A core function of health care financing is purchasing – the process by which funds are allocated to providers to obtain health services on behalf of a population. If designed and undertaken strategically, purchasing can improve health systems performance by promoting quality, efficiency, equity and responsiveness of health service provision and, in doing so, facilitate progress towards Universal Health Coverage

RESYST have conducted research to critically assess how selected purchasing mechanisms performed in a range of low and middle-income countries from the strategic purchasing perspective and identified factors influencing that performance. 

This sheet presents the following key findings:

• Purchasing is an undervalued function of healthcare financing in the public integrated system. 
• The capacity of purchasers is important in the effective implementation of strategic purchasing actions. 
• The implementation of strategic purchasing in the public contract system is constrained by the absence of a shared understanding of the purchasing function. 
• Parallel purchasing mechanisms, unless designed as part of an integrated system, can undermine the ability of purchasers to undertake strategic purchasing. 
• All case studies revealed poor accountability to citizens.