Table 4.

Strengths and weaknesses in the SHP function of providers from whom goods and services are purchased

State budgetary allocation for health	State social health insurance scheme
Strengths include - Supply side subsidies to public providers to enhance service delivery standards - Contracting with private providers for the supply of medicines, medical devices and supplies - Supportive supervision of public providers to ensure compliance to quality standards - Occasional sanctions to erring providers Weaknesses include - Lack of standards and performance criteria to hold providers accountable for service delivery - Lack of providers’ compliance to procuring medicines, medical devices and supplies from accredited vendors - Weak data systems to support monitoring of provider performance. - Poor coordination across levels of care	Strengths include existence of - Accreditation guidelines that determine eligibility for providers of healthcare services to participate for each level of care - Eligibility standards for providers of medicines, medical devices and supplies - Clear guidelines which specify that at least 30% of health service providers will be from the private sector Weaknesses include - Lower eligibility standards for public providers compared to private providers
Opportunity	Opportunity
Contracting with private sector providers for service provision to improve access to and quality of care	Selective contracting across public and private facilities to improve the quality of health service delivery and build provider trust
Threat	Threat
Weak data systems for performance monitoring and poor provider compliance can lead to poor quality of service delivery and undermine people’s trust in the health system	Poor quality of service delivery in public health facilities can undermine trust in the scheme