Private Sector

This study describes the work of the Choose to Care initiative of the Catholic Church in Southern Africa which began in 2000. It shows that effective scaling-up of programmes in the response to HIV does not necessarily have to be the expansion of a single central service. Working through the diocesan and parish system,…the Catholic Church scaled up service provision by the replication of smaller scale programmes rooted in and responsive to the needs expressed by local communities in this five-country area.

The content of these guidelines focuses on nurse entrepreneurs providing nursing services. These guidelines aim to: provide background knowledge on the development of nurse entrepreneurs providing nursing service; establish the link between nurse entrepreneurs and intrapreneurs; identify the roles, services, basic profile and requirements of nurse entrepreneurs; and define the potential role of national nurses’ associations in the development and regulation of nurse entrepreneurs providing nursing service. [adpated from author’s description)

The Public Private Partnership in Health (PPPH) is an element of Uganda’s Health Sector Strategic Plan II. The private sector includes not-for-profit providers, for-profit providers called private health practitioners (PHPs), and traditional and complementary medicine providers. A representative sample of facilities was selected and surveyed to provide in-depth information on PHP facilities, which could be extrapolated to the national database. The survey collected information from 359 facilities on facility ownership, human resources, staff employment in other facilities, infrastructure and equipment, health services provided including in-depth information on HIV/AIDS services, drug availability, health management information systems, financial management procedures, and registration and organizational affiliation.

This presentation was part of the 2006 Global Health Mini-University. This session will provide an overview of factors that support or constrain the delivery of expanded services by midwives. It will discuss successful case studies to build sustainable practices. This includes a program to promote business training and access to financing to grow and improve private midwife practices in the Philippines. Presenters will also discuss the use of networks for private midwives for service expansion, quality improvement, and sustainability in Kenya. [adapted from publisher’s description]

Networks of private providers can be highly effective in reaching women with Family Planning/Reproductive Health (FP/RH) services Advantages: service delivery points are already in place, often financially sustainable, and have excess capacity. Private midwives provide 46% of all contraceptive use in Indonesia. A “linking organization” is key to link providers, identify incentives, develop a plan to meet service objectives and broker training, supplies, quality, and outreach to customers. [author’s description]

This publication is part of a series that highlights some of the key challenges, opportunities and practical examples that were identified in dialogues among over 400 leaders in business, government, development agencies, civil society, and academia to share good practices and identify practical and feasible models of collective business action and public-private partnership aimed at achieving more systemic and scalable solutions to global challenges. It makes recommendations for ways that companies can get directly engaged in specific initiatives on-the-ground. [adapted from author]

The Quality Assurance Project undertook a national assessment of private sector tuberculosis (TB) services in Cambodia to improve understanding of private sector practices and the sector’s willingness to participate in efforts to improve TB services. Over 500 respondents, including doctors, pharmacists, drug sellers, and TB patients, participated. In addition, mystery shoppers visited private pharmacists and drug sellers so that the surveyed groups’ reports could be compared to actual experiences.

As part of the African Growth and Opportunitues Forum, this paper addresses how African businesses are responding to the HIV/AIDS crisis. It is imperative that businesses take immediate action to lessen the economic and social consequences of HIV/AIDS. If they take action, businesses can ensure that economic initiatives, such as the African Growth and Opportunities Act (AGOA) will succeed in stimulating economic growth in Africa. While both the public and private sector should have HIV/AIDS policies and programs, this paper addresses only the private business sector response to the epidemic. However, many of the actions, best practices, and conclusions discussed in this paper are also applicable to public sector policies and programs.

This report aims to provide assistance to business and associated partners in recognising the business case for further action against HIV/AIDS in the workplace and beyond. This is achieved through providing evidence of the impact that HIV/AIDS has on business activities and by highlighting the lessons learned from past and current responses. Guidance is provided in the form of policy tools, case studies and an examination of how to undertake successful partnerships in response to HIV/AIDS. This publication does not seek to provide standard models but tools to guide effective, efficient and needs-specific responses to HIV/AIDS.

This study examines the relationship between medical practice and type of clinic ownership in HeBei province in the People’s Republic of China. The objective was to find out whether the kind of clinic ownership affects health care delivery patterns and access to health care. The study was carried out between 1995 and 2000 by a team of researchers from China, Israel and the Netherlands. [from preface]

This manual was developed to assist district health management teams in countries where malaria is endemic to improve the quality of malaria treatment given by private clinics, pharmacies, shops and kiosks. It gives step-by-step instructions for how to implement a public health activity that will involve wholesalers in communicating malaria guidelines to retailers and private clinics. [author’s description]

The objective of this document is to implement and evaluate a public–private partnership to deliver the internationally recommended strategy DOTS for the control of tuberculosis (TB) in Lalitpur municipality, Nepal, where it is estimated that 50% of patients with TB are managed in the private sector. [author’s description]

