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Chapter 27 - Harnessing the Contribution of the Private Health Care Sector toward Public Health Goals

from Section 2 - Transforming Health Systems: Confronting Challenges, Seizing Opportunities

Published online by Cambridge University Press:  08 December 2022

By
Dominic Montagu ,
A. Venkat Raman  and
Malabika Sarker
Edited by
Sameen Siddiqi ,
Awad Mataria ,
Katherine D. Rouleau  and
Meesha Iqbal
Sameen Siddiqi
Affiliation:
Aga Khan University
Awad Mataria
Affiliation:
World Health Organization, Egypt
Katherine D. Rouleau
Affiliation:
University of Toronto
Meesha Iqbal
Affiliation:
UTHealth School of Public Health, Houston
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Summary

Private hospitals, clinics, and pharmacies, and the doctors, nurses, and other medical personnel who staff them provide a large portion of healthcare services in low- and middle-income countries (L&MICs). In some, the private sector delivers much more care than the government. Understanding the scale, capacity, quality, constraints and motivations of private providers and private facilities – whether for-profit, non-profit, formal or informal – is critical to assuring that health services and medicines support and expand the goals of access to quality health care for all. This chapter sets out what is known regarding private care provision, from world-class hospitals to unlicensed and untrained village drug-sellers and summarizes the experience and frameworks being applied around the world to measure, regulate, and assure the efficient and effective provision of private health care as part of mixed-health-systems in L&MICs. In many settings the challenges of private sector governance are complicated by limited data, minimal financial transfers, and weak regulatory systems. Despite this, advances have been made in L&MICs to defining and applying good governance strategies.

Keywords

Private sectorPrivate carePrimary health careHospitalsQualityEquityGovernanceRegulationAccreditationPrivate health care sectorPrivate provisionResponsivenessPublic private engagementL&MIC
Type
Chapter
Information
Making Health Systems Work in Low and Middle Income Countries
Textbook for Public Health Practitioners
 , pp. 421 - 434
Publisher: Cambridge University Press
Print publication year: 2022

