6. Abramson, W.B. (2004) ‘Contracting for Health Care Service Delivery: A Manual for Policy Makers’ John Snow Inc. and USAID, Washington DC.

This guide meant to serve as an aid to the policymakers in assessing and understanding the essence of contracting. With this information the policymaker will be able to approach performance-based contracting as a tool to achieving public sector objectives. Contracting is an important tool that can be utilized by public -sector policymakers to meet the health care needs of target populations. Some of the opportunities that contracting can bring include extending coverage to underserved populations and increasing the provision of priority services to targeted groups, improving the quality of health care delivery, and increasing efficiency in the use of public –sector resources. There are, however, certain prerequisite conditions that need to exist before the public sector contracts. The public sector must have the capability to gather and utilize programmatic, administrative, and financial data in order to properly regulate service providers—particularly private providers under government contract. Information systems and data collection processes need to be functioning in order to ensure proper contract supervision and monitoring. An analysis of unit costs by the public sector is essential in order for the government to act as an informed purchaser of services. The national legal framework and political environment need to be considered prior to contracting. In addition, the availability of service delivery providers as potential contractors needs to be measured. Contracting with private providers serves to utilize existing health resources to service the public sector and decrease coverage gaps and improve the efficiency of public resources.