Improving health service delivery in conflict-affected settings: Lessons from a nationwide strategic purchasing mechanism in Afghanistan.

ABSTRACT:

Background

Due to ongoing insecurity, the government of Afghanistan delivers health care to the country's population by contracting out service delivery to non-governmental organization service providers (SPs). In 2018, major changes to SP contracts were introduced, resulting in a new pay-for-performance service delivery model. This model, called "Sehatmandi", pays SPs based on the volume of 11 key services they provide.

Methods

A narrative review of Sehatmandi's key features is presented, as well as lessons learned during implementation. Counterfactual comparisons of service delivery data for 10 payment-related service indicators are made. The first comparison is between the rate of change in the volume of services delivered from 2018 to 2019 (ie, the first year of Sehatman

SUBMITTER: Andersen CT 

PROVIDER: S-EPMC8285764 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature