Swiss Red Cross, UK.
Health Policy Plan. 2010 May;25(3):197-208. doi: 10.1093/heapol/czp049. Epub 2009 Nov 16.
Contracting non-governmental organizations (NGOs) has been shown to increase health service delivery output considerably over relatively short time frames in low-income countries, especially when applying performance-related pay as a stimulus. A key concern is how to manage the transition back to government-operated systems while maintaining health service delivery output levels. In this paper we describe and analyse the transition from NGO-managed to government-managed health services over a 3-year period in a health district in Cambodia with a focus on the level of health service delivery. Data are derived from four sources, including cross-sectional surveys and health management and financial information systems. The transition was achieved by focusing on all the building blocks of the health care system and ensuring an acceptable financial remuneration for the staff members of contracted health facilities. The latter was attained through performance subsidies derived from financial commitment by the central government, and revenue from user fees. Performance management had a crucial role in the gradual handover of responsibilities. Not all responsibilities were handed back to government over the case study period-notably the development of performance indicators and targets and the performance monitoring.
签约非政府组织（NGO）已被证明可以在相对较短的时间内显著提高低收入国家的卫生服务提供量，尤其是在采用绩效工资作为激励措施的情况下。一个关键问题是如何在保持卫生服务提供量水平的同时，管理向政府运营系统的过渡。本文通过在柬埔寨一个卫生区进行的为期 3 年的 NGO 管理向政府管理卫生服务的过渡，描述和分析了这一过渡，重点是卫生服务提供水平。数据来自四个来源，包括横断面调查以及卫生管理和财务信息系统。通过关注医疗体系的所有组成部分，并确保对签约医疗机构的员工有可接受的经济报酬，实现了这一过渡。后者是通过中央政府的财政承诺和医疗服务收费来提供绩效补贴实现的。绩效管理在逐步交接责任方面发挥了至关重要的作用。在整个案例研究期间，并非所有责任都移交给了政府——尤其是绩效指标和目标的制定以及绩效监测。