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References

Lagomarsino, G., de Ferranti, D., Pablos-Mendez, A., et al. Public stewardship of mixed health systems. Lancet 2009; 374(9701): 1577–1578.Google Scholar
World Health Organization. Engaging the private health service delivery sector through governance in mixed health systems. 2020. www.who.int/docs/default-source/health-system-governance/strategy-report-engaging-the-private-health-service-delivery-sector-through-governance-in-mixed-health-systems.pdf?sfvrsn=3e870582_1 (accessed November 6, 2021).Google Scholar
World Bank. Healthy partnerships: how governments can engage the private sector to improve health in Africa. 2011. https://openknowledge.worldbank.org/handle/10986/2304 (accessed November 8, 2021).Google Scholar
Hooda, S. K.. Growth of formal and informal private health care providers in India: structural changes and implications. J Health Care Finance 2017; 44(2).Google Scholar
Davalbhakta, S., Sharma, S., Gupta, S., et al. Private health sector in India: ready and willing, yet underutilized in the Covid-19 pandemic – a cross-sectional study. Front Public Health 2020; 8: 571419.CrossRefGoogle ScholarPubMed
Hort, K., Annear, P.. The growth of non-state hospitals in Indonesia and Vietnam: market reforms and mixed commercialised health systems. 2012. www.ssrn.com/abstract=2069757 (accessed November 5, 2021).Google Scholar
Mackintosh, M., Channon, A., Karan, A., et al. What is the private sector? Understanding private provision in the health systems of low-income and middle-income countries. Lancet 2016; 388(10044): 596–605.Google Scholar
Morgan, R., Ensor, T.. The regulation of private hospitals in Asia. Int J Health Plann Manage 2016; 31(1): 49–64.Google Scholar
Venkat Raman, A., Bjorkman, J.W.. Public–Private Partnership in Health Care in India, London, Routledge, 2009.Google Scholar
Montagu, D., Chakraborty, N.. Standard survey data: insights into private sector utilization. Front Med (Lausanne) 2021; 8: 624285.Google Scholar
Kagawa, R. C., Anglemyer, A., Montagu, D.. The scale of faith based organization participation in health service delivery in developing countries: systematic [corrected] review and meta-analysis. PLoS One 2012; 7(11): e48457.Google Scholar
Babar, Z. U.. Ten recommendations to improve pharmacy practice in low and middle-income countries (LMICs). J Pharm Policy Pract 2021; 14(1): 6.Google Scholar
McPake, B.. Hospital policy in Sub-Saharan Africa and post-colonial development impasse. Soc Hist Med 2009; 22(2): 341–360.Google Scholar
León-Cortés, J. L., Leal Fernández, G., Sánchez-Pérez, H. J.. Health reform in Mexico: governance and potential outcomes. Int J Equity Health 2019; 18(1): 30.Google Scholar
Witter, S.. “Doi Moi” and health: the effect of economic reforms on the health system in Vietnam. Int J Health Plann 1996; 11(2): 159–172.Google Scholar
Chuc, N. T., Tomson, G.. “Doi moi” and private pharmacies: a case study on dispensing and financial issues in Hanoi, Vietnam. Eur J Clin Pharmacol 1999; 55(4): 325–332.Google Scholar
Grépin, K. A.. Private sector an important but not dominant provider of key health services in low- and middle-income countries. Health Aff (Millwood) 2016; 35(7): 1214–1221.Google Scholar
Siddiqi, S., Hamid, S., Rafique, G., et al. Prescription practices of public and private health care providers in Attock District of Pakistan. Int J Health Plann Mgmt 2002; 17(1): 3–40.Google Scholar
Trivedi, R., Jagani, K.. Perceived service quality, repeat use of health care services and inpatient satisfaction in emerging economy: empirical evidences from India. Int J Pharm Healthc Mark 2018; 12(3): 288–306.Google Scholar
Young, G. J., Meterko, M., Desai, K. R.. Patient satisfaction with hospital care: effects of demographic and institutional characteristics. Med Care 2000; 38(3): 325–334.Google Scholar
Khattak, A., Alvi, M. I., Yousaf, M. A., et al. Patient satisfaction: a comparison between public & private hospitals of Peshawar. IJCRIMPH 2012; 4(5): 713–722.Google Scholar
Chakraborty, N. M., Sprockett, A.. Use of family planning and child health services in the private sector: an equity analysis of 12 DHS surveys. Int J Equity Health 2018; 17(1): 50.Google Scholar
Grépin, K. A.. Private sector an important but not dominant provider of key health services in low- and middle-income countries. Health Aff (Millwood) 2016; 35(7): 1214–1221.Google Scholar
National Institute of Population Studies (NIPS). Pakistan Demographic and Health Survey, 2017–18. 2019. https://dhsprogram.com/pubs/pdf/FR354/FR354.pdf (accessed November 19, 2021).Google Scholar
Shah, N. M., Brieger, W. R., Peters, D. H.. Can interventions improve health services from informal private providers in low and middle-income countries? A comprehensive review of the literature. Health Policy Plan 2011; 26(4): 275–287.CrossRefGoogle ScholarPubMed
Sudhinaraset, M., Ingram, M., Lofthouse, H. K., et al. What is the role of informal health care providers in developing countries? A systematic review. PLoS One 2013; 8(2): e54978.Google Scholar
