Table 2 Key actions for strategic purchasing in relation to different stakeholders within the health system

Key strategic purchasing actions by government

• Establish clear frameworks for purchaser(s) and providers

• Ensure accountability of purchaser(s)

• Ensure adequate resources mobilised

• Fill service delivery infrastructure gaps

Key strategic purchasing actions in relation to citizens/population served

• Assess needs, preferences, values of the population to specify benefits

• Inform the population of entitlements, establish mechanisms for complaints and feedback, publicly report on use of resources and performance

Key strategic purchasing actions in relation to providers

• Select (accredit) providers

• Establish service agreements/contracts

• Design, implement, modify provider payment methods to encourage efficiency and quality

• Establish provider payment rates and pay providers regularly

• Allocate resources equitably, implement other strategies to promote equitable access and monitor user payment policies

• Develop, manage and use information systems, secure information on services provided, monitor/supervise provider performance and act on poor performance, audit provider claims, protect against fraud and corruption