Factors driving changes in the design, implementation, and scaling-up of the contracting of health services in rural cambodia, 1997–2015

Abstract

Contracting approaches have been used in various forms to improve the delivery of public health services in low-and middle-income countries. Cambodia has embarked on a public-sector reform that includes a model of internal contracting of health care through the Ministry of Health, supported by incentive payments for staff and facilities. Contracting for health care in Cambodia has evolved through three phases during 1997–2015, each with particular design features, arrangements, and structures; different levels of involvement of local and international stakeholders; and modifications based on evidence from operational research. Based on a review of published and gray literature and interviews..