From public to private and back again: sustaining a high service-delivery level during transition of management authority: a Cambodia case study
Contracting non-governmental organizations (NGOs) has been shown to increase health service delivery output considerably over relatively short time frames in low-income countries, especially when applying performance-related pay as a stimulus. A key concern is how to manage the transition back to go...
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| Veröffentlicht in: | Health policy and planning 2010-05, Vol.25 (3), p.197-208 |
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| creator | Jacobs, Bart Thomé, Jean-Marc Overtoom, Rob Sam, Sam Oeun Indermühle, Lorenz Price, Neil |
| description | Contracting non-governmental organizations (NGOs) has been shown to increase health service delivery output considerably over relatively short time frames in low-income countries, especially when applying performance-related pay as a stimulus. A key concern is how to manage the transition back to government-operated systems while maintaining health service delivery output levels. In this paper we describe and analyse the transition from NGO-managed to government-managed health services over a 3-year period in a health district in Cambodia with a focus on the level of health service delivery. Data are derived from four sources, including cross-sectional surveys and health management and financial information systems. The transition was achieved by focusing on all the building blocks of the health care system and ensuring an acceptable financial remuneration for the staff members of contracted health facilities. The latter was attained through performance subsidies derived from financial commitment by the central government, and revenue from user fees. Performance management had a crucial role in the gradual handover of responsibilities. Not all responsibilities were handed back to government over the case study period—notably the development of performance indicators and targets and the performance monitoring. |
| doi_str_mv | 10.1093/heapol/czp049 |
| format | Article |
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| fulltext | fulltext |
| identifier | ISSN: 0268-1080 |
| ispartof | Health policy and planning, 2010-05, Vol.25 (3), p.197-208 |
| issn | 0268-1080 1460-2237 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_757165845 |
| source | MEDLINE; PAIS Index; Applied Social Sciences Index & Abstracts (ASSIA); Jstor Complete Legacy; Oxford Journals Open Access Collection; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Cambodia Case studies Community Health Services - organization & administration Continuity of Patient Care Contract Services - organization & administration contracting Developing countries Financial incentives Financial information Health Health administration Health management Health services Health systems Humans Information systems Longitudinal Studies Low income Low income countries Management of change Maternal-Child Health Centers - organization & administration Monitoring NGOs Nongovernmental organizations Organizational Case Studies Original articles Performance management Personnel Management Program Evaluation Public-Private Sector Partnerships Quality Indicators, Health Care Regional Health Planning Service delivery Studies Total Quality Management - methods Total Quality Management - organization & administration user fees |
| title | From public to private and back again: sustaining a high service-delivery level during transition of management authority: a Cambodia case study |
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