Solanki, A., Kashyap, S.. Medical education in India: current challenges and the way forward. Med Teach 2014; 36(12): 1027–1031.Google Scholar
Mahal, A., Mohanan, M.. Growth of private medical education in India. Med Educ 2006; 40(10): 1009–1011.Google Scholar
Rannan-Eliya, R. P., Wijemanne, N., Liyanage, I. K., et al. The quality of outpatient primary care in public and private sectors in Sri Lanka: how well do patient perceptions match reality and what are the implications? Health Policy Plann 2015; 30(Suppl. 1): i59–i74.Google Scholar
McFarland, D. C., Shen, M. J., Parker, P., et al. Does hospital size affect patient satisfaction? Qual Manag Health Care 2017; 26(4): 205–209.Google Scholar
Fayyaz, R., Ahmed, F. A., Abid, A., et al. The quality of patient care in oncology departments in Karachi, Pakistan: patients’ perceptions. Int J Health Care Qual Assur 2020. doi: 10.1108/IJHCQA-12-2019-0201.Google Scholar
Aujla, N., Chen, Y. F., Samarakoon, Y., et al. Comparing the use of direct observation, standardized patients and exit interviews in low- and middle-income countries: a systematic review of methods of assessing quality of primary care. Health Policy Plann 2021; 36(3): 341–356.Google Scholar
Yadav, J., Menon, G. R., John, D.. Disease-specific out-of-pocket payments, catastrophic health expenditure and impoverishment effects in India: an analysis of national health survey data. Appl Health Econ 2021; 19: 769–782.Google Scholar
Barasa, E. W., Maina, T., Ravishankar, N.. Assessing the impoverishing effects, and factors associated with the incidence of catastrophic health care payments in Kenya. Int J Equity Health 2017; 16(1): 31.Google Scholar
Khan, J. A. M., Ahmed, S., Evans, T. G.. Catastrophic health care expenditure and poverty related to out-of-pocket payments for health care in Bangladesh: an estimation of financial risk protection of universal health coverage. Health Policy Plan 2017; 32(8): 1102–1110.Google Scholar
Harding, A., Montagu, D.. Role of the private sector in health-care financing and provision. In Carrin, B., Heggenhougen, Q., eds., Health Systems Policy, Finance, and Organization. Geneva, Elsevier, 2009.Google Scholar
Montagu, D., Goodman, C.. Prohibit, constrain, encourage, or purchase: how should we engage with the private health-care sector? Lancet 2016; 388(10044): 613–621.CrossRefGoogle ScholarPubMed
Montagu, D.. The provision of private health care services in European countries: recent data and lessons for universal health coverage in other settings. Front Public Health 2021; 9: 636750.Google Scholar
Randive, B., Diwan, V., De Costa, A.. India’s conditional cash transfer programme (the JSY) to promote institutional birth: is there an association between institutional birth proportion and maternal mortality? PLoS One 2013; 8(6): e67452.Google Scholar
Tougher, S., Ye, Y., Amuasi, J. H., et al. Effect of the Affordable Medicines Facility–malaria (AMFm) on the availability, price, and market share of quality-assured artemisinin-based combination therapies in seven countries: a before-and-after analysis of outlet survey data. Lancet 2012; 380(9857): 1916–1926.Google Scholar
Lönnroth, K., Uplekar, M., Arora, V. K., et al. Public–private mix for DOTS implementation: what makes it work? Bull World Health Organ 2004; 82: 580–586.Google Scholar
McPake, B., Hanson, K.. Managing the public–private mix to achieve universal health coverage. Lancet 2016; 388(10044): 622–630.Google Scholar
Lagarde, M., Palmer, N.. The impact of contracting out on health outcomes and use of health services in low and middle-income countries. Cochrane Database Syst Rev 2009; 4: CD008133.Google Scholar
Karara, G., Verbeke, F., Nyssen, M.. The role of hospital information systems in universal health coverage monitoring in Rwanda. Stud Health Technol Inform 2015; 216: 193–197.Google Scholar
World Health Organization. Social health insurance: sustainable health financing, universal coverage and social health insurance: report by the Secretariat. 2005. https://apps.who.int/iris/handle/10665/20302 (accessed November 18, 2021).Google Scholar
Das, J., Holla, A., Das, V., et al. In urban and rural India, a standardized patient study showed low levels of provider training and huge quality gaps. Health Aff (Millwood) 2012; 31(12): 2774–2784.Google Scholar
Báez-Montiel, B. B., Gutiérrez-Islas, E., Bolaños-Maldonado, M., et al. The odysseys of Ulysses: a study of tales in a normal working day of the family doctor in Paraguay, Mexico, Peru, and Spain. Aten Primaria 2014; 46(2): 68–76. In Spanish.Google Scholar
Macaia, D., Lapão, L. V.. The current situation of human resources for health in the province of Cabinda in Angola: is it a limitation to provide universal access to health care? Hum Resour Health 2017; 15(1): 88.Google Scholar
Das, J., Hammer, J.. Money for nothing: the dire straits of medical practice in Delhi, India. J Dev Econ 2007; 83(1): 1–36.Google Scholar

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