Description
Strategic Health Purchasing is a transformative health financing mechanism that aligns health system resources with priority health outcomes to improve efficiency, equity, and effectiveness. Unlike passive purchasing, SHP directs funds toward targeted interventions, maximizing health impact and supporting Universal Health Coverage. Governance is crucial in operationalizing SHP, ensuring transparent and accountable decision-making in line with national health priorities. This literature review aims to analyze existing governance systems for SHP in selected African countries to identify key lessons and gaps within these systems, providing a foundation for proposing potential governance reforms. Using the SHP progress monitoring framework, this literature review examines SHP governance models in Africa based on decision-making, autonomy, health information systems, stakeholder engagement, and transparency in resource allocation. The study focuses on Burkina Faso, Kenya, Nigeria, Morocco, and Tunisia to ensure good representation of different regions of the continent. The findings from these countries reveal several governance challenges, such as fragmented decision-making frameworks and unclear roles for both purchasers and service providers, which weaken the health system's performance. Additionally, insufficient regulatory oversight prevents purchasers from pushing providers toward higher service standards, and inadequate health information system infrastructure limits data-driven decision-making. Moreover, while transparency in resource allocation is essential for trust and system efficiency, most countries face difficulties in this regard, leading to reduced confidence in health financing mechanisms. To improve SHP effectiveness in Africa, governments and policymakers must take decisive actions to overcome governance barriers. Strengthening regulatory frameworks will allow purchasers to enforce higher service standards while investing in health information system infrastructure will enable data-driven decision-making for better resource allocation. Furthermore, implementing transparency measures in health financing will enhance trust and ensure equitable resource distribution.
| Section | Synthèses de littérature |
|---|---|
| Mot-clé 1 | Achat Stratégique |
| Mot-clé 2 | Financement de la Santé |
| Mot-clé 3 | Gouvernance |
