Center for Health Market Innovations (CHMI)

The contracting process took off in the health sector in the early 2000s; at the time a national strategic framework was still lacking. Hence, the pilots were isolated cases developed with very limited interaction between the Ministry and the local church authorities. They addressed identified needs and arose because the state was unable (financially) to set up its own facilities there. These contracts recognized the essential role played by the faith-based hospitals33 - they got the status of district referral hospital - and defined the scope of their collaboration with the MOH.

From 2000 onwards the conditions were gradually fulfilled for a formalized contracting policy: a collaboration framework (2001), health sector strategy (2001-2010), the creation of a sub-directorate for national partnership (2002) and then progressive collaboration of the sector partners in the Cooperation Directorate (DCOOP) of the MOH in order to develop a more comprehensive partnership approach. The process was speeded up by the arrival of the C2D project, which gave support to the private not-for-profit sector through contracting: the work of drawing up a partnership strategy, started in 2003, was finished in 2006. Models for framework agreements and implementation contracts were finally ready at the end of 2007.