ABSTRACT
Recourse to contracting in the health sector initially developed in a technical direction due to the need to draw up sound contracts. Contracting is a process that works a profound change in the relationships between stakeholders at all levels of the health system. This diversity of methods for achieving objectives should be recognized and certainly one of the strengths of contracting. It is important for political decision-makers to be aware of this diversity so that they can make the most of the opportunities it presents. When contracting emerged in the context of health systems, the debate tended to focus on technical aspects such as drawing up and managing contracts. To visualize contracting in the broader context of health sector reforms, States would be better advised to incorporate contracting into their health policy. The design and oversight of a contracting process and the implementation and monitoring of a contracting policy require level of technical know-how that the partners involved sometimes lack.
