
SEX WORKERS
dc.subject
SUPERVISION
dc.subject
TUBERCULOSIS
dc.subject
VACCINATION
dc.subject
WEIGHT
dc.subject
WORKERS
dc.title
Contracting for the Delivery of Community Health Services : A Review of Global Experience
en
okr.doctype
Publications & Research :: Working Paper
okr.doctype
Publications & Research
okr.docurl
http://documents.worldbank.org/curated/en/2004/09/5620866/contracting-delivery-community-health-services-review-global-experience
okr.globalpractice
Poverty
okr.globalpractice
Governance
okr.globalpractice
Health, Nutrition, and Population
okr.googlescholar.linkpresent
yes
okr.identifier.externaldocumentum
000090341_20050223140558
okr.identifier.internaldocumentum
5620866
okr.identifier.report
31506
okr.language.supported
en
okr.pdfurl
http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2005/02/23/000090341_20050223140558/Rendered/PDF/315060HNP0Contracting0LoevinsohnHarding.pdf
en
okr.topic
Health Monitoring and Evaluation
okr.topic
Health, Nutrition and Population :: Adolescent Health
okr.topic
Health Economics and Finance
okr.topic
Poverty Reduction :: Poverty Assessment
okr.topic
Governance :: Governance Indicators
okr.unit
Health, Nutrition & Popultn Team (HDNHE)
okr.volume
1 of 1

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