To deliver better quality services at a lower cost, the Government of Botswana has been pursuing a strategy of outsourcing nonclinical hospital services ‒ such as laundry, cleaning, and security ‒ to private vendors since 2011. In theory, outsourcing these services should save hospitals money – money that could then be used to buy more medical supplies, and to pay nurses and doctors. But hospital managers have been signing outsourcing contracts without knowing whether outsourcing really offers them a better deal than their current systems.