Stakeholders

Financial Incentives, Healthcare Providers and Quality Improvements: a Review of the Evidence

This study reviews the healthcare literature that examines the effect of financial incentives on the behaviour of healthcare organisations and individuals with respect to the quality of care they deliver to consumers. Its purpose is to provide guidance to policy-makers in government and decision-makers in the private sector in their efforts to improve quality of care through payment reforms. [adapted from summary]

Reaching the Poor with Health Services: Cambodia

This brief reports on a project through Cambodia’s Ministry of Health which contracted health services to NGOs. Contracting NGOs to manage the primary health care system was found to be an effective means to increase service coverage and achieve a more pro-poor distribution of services in rural areas of Cambodia. [adapted from introduction]

How Private Health Care Can Help Africa

To understand how the private health sector might better complement Africa’s public health systems, we studied the health care sectors of 45 sub-Saharan African countries. The findings suggest opportunities for private enterprise to help improve the region’s woefully poor health outcomes.

Long Road to Adequate and Sustained Donor Financing for Health

This presentation was given at the First Forum on Human Resources for Health in Kampala. It breaks down current health spending including HRH resource needs and gaps, provides a critical assessment of HRH financing by some of the top donors and addresses campaiging for adequate and sustained donor financing. [adapted from author]

How Can Management and Leadership Training for Health Be Made Affordable, Accessible, Sustainable and Scalable? The Role of Private Sector Collaboration

This presentation was given at the First Forum on Human Resources for Health in Kampala. It discusses the need for scaled-up management and leadership training to equip healthcare professionals with the skills, experience and knowledge to manage health programs effectively and how private sector approaches to this challege offer a strategic resource to improve the management and output of health systems. [adapted from author]

Managerial Competencies of Hospital Managers in South Africa: a Survey of Managers in the Public and Private Sectors

This study evaluated the skills and competency levels of hospital managers in South Africa to determine whether there are any significant differences between managers in the public and private sectors. The results show that managers in the private sector perceived themselves to be significantly more competent than their public sector colleagues in most of the management facets. Public sector managers were also more likely than their private sector colleagues to report that they required further development and training. [adapted from abstract]

Financing and Training Needs of Small-Scale Private Health Care Providers and Distributors in Romania

This report assesses the business development needs, particularly financial and training, of private health care providers and distributors of reproductive health and family planning products and services in Romania. [adapted from author]

Business of Health in Africa: Partnering with the Private Sector to Improve People's Lives

This report describes opportunities for engaging and supporting a well managed and effectively regulated private sector to improve the region’s health. This report highlights the critical role the private sector can play in meeting health care needs in Sub-Saharan Africa. It also identifies policy changes that governments and international donors can make to enable the private sector to take on an ever more meaningful role in closing Africa’s health care gap. [adapted from publisher]

Maximizing Private Sector Contribution to Family Planning in the Europe & Eurasia Region: Context Analysis and Review of Strategies

This paper looks at reproductive health and family planning programs in the Eastern Europe and Eurasian region. It includes: a methodology to analyze the RH/FP market; an overview of opportunities and constraints to the private sector region; a description of current practices in the region that foster a greater private sector role in the provision of FP services and products; and recommendations for leveraging and maximizing private sector contribution to RH/FP goals. [adapted from author]

Public Policy and Franchising Reproductive Health: Current Evidence and Future Directions

This guide offers policymakers and researchers the latest evidence on private-provider networks and franchises, lessons learned in the field, and policy recommendations on how to mobilize private-provider networks and health franchises to help address reproductive health care needs in developing countries. [adapted from publisher]

India Local Initiatives Program: A Model for Expanding Reproductive and Child Health Services

The India Local Initiatives Program adapted a model used in Indonesia and Bangladesh to implement the government’s reproductive and child health strategy. From 1999 to 2003, three Indian nongovernmental organizations (NGOs) provided services for 784,000 people in four northern states. This model proved to be a suitable platform upon which to build health-care service delivery and create behavioral change, and the NGOs quickly found ways to sustain and expand services. [from abstract]

Why Policy Matters: Regulatory Barriers to Better Primary Care in Africa: Two Private Sector Examples

This paper examines recent experiences in Zambia, and Ethiopia that illustrate why policy matters for developing the private health sector and underscoring the need for rational regulatory policies and practices. [author’s description]

South African Health Review 2007

This edition focuses on the role of the private sector, a part of the health system that has not previously been accorded extensive coverage in the SAHR. The contrast between the public and private sectors remains stark in many facets and the deepening inequity is cause for profound concern. The significance of the private sector cannot be underestimated both with regard to its potential contribution to the health and well-being of this country’s people, as well as its role in drawing resources (financial and human) from the public sector.

Public-Private Options for Expanding Access to Human Resources for HIV/AIDS in Botswana

In responding to the goal of rapidly increasing access to antiretroviral treatment (ART), the government of Botswana undertook a major review of its health systems options to increase access to human resources, one of the major bottlenecks preventing people from receiving treatment. In mid-2004, a team of government and World Health Organization (WHO) staff reviewed the situation and identified a number of public sector scale up options. The team also reviewed the capacity of private practitioners to participate in the provision of ART. Subsequently, the government created a mechanism to include private practitioners in rolling out ART.

