Advancing strategic purchasing in Ethiopia: Five policy briefs

Results for Development (R4D) collaborated with London School of Hygiene and Tropical Medicine (LSHTM) through the Lancet Global Commission on Financing Primary Healthcare, to co-author five policy briefs to generate evidence for the Ethiopian government to improve strategic purchasing. This was based on a request from the Ethiopian Ministry of Health (MOH) and Ethiopian Health Insurance Services (EHIS), for an evidence review and synthesis on four questions prioritized in a January 2023 workshop facilitated by LSHTM. The four questions were:

  1. What purchasing functions should take place at different levels to reduce fragmentation?
  2. What would a unified benefits framework look like in Ethiopia and what are different expansion paths towards higher coverage?
  3. What do blended provider payment systems look like in practice? How do countries move from a muddled to a blended payment system and how can this improve incentives and patient experience (equity and quality of care)?
  4. What are the system requirements for strategic purchasing with multiple schemes?

The policy briefs — which were developed in partnership with the MOH and EHIS — translate findings of the Lancet Global Health Commission on Financing Primary Health Care (PHC) report, with experience from countries, into relevant policy lessons for Ethiopia. These briefs and lessons were disseminated to a broad group of health care financing stakeholders from Ministries of Health and Finance, EHIS, Addis Ababa and Oromia Regional Health Bureaus, development and implementing partners on 20 June 2023. At the dissemination meeting, stakeholders further distilled the lessons into recommendations and next steps to advance strategic purchasing for Ethiopia.

The briefs cover the following topics:

  • Brief 1 – Mapping research on Primary Health Care financing in Ethiopia
  • Brief 2 – Institutional arrangements, accountability and harmonization for strategic purchasing
  • Brief 3 – Managing fragmentation in benefits by moving towards an integrated benefits framework
  • Brief 4 – How to design a blended payment system for Primary Health Care providers in Ethiopia
  • Brief 5 – What are the system requirements for strategic purchasing with multiple schemes?

Results for Development’s Cheryl Cashin and Agnes Munyua were the lead authors on Brief 2 and Brief 5.

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