Applying the
Strategic Health Purchasing
Progress Tracking Framework

A Toolkit

This toolkit provides step-by-step guidance on how to conduct a system-wide assessment of health purchasing by applying the Strategic Health Purchasing Progress Tracking Framework. It is designed to support policymakers, researchers and anyone interested in improving health purchasing in their country to identify entry points and steps toward building more strategic approaches. The toolkit also documents resources and lessons learned from applying the Framework in more than 20 countries in Africa and Asia.

Strategic purchasing is deliberately directing health funds to priority populations, interventions, and services, and actively creating incentives so funds are used by providers equitably and aligned with a population’s health needs. It is one way for governments to get more for the money they spend on health and make faster progress toward Universal Health Coverage.

The Strategic Purchasing Africa Resource Center (SPARC) is a resource hub incubated by Results for Development (R4D) and hosted by Amref Health Africa. SPARC aims to generate evidence and strengthen strategic health purchasing in Africa to enable better use of health resources. As the core technical partner, R4D facilitated eleven technical partners affiliated with SPARC to create a framework to understand strategic purchasing, and track progress in strategic health purchasing.

ACKNOWLEDGEMENTS

This toolkit came about as a response to the growing interest in applying the Strategic Health Purchasing Progress Tracking Framework co-created by 11 African academic and research institutions through the Strategic Purchasing Africa Resource Center (SPARC). It is the product of many people’s efforts, experiences and talents. We acknowledge the leadership of Cheryl Cashin, Managing Director, Results for Development (R4D), who led the design of the Framework and Benchmarks, and provided technical oversight in the development of this toolkit. Catherine Connor, R4D Senior Fellow, was the lead author. Agnes Gatome-Munyua, program director, R4D, was the technical lead and co-author. Seyni Mbaye, senior program officer, R4D, led the online survey. Rachel Gates Gessel, program associate, R4D, managed the entire process. The Toolkit is greatly enhanced by all the videos and animations produced by Training Resource Group, Inc. Graphic and web design support was provided by the R4D Communications team (Katie Fly, digital communications manager and Leif Redmond, senior manager, strategic communications).

The team is indebted to the many experts in the field of health financing and strategic purchasing who were so generous with their time and insights applying the framework in their countries:

  1. Stella Matutina Umuhoza, University of Rwanda, College of Health Sciences, School of Public
    Health Rwanda
  2. Sven Engles and Nida Hameed, ThinkWell, Pakistan
  3. Tseday Zerayacob, Ethiopia
  4. Isidore Sieleunou, Research for Development International, Cameroon
  5. Ryan Rachmand Nugraha, PhD Fellow at the University of Antwerp, Indonesia
  6. Capucine Barcellona, Saw Swee Hock School of Public Health, National University of Singapore,
    Singapore
  7. Otieno Osoro, University of Dar es Salaam, Tanzania
  8. Suzan Makawia, Ifakara Health Institute, Tanzania
  9. Uchenna Ezenwaka, University of Nigeria, Nssuka Campus, Nigeria
  10. Eugenia Amporfu, Kwame Nkrumah University of Science and Technology, Ghana

We also acknowledge the experiences of researchers and partners through the Strategic Purchasing Resource Center for India.

The team recognizes the many individuals who reviewed the toolkit Adeel Ishtiaq, Amanda Folsom, Boniface Mbuthia, Laurel Hatt and Mary D’Alimonte.

The Strategic Health Purchasing Progress Tracking Framework was co-created by the academic and research institutions facilitated by R4D under SPARC.

  • Centre de Recherche en Reproduction Humaine et en Démographie — Benin
  • Recherche pour la Santé et le Développement — Burkina Faso
  • Research For Development International — Cameroon
  • Kwame Nkrumah University of Science and Technology — Ghana
  • KEMRI Wellcome Trust Research Programme — Kenya
  • Health Policy Research Group — Nigeria
  • University of Rwanda School of Public Health — Rwanda
  • University of Cape Town Health Economics Unit — South Africa
  • Ifakara Health Institute — Tanzania
  • University of Dar es Salaam — Tanzania
  • Makerere University School of Public Health — Uganda

We are grateful for the support of the Bill & Melinda Gates Foundation through Amref Health Africa.

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