International Journal of Research and Innovation in Social Science (IJRISS) | Volume VI, Issue VII, July 2022 | ISSN 2454–6186
Strategic Health Purchasing and Health System Performance in Nigeria
Saheed O. Olayiwola1, Francis O. Adeyemi2
1Department of Economics, Federal University of Technology, Akure,
2Department of Economics, Precious Cornerstone University, Ibadan, Nigeria
Abstract: Purchasing has been adopted by many countries as a mechanism to achieve greater efficiency and improved responsiveness of services to patient demands. This study examined the effects of strategic health purchasing on health system performance in Nigeria. The data for the study was collected using a purposive sampling survey in the Akure metropolis. The results indicated a positive relationship between health system performance and purchasing strategy, payment mechanism and service utilisers with the regression coefficients of 0.30, 0.16 and 0.33. This implied that purchasing strategy, payment mechanism and service utilisers are likely to improve health system performance. The results also revealed a positive relationship between each of the health system performance measurement dimensions (life expectancy, the performance of different areas of health services, distribution of access to health facilities, fairness of health financing, prompt attention to medical needs and purchasing strategy, providers payment mechanism and service utilisers. It was concluded that health system performance can be improved by the implementation of strategic health purchasing. Therefore, paying for health care services should be made strategic and rules relating to auditing and accountability should be made more effective.
Keywords: Health Purchasing, Health system, Performance, Payment mechanism, Service utilisers
JEL Classification: I13 I19
I.INTRODUCTION
The Health system encompasses organizations, institutions and resources used in generating activities targeted at improving health (WHO, 2018). The Health system used some form of purchasing that creates the allocation of funds to provider organisations. When purchasing is associated with societal healthcare needs it can play a central role in determining a health system’s overall performance (Busse et al, 2007). Strategic purchasing of health services is an incessant search for finding the best method through the decision making about what to purchase, from whom these should be purchased and how to pay for them, to maximise overall health system performance (WHO, 2000). It intends increasing health system performance through the effective allocation of financial resources to providers. This comprises three sets of decisions Vis which interventions to purchase given population health needs and wishes, how to purchase the interventions, including contractual mechanisms and payment systems; and from whom they should be purchased given providers’ levels of quality and efficiency (Busse et.al, 2007). Thus, it involves an evaluation of population health needs, the planning and design of healthcare services, the