Experiences of contracting: an overview of the literature


This literature review focuses, in the context of developing countries, on the impact of marketisation reforms on the efficiency of health service providers and of the health system more generally, on equity and other social objectives, and on the costs of the reforms. There is a specific emphasis on contracting as the key manifestation of the general trend towards marketisation. It is concluded that there remains much uncertainty as to the overall impact of contracting on efficiency and equity, as well as to the determinants of efficiency and the necessary conditions for ensuring efficiency gains when such reforms are implemented. [Paper prepared for a WHO Technical Meeting 'Towards new partnerships for health development: The contractual approach as a policy tool', Geneva, Switzerland, 4-6 February 1998].


Mills, A.; Broomberg, J. Experiences of contracting health services: an overview of the literature. London School of Hygiene and Tropical Medicine, London, UK (1998) 59 pp. [HEFP working paper 01/98] [Also published as a technical paper in the “Macroeconomics, Health and Development Series”, number 33, World Health Organization, Geneva, Switzerland, 1998]

Experiences of contracting: an overview of the literature

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