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Figure 5.3
Framework 2:
Five main elements used in conceptual policy deliberations that
must be considered for the implementation of strategic purchasing

Population
health

Incorporating Citizen
cost-effective empowerment
contracting
Strategic
purchasing

Developing Strengthening
effective government
purchaser and stewardship
provider and
organisations capacity

Source: Klasa et al., 2018

The second framework further elaborates on key policy themes that need to be considered
to optimise the outcomes of applying a strategic purchasing process. First mentioned in
Chapter 2 and later used as an evaluation framework of PPPs in Chapter 3 of this report,
these elements represent a synthesis of theoretical models and definitions of strategic
purchasing and references to policy themes that are critical for implementation as reflected in
the WHO’s Strategic Purchasing framework (Klasa et al., 2018; WHO, 2017b). These
elements include: i) Population Health; ii) Citizen Empowerment; iii) Strengthening
Government Stewardship and Capacity; iv) Developing Effective Purchaser
and Provider Organisations; and v) Incorporating Cost-effective
Contracting (see Chapter 2).

While these frameworks may appear to suggest singular decisions throughout the
implementation of strategic purchasing, in actuality, such decisions are iterative. Strategic
purchasing occurs as a process that requires continuous revisiting of these steps and
considerations. Our recommendations for the Government to adopt the proposed
programme for chronic disease screening and management based on strategic purchasing
practices are presented in the following section will highlight the iterative nature of these
policy considerations.

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