Date	Event	Description
26 January 2018	New citation required but conclusions have not changed	Included studies Given EPOC's revised study design criteria (EPOC 2017a), we excluded from this update 2 of the studies included in the previous version of this review. We included 1 new study, bringing the total number of included studies in this review to 2. New review author team Willem A Odendaal, Kim Ward, Jesse Uneke, Henry Uro‐Chukwu, Dereck Chitama, Yusentha Balakrishna, Tamara Kredo
26 January 2018	New search has been performed	This is the first update of a Cochrane Review published in 2009. We conducted a new search and updated other content. We made the following 3 changes to the original Review. Outcomes Secondary outcomes We added the following 2 outcomes. Economic outcomes cost‐effectiveness of delivering contracted out clinical health services costs and savings to government, contracted agencies, and patients economic measures of health benefit Health system performance as measured in terms of health service delivery, health workforce, health information, availability of essential medicines, and health financing Search strategy Given the added secondary outcomes, we changed the search strategy Study design criteria Controlled before‐after (CBA) studies To fulfil the EPOC inclusion criteria for a CBA, the study must have at least 2 intervention sites and 2 control sites Criteria reported in the 2009 review were as follows: "For this review, the control group for both RCTs and CBAs had to be areas or health facilities where the provision of health services was undertaken by the public using a traditional type of management, i.e. without the possibility for healthcare managers at the lower levels to define the remuneration levels of their staff" (Lagarde 2009, p. 5)