A framework for assessing governance arrangements for strategic purchasing
Governance for the purchasing of health services has received little attention in either research or policy communities, despite its importance. Making purchasing more strategic requires effective governance arrangements. The key issues include how to assess governance arrangements in a country’s health system, and how to strengthen and improve them. To address these questions, the WHO’s Department of Health Systems Governance and Financing hosted a skills building workshop on 8 October 2018, as part of the Global Symposium on Health Systems Research in Liverpool.
The objectives of this skills building session were to contribute to the development of skills to undertake a systematic analysis of a country’s governance arrangements for strategic purchasing; and to explore ways to enhance capacities of governance and purchasing actors.
After an introduction into the session by Inke Mathauer, Loraine Hawkins presented the new (draft) WHO analytical framework on governance for strategic purchasing, with a focus on the governance arrangements of the purchaser market, and on the governance arrangements of an individual purchasing agency. Mohamed Mokdad provided a country illustration from Tunisia where this framework has been applied. Ayako Honda’s reflections and examples from other countries further complemented this.
A first skills building group discussion allowed participants to apply the framework’s component to their own country context and share country experiences on the strengths and weaknesses of their governance arrangements in relation to strategic purchasing.
Thereafter, Isidore Sieleunou shared insights and findings from the Collectivity Group that explored governance arrangements for purchasing in several countries. This was followed by a second skills building element that focused on ways to address the identified gaps in governance arrangements for purchasing, and how to strengthen capacity for governance of purchasing. A third group identified future research questions on governance for strategic purchasing.