Why Is Strategic Purchasing Critical for Universal Health Coverage in Sub-Saharan Africa?

Area of Science:

• Health Systems Strengthening
• Health Economics
• Public Health Policy

Background:

• Universal health coverage (UHC) requires increased public health resources and improved resource utilization.
• Health purchasing, a key health financing function, involves transferring pooled funds to providers.
• Strategic purchasing deliberately directs funds to priorities and incentivizes equitable, needs-aligned provider performance.

Purpose of the Study:

• To explore the critical role of strategic purchasing in advancing UHC in sub-Saharan Africa.
• To examine the rationale, promise, and challenges of strategic purchasing in the region.
• To propose practical steps for improving strategic purchasing functions and policies.

Main Methods:

• Literature review and policy analysis.
• Exploration of strategic purchasing principles and their application.
• Case study considerations for sub-Saharan African contexts.

Main Results:

• Strategic purchasing is vital for UHC progress, especially where public health funding is limited.
• Variations in UHC progress and health outcomes in sub-Saharan Africa are not solely explained by spending.
• Effective strategic purchasing can align resources with population health needs and improve equity.

Conclusions:

• Governments and partners must prioritize and invest in strategic purchasing to achieve UHC.
• Addressing challenges in strategic purchasing is essential for realizing its potential in sub-Saharan Africa.
• Incremental improvements in strategic purchasing functions and policies are feasible and necessary.