HLTH 8052 Week 10 Contracting Counterposition Brief Example

Course	HLTH 8052 Advanced Issues in Global Public Health
Week	Week 10
Paper type	Counterposition brief
Length	About 780 words, 5 pages
Format	APA 7 student paper
School	Walden University
Program	PhD in Public Health
Updated	October 2026

Free sample paper for HLTH 8052 Week 10

Counterposition Brief: The Strongest Case Against Contracting Non-State Providers for District Primary Care in a Post-Conflict Ministry, in Three Strands Ranked by Damage

Student Name

Walden University

HLTH 8052: Advanced Issues in Global Public Health

Instructor Name

Month Day, Year

What this page is doingThe title commits the brief to attacking its author's own conclusion and to ranking the objections, which is what separates a counterposition from a disguised defense.

Counterposition Brief: The Strongest Case Against Contracting Non-State Providers for District Primary Care in a Post-Conflict Ministry, in Three Strands Ranked by Damage

The Conclusion Under Attack

My standing conclusion is that a ministry of health emerging from conflict should contract non-governmental organizations to run primary care in its districts. The evidence behind that view is real. A review of ten contracting experiences in developing countries concluded that contracting for primary care can be very effective, that improvements can be rapid and that seven of the nine cases with more than three years of experience had been sustained and expanded (Loevinsohn & Harding, 2005). This brief sets that evidence aside and builds the strongest case against the conclusion, as a capable opponent would. It does not answer the objections; that is the work of the final paper.

What this page is doingStating the conclusion in one sentence gives every strand a definite target.

Strand 1: The Fiscal Cliff

The most damaging objection is that contracts financed by external money can lapse together when donor priorities change, leaving districts with no provider and no public fallback. A contracting system is only as durable as its funder. When a ministry relies on donors to pay non-governmental providers across most of its districts, a single decision in a donor capital can withdraw services from millions of people at once. Afghanistan, the best-known contracting case, shows the risk. After the change of government in August 2021, a survey of health workers across the country's provinces found that almost half reported reduced availability of maternal and child health care, and its authors identified the lack of sustained donor support as one of the causes of the crisis, alongside economic collapse and restrictions on women (Glass et al., 2023). A ministry that had built its own services would have faced the same economic shock, but it would not have faced the sudden loss of the contractors themselves. This strand is ranked first because it threatens not service quality but service existence.

Strand 2: The Hollow Purchaser

The second objection is institutional. Contracting may improve services while the ministry's own capacity to deliver, or even to manage contracts, erodes. A ministry that becomes a purchaser rather than a provider needs different skills: writing performance-based contracts, monitoring them, paying on time and replacing poor performers. Palmer and colleagues, writing about Afghanistan, asked whether the contracting approach was sustainable in the longer term, given that non-governmental organizations were providing most of the country's health services (Palmer et al., 2006). The concern is that a ministry staffed for oversight but never for delivery cannot take services back if contracts fail, and that the skills of managing district health services migrate permanently to the contractors. This strand is ranked second because it describes a slow loss rather than a sudden one, but it leaves the state without options when the first strand strikes.

What this page is doingEach strand is given its strongest source and its mechanism, not a softened version.

Strand 3: A System Harder to Steer

The third objection is fragmentation. Separate contractors in separate districts, each with its own reporting, staffing rules and management culture, can make a national system harder to steer. Health information may flow to donors and contractors rather than to the ministry, and national policies may be applied unevenly. Reviews of large disease-focused initiatives have documented the same pattern of parallel planning and monitoring systems weakening national coordination (Biesma et al., 2009). In a post-conflict setting, where the state is trying to establish its authority, a health system run by many organizations may also weaken the public's sense that the government provides services at all. This strand is ranked third because its effects can be reduced by contract design, such as common reporting requirements, but it remains a real cost.

The Evidence Gap Under All Three

Beneath the three strands sits a weakness in the supporting evidence. A Cochrane review found only three studies of contracting out that met its design criteria; they suggested contracting can increase access and use of services, but the review noted methodological weaknesses and found no evidence on whether contracting was more effective than a similar investment in the public sector (Lagarde & Palmer, 2009). The comparison that matters for a ministry choosing a strategy, contracting versus spending the same money on its own services, has not been tested.

The Strand Hardest to Answer

I find the fiscal strand hardest to answer. The institutional and fragmentation strands describe risks that contract design and capacity building can reduce. The fiscal strand describes a dependency that only a change in who pays can remove, and a post-conflict ministry has little power over that. Any defense of contracting will have to show either a domestic financing fallback or a reason to believe donor funding will be stable, and the evidence for the second is weak.

