Infrastructure investments in the health sector often face manifold problems, ranging from incompatible equipment, lack of knowledge to operate it and insufficient maintenance. As a result, adequate medical treatment is hampered and scarce funds are used inefficiently.

A systemic call for tender offers an alternative approach. It comprises an integrated view starting from the planning phase and provides a holistic solution by one party. While a systemic call for tender is not a one-sizefits- all solution for every investment situation, in appropriate cases it offers significant advantages. It can help to ensure greater sustainability (e.g. by including life-cycle costs), avoid breaks between planning and execution and reduce the coordination between otherwise separate construction and equipment suppliers.

It has to be analysed in terms of how far the operation needs to be adapted for optimal use of the new technical acquisition as well as a smooth progress of operation, which human and financial resources are needed to achieve it and how these resources can be generated permanently. Such an approach sharpens awareness of the dimension and importance of the required reforms. It therefore bears considerable potential to influence the working culture on a lasting basis, to lead to quality enhancement in daily therapeutic practice and thus ultimately to optimize the use of the new technical acquisition at patient level.

To develop the potential of systemic calls for tender in the German development cooperation (DC), the German Healthcare Partnership (GHP) launched the “dialogue on systemic procurement in the health sector” initiative at the beginning of 2012. The present study, which was commissioned in the course of this initiative, deals with specific questions regarding technical cooperation (TC).