Factors Driving Changes in the Design, Implementation, and Scaling-Up of the Contracting of Health Services in Rural Cambodia, 1997–2015

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2017-03-01 DOI:10.1080/23288604.2017.1291217

K. Khim, P. Ir, P. Annear

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引用次数: 18

Abstract

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 with 29 local and international key informants, we identify national ownership, financial sustainability, and the need to strengthen service delivery institutions as the major forces that have shaped contracting in Cambodia, culminating in the move to internal contracting arrangements for public health care delivery. There remains a need to strengthen contracting governance arrangements.

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1997-2015年推动柬埔寨农村卫生服务承包设计、实施和扩大的因素

摘要:在低收入和中等收入国家，缔约方式已以各种形式用于改善公共卫生服务的提供。柬埔寨已开始进行公共部门改革，其中包括通过卫生部内部承包保健服务的模式，并向工作人员和设施提供奖励。1997年至2015年期间，柬埔寨的医疗保健承包经历了三个阶段的演变，每个阶段都有特定的设计特点、安排和结构;本地及国际持份者的不同参与程度;以及基于运筹学证据的修改。根据对已发表文献和灰色文献的审查，以及对29名当地和国际关键线人的采访，我们确定，国家所有权、财务可持续性和加强服务提供机构的必要性是影响柬埔寨承包的主要力量，最终导致公共卫生服务提供转向内部承包安排。仍然需要加强承包治理安排。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.