Malaria Treatement and Policy in Three Regions in Nigeria: the Role of Patent Medicine Vendors

Malaria is a major cause of illness and death in Nigeria, and a significant drain on its economy and the poor. Yet most Nigerians do not obtain appropriate treatment for malaria, and depend on informal private providers for anti-malarial drugs (AMDs), largely through patent medicine vendors (PMVs). This study seeks to better understand the role played by PMVs in the provision of AMDs in Nigeria, and to explore ways to improve the regulation and delivery of AMDs. [from summary]

Contribution of Privately Owned Hospitals in the Provision of Essential Obstetric Care in Nigeria

The objective of the study reported in this article was to highlight the private sector contribution in the provision of essential obstetric care in Abia State, Southeastern Nigeria. [adapted from abstract]

Tackling Malawi’s Human Resources Crisis

Since the late 1990s, Malawi’s public health services have appeared to be heading for collapse due to declining staffing levels. The government launched the Essential Health Package in 2004 to help improve the health of the population, which includes scaling-up HIV and AIDS-related services. The biggest challenge facing the initiative is improving human resource levels. [adapted from author]

Distribution of Public Sector Health Workers in Zimbabwe: a Challenge for Equity in Health

This study explored the distribution of public sector health workers [in Zimbabwe] to show how its pattern impacts on equity objectives in health care delivery. [from executive summary]

Regulating Private Practice: the (In)Visible Hand of Government in the Medical Marketplace

This presentation discusses quality issues in private practice in developing countries, how the government can make licensing and regulation more effective, shifting the quality distribution and the use of accreditation. [adapted from author]

Impact of Private Clinic Networks on Client Service Access and Quality: Evidence from Ethiopia, India and Pakistan

This presentation is from PSP-One’s GHC Expert Panel - Expanding Health Service Access, Quality, and Equity in Developing Countries: The Role of the Private Sector. It presents franchise models for delivering family planning and reproductive health services by the private sector.

Chiranjeevi: Involving Private Obstetricians to Reduce Maternal Mortality in Gujarat (India)

This PowerPoint was presented at the 2007 GHC expert panel “Making it Work: Private Sector Partnerships to Improve Women’s Health.” It discusses the challenges, costs and results of a program to use private practitioners for improving maternal and child survival.

What Can Be Done about the Private Health Sector in Low-Income Countries?

In recent years there has been a considerable growth of interest in the activities of providers in the private health sector in low income countries, and in how policy-makers might best capitalize on the accessibility and popularity of this sector. However, the evidence is limited as to which approaches work best. The aim of the present paper is to consider how the activities of the private health sector in low-income countries can be influenced so that they help to meet national health objectives. [from introduction]

Expanding Access to the Management of HIV/AIDS Through Physicians in Private Practice: and Exploratory Survey of Knowledge and Practices in Two Nigerian States

A significant proportion of people in Nigeria seek medical care primarily in the “for profit” private sector. The complexity of managing HIV and AIDS has led to debates on whether care should only be restricted to trained and accredited experts in HIV care. This research studied the knowledge and practices of physicians in private practice in two Nigerian states on the management of patients with HIV/AIDS using an anonymous self-administered questionnaire eliciting knowledge and attitudinal information. This is to ascertain their preparedness to manage HIV positive patients. [from abstract]

Shortage of Health Workers in the Malawian Public Health Services System: How Do Parliamentarians Perceive the Problem?

The quality and quantity of health care services delivered by the Malawi public health system is severely limited, due to, among other things the shortage of adequate numbers of trained health care workers. In order to suggest policy changes and implement corrective measures, there may be need to describe the perceptions of the legislature on how they perceive as the cause of the problem, which could be the solutions and an evaluation of those solution. In this paper, I present the finding from a qualitative study of Hansards (official verbatim record of parliamentary speeches) analysed by discourse analysis.

Assessing the Level of Preparedness of Private Health Providers for Clinical Management of HIV/AIDS Epidemic in Nassarawa State, Nigeria

Very little information is available on the extent to which the private health sector is involved in clinical management of HIV/AIDS in Nigeria. This study assessed the potentials and existing capacity of 15 private health facilities in Nassarawa state for clinical management of HIV/AIDS. [from abstract]

Guatemala, Pro Redes Salud: Rapid Scale-Up of Primary Health Care Through NGOs

Before the project began, 300,000 remote rural inhabitants in the Mayan highlands lacked basic primary care, the NGO civil society in health lacked cohesion, and the MOH NGO granting program needed revising. From 2000 to 2004, the NGO Networks Project implemented a grants program that helped form networks of NGOs, strengthening health services and testing innovations in service delivery, and improved monitoring and evaluation.

Utilizing the Potential of Formal and Informal Private Practitioners in Child Survival: Situation Analysis and Summary of Promising Interventions

This review and discussion paper highlights the important role that private practitioners are already playing in providing health services to children in many countries, and the far greater contribution that they could be called upon to make.

Social Franchising of Sexual and Reproductive Health Services in Honduras and Nicaragua

This document outlines the outcome of three franchising projects implemented by Partners of Marie Stopes International (MSI) in Honduras and Nicaragua. The projects were designed to pilot full and partial social franchising models as part of an initiative to test and develop alternative forms of delivering quality sexual and reproductive health (SRH) services by a non government organisation (NGO). [abstract]

Creating Conditions for Greater Private Sector Participation in FP/RH: Benefits for Contraceptive Security

Contraceptive security requires comprehensive and integrated approaches that go beyond the public sector. Private sector involvement is critical not only in helping respond to growing market demand but also in ensuring equity in the contraceptive market. Redirecting well-off clients to the private sector will free up scarce donor and public resources for those most vulnerable and in need. Governments and donors cannot mandate private sector expansion and roles; however, they can create favorable conditions that induce private providers to enter the FP/RH market. [author’s description]

Strengthening Health Professional Associations

This technical brief discusses various approaches for strengthening professional associations and outlines the benefits and challenges of such efforts. [author’s description]