AFRO-NETS> RFI: Decentralised Health System and Faith-Based Organisations (2)

[Thomas Schwarz <tschwarz@medicusmundi.ch>]

RFI: Decentralised Health System and Faith-Based Organisations (2)
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Dear Anneli,
 
You might have a look at the World Health Assembly's Resolution 
on "Strengthening health systems in developing countries. The 
role of contractual arrangements in improving health systems? 
performance" (WHA56.25, see below, can be downloaded from on WHO 
website) and on the work undertaken by Medicus Mundi Interna-
tional on this behalf: (http://www.medicusmundi.org, including 
the recently published guidelines "The contractual approach. 
Guidelines for contract procedures for a healthcare structure 
within a health district in partnership with a Ministry of Health 
and an NGO" (2003).
 
Best regards,
 
Thomas Schwarz
Medicus Mundi Switzerland
mailto:tschwarz@medicusmundi.ch
 
 
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WHA56.25
THE ROLE OF CONTRACTUAL ARRANGEMENTS IN IMPROVING HEALTH SYSTEMS? 
PERFORMANCE
 
The Fifty-sixth World Health Assembly,
 
Having considered the report on the role of contractual arrange-
ments in improving health systems? performance;
 
Noting that the performance of health systems must be strength-
ened in order further to improve the health of populations, en-
sure equitable financing of health, and meet the legitimate ex-
pectations of the population;
 
Considering that the reform of health systems has generally in-
volved institutional restructuring, with a diversification of the 
agents involved in the field of health, in the public and private 
sectors, and among associations;
 
Noting that cultural change within health services, such as 
greater focus on patient needs, a broader population-health ap-
proach, and emphasis on addressing health inequalities, is often 
required to improve performance, and that health-system culture 
may be unaffected by structural change;
 
Recognizing the important role of government stewardship in regu-
lation of contractual arrangements in the health sector,
 
1. URGES Member States:
 
(1) to ensure that contractual arrangements in the field of 
health adopt rules and principles that are in harmony with na-
tional health policy;
 
(2) to frame contractual policies that maximize impact on the 
performance of health systems and harmonize the practices of all 
parties in a transparent way, in order to avoid adverse effects;
 
(3) to share their experiences on contractual arrangements in-
volving the public and private sectors and nongovernmental or-
ganizations in the provision of health services;
 
2. REQUESTS the Director-General:
 
(1) to create an evidence base so as to permit evaluation of the 
impact of differing types of contractual arrangements on the per-
formance of health systems and identification of best practices, 
taking account of socio-cultural differences;
 
(2) to provide, in response to requests from Member States, tech-
nical support in strengthening capacities and expertise in the 
development of contractual arrangements;
 
(3) to develop, in response to requests from Member States, meth-
ods and tools tailored to country realities to provide support to 
Member States in establishing a system of supervision in order to 
ensure the provision of high-quality health services, for example 
by accreditation, licensing and registration of public and pri-
vate-sector and nongovernmental organizations in the health sec-
tor;
 
(4) to facilitate the exchange of experience among Member States;
 
(5) to report to the Executive Board at its 117th session and to 
the Fifty-ninth World Health Assembly on the ways in which con-
tractual arrangements and other strategies to strengthen health 
systems improve the performance of health systems in Member 
States.
 
(Tenth plenary meeting, 28 May 2003 ­ Committee B, fifth report)

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