Table 1 Summary of strategic purchasing actions

Government–purchaser axis

 Governments should provide policy and regulatory frameworks that support strategic purchasing

Purchaser–provider axis

 Purchasers should select and contract health service providers based on criteria including capacity and geographical distribution

 Purchasers should require providers to ensure quality of service including through quality improvement mechanisms such as the use of standard treatment guidelines

 Purchasers should incentivize provider performance through payment mechanisms and related incentives

Citizen–purchaser axis

 Benefit packages should reflect the needs and preferences of the target population

 Benefit packages should offer protection from financial catastrophe