Building a network of African institutions to support countries
with health financing reform

Macenta hospital. Macenta is a prefecture in the forest region of Guinea near the Liberian border that was close to the epicenter of the Ebola outbreak in Guinea in 2014. The health administration of Macenta is now receiving technical assistance from the Guinean government and international partners for health systems strengthening to rebuild after Ebola. R4D provides health systems strengthening support with the USAID Maternal Child Survival Project (MCSP) in Guinea, West Africa, and 5 other countries.

Q&A: What is strategic purchasing?

As countries move toward universal health coverage, resources are constrained and funds must be used wisely. Strategic purchasing is one way to get more value for the money spent and ensure equity.

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Many countries on the African continent are designing health financing policies to ensure limited funds are used strategically to purchase health services and improve health outcomes. Historically, R4D has engaged directly with countries to support health financing reforms. But, in 2017, we began an initiative to strengthen and elevate the deep health financing expertise in sub-Saharan Africa to lead that support.

With support from the Bill & Melinda Gates Foundation, we partnered with Nairobi-based Amref Health Africa, to launch the Strategic Purchasing Africa Resource Center (SPARC), and together we recruited a consortium of 11 Anglophone and Francophone Africa-based academic and policy analysis institutions to support their governments and drive the strategic health purchasing agenda on the continent. These institutions are beginning to deliver technical support, and now offer tailored packages to change agents.

SPARC is becoming a go-to source of expertise for country change agents

In Burkina Faso, SPARC has been facilitating a process to strengthen purchasing arrangements and get more value for money in the country’s free care program for children under 5 and pregnant women.

In Rwanda, SPARC supported the government and other stakeholders to develop a theory of change and framework for the country’s strategic health purchasing agenda. SPARC facilitated these discussions, which led to the formation of a technical working group. Among other priorities, the group is working to update provider payment mechanisms under the Community-Based Health Insurance (CBHI) program — to ensure its financial sustainability while continuing to improve access and quality of care.

Though SPARC was incubated and supported initially by R4D, it now has its own staff and direct funding and is a fully functioning resource center within Amref.

Photos courtesy of SPARC

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“We are reaching out to SPARC because of what we have seen about its coaching and mentoring approach, and the neutrality it displays in facilitating country processes.” —Dr. Pierre Yameogo, Technical Secretary, Office of the Minister of Health, Burkina Faso

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“This is the first time these three agencies/institutions are sitting in one room, not arguing, but aligning on a single focus — to improve strategic purchasing in Rwanda.” —Dr. Parfait Uwaliraye, Director General, Ministry of Health, Rwanda

Strengthening strategic purchasing expertise in Africa

To build and channel existing expertise in sub-Saharan Africa, R4D partnered with Amref Health Africa to establish a Strategic Purchasing Africa Resource Center (SPARC). SPARC matches expertise to country demand — by brokering tailored packages of strategic purchasing support.