At Results for Development (R4D), Ms. Gates is a program associate on the Strategic Purchasing Africa Resource Center (SPARC) and Cross-Programmatic Efficiency Analysis (CPEA) teams. In this role, she assists in program management, country engagement and the facilitation of collaborative learning. She also works with R4D’s coaching team on management of the Experts Database.

Prior to joining R4D full-time, Ms. Gates interned with the R4D-led Health Systems Strengthening Accelerator (Accelerator), the Primary Health Care Performance Initiative (PHCPI) and R4D’s Frontier Health Market (FHM) Engage team to provide support in program management and day-to-day responsibilities.

Ms. Gates holds a BS in public health with an emphasis in environmental/occupational health and a minor in international development from Brigham Young University.

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This report examines the overall landscape of Ethiopia’s health care purchasing arrangements and identifies barriers to and opportunities for building a foundation for strategic health purchasing. It also recommends strategic actions that, when implemented together, can support Ethiopia’s move toward UHC.

Additional Resources

• Policy Brief: Advancing Strategic Health Purchasing in Ethiopia

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In June 2022, Results for Development (R4D) and the Strategic Purchasing Africa Resource Centre (SPARC) partnered with the WHO Health Financing Team and the WHO Regional Office for Africa, to host a three-day virtual workshop convening a diverse set of stakeholders, primarily from seven countries that conducted a CPEA assessment: Côte d’Ivoire, Comoros, Kenya, Ghana, United Republic of Tanzania, Nigeria and Uganda.

The workshop’s primary objective was to enable collaboration and learning across countries in the WHO African Region that have conducted a CPEA and to facilitate real and sustainable policy progress
to address and resolve inefficiencies.

This summary report synthesizes the findings and messages related to CPEA implementation, including both the cross-programmatic inefficiencies identified as well as mechanisms to address them. Key themes and learnings include:

• Undue fragmentation across health programs constrained each country’s progress towards Universal Health Coverage (UHC)
• CPEA can be institutionalized as a lever and integrated with other health system reforms to improve efficiency across health programs
• Both technical expertise and political commitment are required to address inefficiencies identified by CPEA
• Coordination, both vertically and horizontally, is critical and can have a multiplier effect throughout the system
• Having a single national plan that’s unified and well connected brings coherence and accountability across the system to address cross programmatic inefficiencies

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Abstract: Rehabilitative care is often overlooked and underfunded despite being a key component of universal health coverage, and now faces further neglect due to indirect impacts of the coronavirus disease 2019 pandemic. Policy-makers can leverage strategic purchasing approaches to make the most of available funds and maximize health gains. To implement more strategic purchasing of rehabilitation, health planners must: (i) develop and prioritize evidence-based rehabilitation service packages; (ii) use fit-for-purpose contracting and provider payment mechanisms to incentivize quality and efficient service delivery; and (iii) strengthen stewardship. This paper examines these three policy priorities by analysing their associated processes, actors and resources based on country experiences. Policy-makers will likely face several obstacles in operationalizing these policy priorities, including: inadequate accountability and coordination among sectors; limited data and research; undefined and non-standardized rehabilitation services, costs and outcomes; and inadequate availability of rehabilitative care. To overcome challenges and institute optimal strategic purchasing practices for rehabilitation, we recommend that policy-makers strengthen health sector stewardship and establish a framework for multisectoral collaboration, invest in data and research and make use of available experience from high-income settings, while creating a body of evidence from low- and middle-income settings.

To read the full article, click here.

Photo © Alex Kamweru/USAID

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At Results for Development (R4D), Mr. Khan is a senior program associate on the market shaping practice. He provides technical and programmatic support to the Maternal and Child Wasting (MCW) project, which works to increase access to nutrition commodities and combat malnutrition in Pakistan and Bangladesh.

Prior to R4D, he worked as a health economics and policy consultant at the Health Finance Institute, working to utilize blended finance approaches to addressing the noncommunicable disease gap. Prior to that, he served as a quality management officer at the Malawi Ministry of Health and Population, through Global Health Corps. In that role, he drafted a five-year health facility accreditation roadmap and finalized the quality of pediatric care standards, with the goal of improving the health care quality in Malawi.

Mr. Khan holds a master’s in public health (with a focus on health management) from the Harvard School of Public Health. He also received a BA from Columbia University in Middle Eastern, South Asian, and African Studies. He is a fluent English speaker.

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At Results for Development (R4D), Ms. Nnachetta is a senior program associate for the market shaping practice. In this role, she analyzes barriers in health product markets and helps in developing strategic solutions to them. She currently supports projects focusing on sexual and reproductive health products, as well as wasting in children and mothers.

Before joining R4D, Ms. Nnachetta worked at FHI 360 supporting the management of large HIV programs for general and key populations across Nigeria. She also supported programming for the COVID-19 emergency response and vaccination efforts in Nigeria, Haiti, Mongolia, Sri Lanka, Maldives, and the Pacific Islands. Prior to that, she was a program assistant in the Office of the Assistant Administrator at USAID’s Global Health Bureau.

Ms. Nnachetta holds a B.S. in biological sciences with a concentration in human nutrition and a minor in global health from Cornell University.

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