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What are the main claims of the paper and how important are they?
The paper presents a literature review on contracting between governments of the fragile states and the private sector healthcare providers with an analysis of the basic principles and technical aspects of contracting. Beside barriers and disadvantages of contracting some potential advantages and recommendations for successful contracting out for health services in fragile states and maximizing the benefits of contracting in reaching both short and long-term goals are presented.
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Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.
The claims are not novel as the paper presents a review of the relevant literature.
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Are the claims properly placed in the context of the previous literature?
Yes
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Do the results support the claims? If not, what other evidence is required?
Yes, the results support the claims.
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If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?
N/A
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Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?
Yes
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Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?
N/A
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Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?
The literature review is up-to-date and comprehensive with a long list of about 60 references, most of them published within the last 5 years. The paper would be of interest primarily to health care policy planners in fragile states in order to use more efficiently the scarce resources and capacities for health care delivery.
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Other Comments:
1. Citing of references in the list need to be improved (Vancouver style) indicating at first author/s (person/s or institution), than title of the reference, and the source with year of publishing, i.e. ref. No. 5, 7, 16, 18, 44, 55, 56 ...
2. Connecting of the references within the text should be harmonized with the references in the list, in proper order and the same style;
3. On the page 2, subtitle "Reasons for fragility", paragraph 3 and 4, some superscript numbers, without meaning and explanation, need to be removed. -
Competing interests:
None
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Invited by the author to review this article? :
No -
Have you previously published on this or a similar topic?:
Yes
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References:
1. Donev D, Bozikov J. Financing of Health Care. In: Bjegovic V, Donev D, editors. Health Systems and their Evidence Based Development. Stability Pact for South Eastern Europe Public Health Cooperation. Lage: Hans Jacobs Publishing Company, 2004:302-23 Available from: http://www.snz.hr/ph-see/index.htm; http://www.snz.unizg.hr/ph-see/publications.htm
2. Donev D, Kovacic L. Payment Methods and Regulation of Providers. In: Bjegovic V, Donev D, editors. Health Systems and their Evidence Based Development. Stability Pact for South Eastern Europe Public Health Cooperation. Lage: Hans Jacobs Publishing Company, 2004:324-341 Available from: http://www.snz.hr/ph-see/index.htm
3. Donev D, Karadzinska-Bislimovska J, Spiroski M. National Public Health Strategy in Macedonia. In: Galan A, Scintee G, editors. Public Health Strategies. Stability Pact for South Eastern Europe Public Health Cooperation. Lage: Hans Jacobs Publishing Company, 2005:381-408 Available from: http://www.snz.hr/ph-see/index.htm; http://www.snz.unizg.hr/ph-see/publications.htm -
Experience and credentials in the specific area of science:
None - How to cite: Donev D M.Contracting out Health Services in Fragile States: Challenges and lessons learned[Review of the article 'Contracting out Health Services in Fragile States: Challenges and lessons learned ' by Khalil A].WebmedCentral 2013;4(2):WMCRW002517
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What are the main claims of the paper and how important are they?
This is a review of the literature on governments contracting health services to a third party. The advantages, disadvantages and recommendations for maximizing the benefit are reviewed.
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Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.
These claims are not novel; the previous literature is reviewed.
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Are the claims properly placed in the context of the previous literature?
Yes.
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Do the results support the claims? If not, what other evidence is required?
The claims are supported by the literature reviewed.
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If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?
N/A
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Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?
N/A
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Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?
N/A
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Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?
This is an up-to-date review which would be of interest primarily to health care policy planners, and would qualify as outstanding to a narrow audience
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Other Comments:
None
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Competing interests:
None
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Invited by the author to review this article? :
No -
Have you previously published on this or a similar topic?:
No
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References:
None -
Experience and credentials in the specific area of science:
Course Director, Global Health - Wright State University Boonshoft School of Medicine
- How to cite: Herchline T .Contracting out Health Services in Fragile States[Review of the article 'Contracting out Health Services in Fragile States: Challenges and lessons learned ' by Khalil A].WebmedCentral 2013;4(1):WMCRW002450
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The major claims of the paper relate to the difficulties of fragile countries in the provision of healthcare. Contracting healthcare services to NGOs have benefits and drawbacks.
While these claims are not especially novel the arguments are well presented. The Discussion of findings focuses on several areas: Reasons for contracting, barriers to contracting, disadvantages of contracting, advantages of contracting, and maximizing benefits for contracting. Each section is clearly presented, although not always supported with adequate citations. It is not always clear if the arguments are based on the literature or on personal experiences/beliefs.
Yes, for the most part. The citations in the text switch from Arabic to Roman numerals which is confusing to the reader - are the Roman numerals referring to Notes (a customary use of Roman numerals) or to references. No notes are provided - so it's not clear if they were omitted or if they refer to references. Also - New Zealand was used as one example as a reason for contracting - New Zealand is not considered a fragile state and therefore it is unclear why it was used as an exemplar.
Additional information concerning how the search was conducted and concluded would have assisted the reader in having greater confidence in the claims.
The protocol for this literature review is not well described. MEDLINE was searched from 1946-2011. No rationale was provided for going back to 1946. Although the inclusion criteria were provided - the number of articles that met the criteria were not provided. Additional information is needed- an algorithm depicting the process would be helpful.
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The paper is interesting and thought provoking.
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None
No
No
No
I have taught health policy at the PhD level- including international health policy