The neglected role of stewardship in strategic purchasing of health services: who should buy?

摘要

The World Health Organization (WHO) introduced a framework to evaluate performance of every health system in its World Heath Report 2000 (1). This framework includes three goals: good health, financial protection against healthcare costs, and responsiveness to nonmedical needs. In order to achieve these goals four functions have been outlined: 1) resources creation and generation; 2) financing; 3) service delivery; and 4) stewardship of health system (1). The financing function consists of three sub-functions; revenue collection, pooling, and purchasing. Based on this function, it is recommended that strategic purchasing should be used instead of inactive (passive) purchasing (1,2).