Challenges of strategic purchasing in healthcare systems of developing countries: a systematic review and meta-synthesis of qualitative studies

Objective To identify and classify the challenges of implementing strategic purchasing for use in decision-making. Methods We conducted a systematic review of qualitative studies using a meta-synthesis approach based on the methods described by Paterson et al. in “Meta-study of qualitative health research: a practical guide to meta-analysis and meta-synthesis, vol 3.” Three electronic databases (PubMed, Scopus, and Web of Sciences) were searched up to 30 October 2020. Results Eleven studies were included in this review. Seven overarching concepts that acted as the main challenges of services strategic purchasing emerged as follows: structure and organization, policy-making and management, resources, service provision, contract, performance, and public involvement. Conclusion The results of this study showed that implementation of strategic purchasing in developing countries faces different challenges at different levels. Identifying challenges in each context is vital for policymakers because these challenges can vary from place to place. However, awareness of these challenges in peer countries can give good clues to decision-makers to make appropriate decisions.