Because these are often negotiated up front, one of the big challenges is making sure that the negotiation capacities are there in the first place. One of the recommendations we made in our paper was to provide resources to service delivery partners once the negotiation phase begins, to ensure that the providers are able to negotiate effectively and they're able to advocate for outcome metrics that work, not only for the organization, but also for investors and the government as well, making sure they work together.
On March 26th, 2015. See this statement in context.