Glossary

 An individual or institution that provides preventive, curative, promotional or rehabilitative health services to a population or community.

A person, company or organisation that sells healthcare goods or services to customers. These customers may include government agencies, healthcare institutions or individuals.

Health financing refers to how financial resources are used to ensure that the health system can cover the collective health needs of every person (WHO). The WHO identifies to three core functions of health financing (WHO):

Revenue raising — the mobilisation of sources of funds, including government budgets, compulsory or voluntary prepaid insurance schemes, direct out-of-pocket payments by users and external aid.

Pooling of funds — the accumulation and management of prepaid funds on behalf of some or all of the population.

Purchasing of services — the payment or allocation of resources to health service providers.

Purchasing refers to the process of allocating funds to healthcare providers to obtain goods and services on behalf of identified groups (RESYST). These services may include medicines and vaccines; medical equipment and consumables; healthcare services (e.g., surgeries and consultations); or healthcare support services (e.g., facilities management, hospital laundry, ambulances).

Purchasers, or purchasing agencies, are entities that have been authorised by the State to enter into health purchasing contracts with suppliers, service providers, etc. (WHO). The purchasers in a country can fall under the Ministry of Health, subnational authorities, a mandatory or voluntary health insurance or a non-governmental organisation.

Government procurement refers to the acquisition of goods and services via contract by Ministries, Departments, Organs of State and Statutory Boards (MOF). The term ‘tender’ refers to an invitation to bid for a project. In the tendering process, governments or financial institutions invite bids for projects to be completed by a set deadline.

Market structure refers to the way that an industry is differentiated according to the nature of its competition. In healthcare purchasing, ‘market structure’ refers to the players involved in buying and selling healthcare services and the nature of the competition among them.

Strategic purchasing refers to the efficient allocation of healthcare goods and services to achieve health system goals. In strategic purchasing, a purchaser aims to achieve efficient and effective outcomes within a set budget. An iterative process of discovering efficient purchasing decisions can transform state health budgets into enhanced coverage and make health systems more efficient. 

A Strategic Purchasing unit refers to a dedicated unit within a country’s Ministry of Health, or another national health institute, which guides strategic health purchasing decisions. Functions of such a unit include making the decisions of what to buy, from whom to buy and how to buy (WHO).

A provider payment method is simply defined as the mechanism used to transfer funds from the purchaser of health care services to the providers of such services (World Bank and USAID).

A provider payment system is defined as the payment method for a health service provider, combined with other supporting systems such as contracting, accountability and information systems that accompany the payment method (World Bank and USAID). Provider payment systems therefore accomplish more than simply transferring funds to providers. They  can incentivise providers to enhance quality of care, promote purchaser-provider accountability and ensure efficient resource utilisation. 

Output-based incentives are a payment model that rewards health care providers, financially or otherwise, by tying incentives to quality indicators or efficacy parameters with an objective of improving the overall quality of care (Mathes et al).

Information is any detail that helps a business or entity to make a decision (e.g. information on supply chain gaps, competitor prices, etc.). An information management system (IMS) refers to any software used to collect, store, organise and distribute information. 

Health system performance refers to how well a health system is operating in terms of cost efficiency, quality, health outcomes, fairness and other metrics relevant to a country’s health goals.

An assessment that seeks to monitor, evaluate, and communicate the extent to which a health system is meeting its key objectives (WHO).