Strategic Purchasing of Health Services in Sierra Leone

46 Pages Posted: 3 Apr 2023

See all articles by Joseph Kamara

Joseph Kamara

National Social Security & Insurance Trust (NASSIT)

Wenhui Mao

Duke University - Duke Global Health Institute

Ipchita Bharali

Duke University - Duke Global Health Institute

Gavin Yamey

Duke Global Health Institute; Duke University - Duke Global Health Institute

Date Written: March 29, 2023

Abstract

This study explored strategic purchasing of health services in Sierra Leone. Purchasing of health
services in Sierra Leone is at a formative stage. Our study identified nine such purchasing schemes, which can be grouped into five major categories of purchasers: a) the ministry of health and sanitation; b) local government; c) the Free Health Care (FHC) Initiative; d) vertical disease programs; and e) private health insurance schemes. The Sierra Leone Social Health Insurance (SLeSHI) scheme is yet to become operational, while the performance-based financing (PBF) scheme wrapped up in 2015. There is a small private health insurance sector in Sierra Leone that covers less than 1% of the population.

The objectives of this study were three-fold: we aimed to (i) map the major purchasers and purchasing arrangements in Sierra Leone, (ii) analyze the incentives at play (and the providers’ responses), and (iii) identify progress, challenges and opportunities in improving governance to better coordinate strategic purchasing. A qualitative mixed-methods approach was used. We identified a total of 18 key informants who were knowledgeable on the subject matter, and who were involved in health financing or strategic purchasing. They were purposively sampled based on their experience and expertise, supplemented with snowball sampling.

Keywords: Strategic purchasing, universal health coverage, health financing, health insurance, benefit package, health information management, perfomance-based financing, governance, coordination, Sierra Leone

Suggested Citation

Kamara, Joseph and Mao, Wenhui and Bharali, Ipchita and Yamey, Gavin, Strategic Purchasing of Health Services in Sierra Leone (March 29, 2023). Duke Global Working Paper Series No. 52, Available at SSRN: https://ssrn.com/abstract=4406260 or http://dx.doi.org/10.2139/ssrn.4406260

Joseph Kamara

National Social Security & Insurance Trust (NASSIT) ( email )

Freetown
Sierra Leone

Wenhui Mao

Duke University - Duke Global Health Institute ( email )

310 Trent Drive
Box 90519
Durham, NC 27710
United States

Ipchita Bharali (Contact Author)

Duke University - Duke Global Health Institute ( email )

310 Trent Drive
Box 90519
Durham, NC 27710
United States

HOME PAGE: http://centerforpolicyimpact.org

Gavin Yamey

Duke Global Health Institute ( email )

Trent Hall
310 Trent Drive
Durham, NC 27708
United States

Duke University - Duke Global Health Institute ( email )

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