This presentation was part of the International Conference on Global Health session, “Answering the Call: Innovations in Human Resources by African Faith-Based Organizations.” From the perspective of the Uganda Catholic Medical Bureau experience, the presentation discusses why the private not-for-profit sector is important in service provision and training; why nurses are in the midst of the human resource crisis; obastacles to increasing the training capacity; and what the PNFP health training institutions are doing to address their weaknesses. [adapted from author]

This study attempted to determine the feasibility of a private sector led long-term intervention to reduce the HIV-infection rate among apparel workers and to provide care and support for those already infected. [author’s description]

HIV counselling and testing is a key component of both HIV care and HIV prevention, but uptake is currently low. We investigated the impact of rapid HIV testing at the workplace on uptake of voluntary counselling and testing (VCT). [author’s description]

These guidelines are designed as a practical tool to help businesses implement effective malaria control programmes in order to protect their employees and the surrounding communities. They are also intended to make the case, from social, economic and business perspectives, for businesses to do so. The guidelines provide companies with a framework for choosing suitable malaria control interventions and give detailed information on how employers can initiate and manage these activities. [author’s description]

In the majority of low and middle-income countries, the private sector presents significant opportunities for expanding the reach of essential child health services and products. Through better coordination with the private sector, governments and donors can improve the availability, quality, and effectiveness of child health services…This document assesses the current importance, and potential, of the private sector in contributing to child health. [author’s description]

As the private sector plays an increasingly critical role in the delivery of reproductive health/family planning (RH/FP) services, donors and public health ministries are turning their attention to business arrangements that offer the potential to increase access to high-quality priority health services. Private provider networks hold the promise of cost effectively expanding the scale of private practice, and are increasingly being considered as a way to achieve national public health objectives.

NGOs that provide basic health care to the poor must become less dependent on donor support by diversifying their funding. The NGO Service Delivery Program (NSDP), a USAID-funded health care program in Bangladesh, is working with NGOs to find corporate sponsorship. [publisher’s description]

This report discusses the impacts of malaria on business. It reviews the academic literature on the impacts of malaria on economies and businesses, presents data from survey on the business impacts of malaria, discusses the actions the private sector can take to combat malaria, and reviews examples of business malaria programs. The final section makes some recommendations for businesses considering engagement in malaria control. [adapted from author]

This case study documents Indonesia’s family planning experience with a view to understanding the factors and conditions that led to the remarkable growth in the private sector’s role in delivering family planning services. [from abstract]

This paper reviews the experiences of franchising and discusses the opportunities and implications for governments and donors of franchising for HIV and AIDS services. [from author]

The purpose of this paper is to begin to develop consensus about key challenges and effective strategies in working with the non-state sector to achieve public health goals. [Author’s description]

This paper evaluates structural quality of hospital care in the context of an evaluation of contracting out district hospital services in South Africa. Three contractor hospitals, run by a private company and paid by public purchasers to provide district hospital care to a rural catchment population, were matched with three adjacent public hospitals and three private hospitals serving largely insured patients. A structured instrument was used to provide a quantitative measure of structural quality. Private hospitals scored highest overall, followed by public and then contractor hospitals.

The Human Resource Management (HRM) Assessment Tool offers a method for assessing what an organization’s Human Resource Management system consists of and how well it functions. The HRM Assessment Tool helps users to develop strategies to improve the human resource system and make it as effective as possible. It can also serve as a basis for focusing discussions, brainstorming, and strategic planning. It is designed to be used in public and private-sector health organizations.

We develop a principal-agent model to analyze how the behavior of a physician in the
public sector is affected by his activities in the private sector. We show that the physician will have incentives to over-provide medical services when he uses his public activity as a way of increasing his prestige as a private doctor. The health authority only benefits from the physician’s dual practice when it is interested in ensuring a very accurate treatment for the patient. Our analysis provides a theoretical framework in which some actual policies implemented to regulate physicians’ dual practice can be addressed.

Action is underway to increase access to antiretroviral drugs, especially in countries with high rates of HIV. The role of private providers is largely ignored, although they are an important source of care for stigmatizing diseases in many poor countries. Evidence is emerging that antiretroviral drugs are leaking into formal and informal private markets. Uncontrolled use of drugs in the private sector will lead to rapid development of HIV resistance. Countries require guidance and support from international policy makers and pharmaceutical companies to implement strategies for working with private providers.

The report presents findings from a baseline survey of 155 primary health care facilities (dispensaries, with and without maternity units) that was carried out in Uganda in the latter part of 2000. The analysis compares service delivery performance in three ownership categories: government, private for-profit, and private nonprofit. Among the topics it explores at the facility level are staffing, availability of drugs and other inputs, remuneration, outputs, and financing. The findings are highly relevant for public policy in Uganda and in other countries in Africa that are undertaking civil service reform and promoting private-public partnerships in health care.

In much of the developing world, private health care providers and pharmacies are the most important sources of medicine and medical care and yet these providers are frequently not considered in planning for public health. This paper presents the available evidence, by socioeconomic status, on which strata of society benefit from publicly provided care and which strata use private health care. [from abstract]