Provider Purchasing and Contracting for Health Services: The Case of Zambia

The study identifies and characterizes a number of contracting models that exist in the Zambian health sector and their impact on access to health. It reveals that the contracting mechanism is prevalent in Zambia, as evidenced by several contracting-in examples (such as different levels of the referral system within the public health sector contracting each other for services) and contracting out arrangements (such as FBOs and NGOs providing care on behalf of the government). It finds that the impact of these programs on the quality of services has remained mixed.