References

Biesma, R. G., Brugha, R., Harmer, A., Walsh, A., Spicer, N., & Walt, G. (2009). The effects of global health initiatives on country health systems: A review of the evidence from HIV/AIDS control. Health Policy and Planning, 24(4), 239-252. https://doi.org/10.1093/heapol/czp025

Glass, N., Jalalzai, R., Spiegel, P., & Rubenstein, L. (2023). The crisis of maternal and child health in Afghanistan. Conflict and Health, 17(1), Article 28. https://doi.org/10.1186/s13031-023-00522-z

Lagarde, M., & Palmer, N. (2009). The impact of contracting out on health outcomes and use of health services in low and middle-income countries. Cochrane Database of Systematic Reviews, (4), Article CD008133. https://doi.org/10.1002/14651858.CD008133

Loevinsohn, B., & Harding, A. (2005). Buying results? Contracting for health service delivery in developing countries. The Lancet, 366(9486), 676-681. https://doi.org/10.1016/S0140-6736(05)67140-1

Palmer, N., Strong, L., Wali, A., & Sondorp, E. (2006). Contracting out health services in fragile states. BMJ, 332(7543), 718-721. https://doi.org/10.1136/bmj.332.7543.718

Reading the HLTH 8052 Week 10 instructions

The Week 10 brief asks students to write the strongest possible case against the position they plan to defend in the final paper. The brief should state the author's conclusion in a sentence, then present the main objections as a capable opponent would, each supported by published evidence. Faculty expect the objections to be ranked by how much damage they do to the conclusion. The brief should not answer the objections; that work belongs to the final paper. It closes by naming the objection the author finds hardest to answer and explaining why. Expect about five pages, formatted in APA 7.

Inside the HLTH 8052 Week 10 example

The brief states the standing conclusion and grants the evidence for it, citing Loevinsohn and Harding's review of ten contracting experiences, then sets that evidence aside. The fiscal strand explains how a single donor decision can withdraw services from many districts and cites Glass and colleagues on reduced maternal and child care after 2021. The institutional strand cites Palmer and colleagues' question about long-term sustainability and describes how delivery skills can migrate to contractors. The fragmentation strand cites Biesma and colleagues on parallel planning and monitoring. A section on the evidence gap reports the Cochrane review's three qualifying studies and the missing comparison with public investment. The final section names the fiscal strand as hardest to answer because only a change in who pays can remove it.

HLTH 8052 Week 10 rubric: what earns full marks

This brief is marked down for self-protection. A counterposition that picks weak objections, or states strong ones and immediately rebuts them, is a disguised defense, and faculty spot it quickly. Each strand is judged on its strength and sourcing; an objection backed by evidence of lapsed services carries more weight than a hypothetical. Ranking the strands by damage earns credit because it shows judgment rather than listing. The section naming the hardest objection is where reviewers look for honesty, and a brief that finds every objection easy to answer suggests the author did not try. Noting gaps in the supporting evidence adds depth. A clear structure and accurate references complete the grade.

Common HLTH 8052 Week 10 mistakes, and how to avoid them

Students find this assignment uncomfortable and often soften it without noticing. Typical signs are objections introduced with "some might argue" and answered in the next sentence, or objections chosen because they are easy to dismiss. Another problem is unsupported objections, which let the final paper win too easily. To write a real counterposition, imagine the most informed critic of your view and list that person's three best arguments. Find evidence for each. Rank them by how much they would damage your conclusion if true. Do not answer them here. Say plainly which one worries you most. If a counterposition against your own thesis would be easier to plan after seeing one, a version can be built for your topic.

Get a HLTH 8052 Week 10 example written to your instructions

Give the desk the conclusion you intend to defend in Week 11, plus this week's prompt and rubric; the counterposition brief arrives in 24-48h, the first at no charge. The sample attacks that position as hard as the published evidence allows and saves every answer for the final paper.

More HLTH 8052 papers and PhD in Public Health samples

HLTH 8052 Week 10 questions, answered

Does the brief answer the objections it raises?

No, and that restraint is the assignment. The counterposition document lays out the opposing case at its strongest and stops; the response belongs to the defended paper due the following week. The sample closes by naming which objection is hardest to answer, which gives your final paper its agenda without pre-empting it.

Can the counterposition use arguments nobody has published?

Sparingly, and only if labeled as the author's own extrapolation. The sample relies on published evaluations and analyses because an objection with documentary support is harder to dismiss. An invented objection, however clever, lets the final paper win too easily, and readers at the doctoral level notice when that happens.

What if the counterposition persuades the author?

Then the final paper can narrow or change the conclusion, and saying so openly is a strength. The sample treats that as a legitimate outcome of the exercise. A defended paper that shifts its claim in response to named evidence reads as rigorous, while one that ignores a damaging strand reads as stubborn.

Where can I find a free HLTH 8052 Week 10 sample paper?

Above this section is the full Week 10 counterposition brief, with three ranked strands against contracting non-state providers for district primary care, an evidence gap section and five references.

Which objection does the brief find hardest to answer?

The fiscal strand, because contracts paid for by external money can lapse together when donor priorities change, and a post-conflict ministry has little power over who pays.