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Tytuł pozycji:

Strengthening district health service management and delivery through internal contracting: Lessons from pilot projects in Cambodia

Tytuł :
Strengthening district health service management and delivery through internal contracting: Lessons from pilot projects in Cambodia
Autorzy :
KHIM, Keovathanak
ANNEAR, Peter Leslie
Health System Reform in Asia 2011(Hong Kong, ; 2011-12)
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Temat :
Aspect social
Social aspect
Aspecto social
Conduite à tenir
Clinical management
Actitud médica
Evaluation performance
Performance evaluation
Evaluación prestación
Financement
Financing
Financiación
Homme
Human
Hombre
Incitation
Incentive
Interne
Internal
Interno
Médecine sociale
Social medicine
Medicina social
Performance
Rendimiento
Pilote
Pilot
Prestation service
Contracting service
Prestación servicio
Projet
Project
Proyecto
Santé publique
Public health
Salud pública
Service santé
Health service
Servicio sanidad
Système santé
Health system
Sistema salud
Cambodia
Contracting
Health services
Incentives
Performance-based financing
Sciences biologiques et medicales
Biological and medical sciences
Sciences medicales
Medical sciences
Sante publique. Hygiene-medecine du travail
Public health. Hygiene-occupational medicine
Santé publique. Hygiène
Public health. Hygiene
Divers
Miscellaneous
Hygiene and public health, epidemiology, occupational medicine
Hygiène et santé publique, épidémiologie, médecine du travail
Sociology
Sociologie
Źródło :
Social science & medicine (1982). 96:241-249
Wydawca :
Kidlington: Elsevier, 2013.
Rok publikacji :
2013
Opis fizyczny :
print; 9; 3/4 p
Materiał oryginalny :
INIST-CNRS
Typ dokumentu :
Conference Paper
Opis pliku :
text
Język :
English
Afiliacje autora :
Nossal Institute for Global Health, The University of Melbourne, 4th Floor, Alan Gilbert Building, 161 Barry St., Carlton, 3010 VIC, Australia
ISSN :
0277-9536
Dostęp URL :
http://pascal-francis.inist.fr/vibad/index.php?action=search&terms=27727786
Prawa :
Copyright 2015 INIST-CNRS
CC BY 4.0
Sauf mention contraire ci-dessus, le contenu de cette notice bibliographique peut être utilisé dans le cadre d’une licence CC BY 4.0 Inist-CNRS / Unless otherwise stated above, the content of this bibliographic record may be used under a CC BY 4.0 licence by Inist-CNRS / A menos que se haya señalado antes, el contenido de este registro bibliográfico puede ser utilizado al amparo de una licencia CC BY 4.0 Inist-CNRS
Numer akcesji :
edsfra.27727786
Konferencja
Following a decade of piloting different models of contracting, in mid-2009 the Cambodian Ministry of Health began to test a form of 'internal contracting' for health care delivery in selected health districts (including hospitals and health centers) contracted by the provincial health department as Special Operating Agencies (SOAs) and provided with greater management autonomy. This study assesses the internal contracting approach as a means for improving the management of district health services and strengthening service delivery. While the study may contribute to the emerging field now known as performance-based financing, the lessons deal more broadly with the impact of management reform and increased autonomy in contrast to traditional public sector line-management and budgeting. Carried out during 2011, the study was based on: (i) a review of the literature and of operational documents; (ii) primary data from semi-structured key informant interviews with 20 health officials in two provinces involved in four SOA pilot districts; and (iii) routine data from the 2011 SOA performance monitoring report. Five prerequisites were identified for effective contract management and improved service delivery: a clear understanding of roles and responsibilities by the contracting parties; implementation of clear rules and procedures; effective management of performance; effective monitoring of the contract; and adequate and timely provision of resources. Both the level and allocation of incentives and management bottlenecks at various levels continue to impede implementation. We conclude that, in contracted arrangements like these, the clear separation of contracting functions (purchasing, commissioning, monitoring and regulating), management autonomy where responsibilities are genuinely devolved and accepted, and the provision of resources adequate to meet contract demands are necessary conditions for success.

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