Public-Private Partnerships

This brief is a summary of the West Africa private health sector assessment conducted by the SHOPS project. The assessment looked at six countries: Burkina Faso, Cameroon, Côte d’Ivoire, Mauritania, Niger, and Togo. The brief presents the assessment methods, findings, and both regional and country-specific recommendations. The recommendations aim to strengthen family planning and HIV service delivery by leveraging the unique capabilities of the West Africa Health Organization as well as each country’s private health sector. [from resource]

‘Dual practice’, or multiple job holding, generally involves public sector-based health workers taking additional work in the private sector. There has been little conceptual or empirical development of the relationship between dual practice and retention. This article helps begin to fill this gap, drawing on empirical evidence from a qualitative
study focusing on South African specialists. [from abstract]

With India’s low life expectancy largely reflecting deaths from preventable diseases, the most significant gains in health would come from population-wide preventive measures. Access to public health care services varies substantially, resulting in many people turning to private-sector providers who mainly serve those who can pay. [from abstract]

El objetivo del estudio es contribuir a mejorar la salud en Colombia mediante el desarrollo de un sistema nacional de indicadores de desempeño del sector salud. Para ello se utilizó un análisis descriptivo de datos secundarios de Colombia e Israel que, como Colombia, tiene un modelo de competencia regulada. [from abstract]

As limited information has emanated from government as to the role of the private health sector in the National Health Insurance (NHI), this chapter directs the enquiry towards the private health sector in order to establish what it perceives as its role in a post-reform healthcare industry. [from abstract]

The increasing number of people requiring HIV treatment in South Africa calls for efficient use of its human
resources for health in order to ensure optimum treatment coverage and outcomes. This paper describes an innovative
public-private partnership model which uses private sector doctors to treat public sector patients and ascertains the
model’s ability to maintain treatment outcomes over time. [from abstract]

Worldwide there are different systems for providing pharmacy services. Most countries have some element of state assistance,either for all patients or selected groups such as children, and some private provisions. Medicines are financed either through cost sharing or full private. The role of the private services is therefore much more significant. Nationally, there is a mismatch between the numbers of pharmacists and where are they worked, and the demand for pharmacy services. [from abstract]

Discussion on global health in both the academic and the public domain has focused largely on research, capacity building, and service delivery. Although these efforts along with financial commitments from public and private partners have contributed to a broader appreciation and understanding of global health challenges, the reflection of global health in academic training has largely been lacking. However, integrative models are beginning to appear.

The health systems of most countries in the region are characterized by the provision of services through both public and private providers, often in parallel or in competition with each other. This has raised the option for governments to purchase services from the private sector, to address gaps in services particularly for the poor and underserved. This policy brief reviews the evidence base of government purchasing primary care services from the private sector.

While concepts such as ‘partnership’ are central to the terminology of private–public mix (PPM), little attention has been paid to how social relations are negotiated among the diverse actors responsible for implementing these inter-sectoral arrangements. India’s Revised National Tuberculosis Control Programme (RNTCP) has used intermediary agents to facilitate the involvement of private providers in the expansion of Directly Observed Therapy, Short-Course (DOTS).

Recent analysis by the SHOPS project shows that the private health sector could help country governments sustain national HIV responses. SHOPS used national health accounts data to track how HIV funds flow through the health systems in Côte d’Ivoire, Kenya, Malawi, and Namibia, and identified ways that donors and the government can better work with the private health sector. [from introduction]

This paper explores the key issues associated with regulation of health markets in LMICs, and the different goals of regulation, namely quality and safety of care, value for money, social agreement over fair access and financing, and accountability. Licensing, price controls, and other traditional approaches to the regulation of markets for health products and services have played an important role, but they have been of questionable effectiveness in ensuring safety and efficacy at the point of the user in LMICs. [from abstract]

Physician dual practice, a combination of public and private practice, has attracted attention due to fear of reduced work supply and a lack of key personnel in the public system, increase in low priority treatments, and conflicts of interest for physicians who may be competing for their own patients when working for private suppliers. In this article, we analyze both choice of dual practice among hospital physicians and the dual practices’ effect on work supply in public hospitals. [from abstract]

One strategic approach to increase the use of appropriate maternal healthcare services is to encourage the expansion of the role of the private sector. However, critics of such an approach argue that increasing the role of the private sector will lead to increased inequity in the use of maternal healthcare services. This article explores this issue in two South Asian countries that have traditionally had high rates of maternal mortality—Nepal and Bangladesh. [from abstract]

Private health professional schools are expanding rapidly. With health training needs increasing and developing country budgets not keeping pace, private-sector schools will soon produce more health workers than public-sector institutions. This free eLearning course explores critical success factors in private-sector health education and training that are also relevant to public institutions. This course is targeted at learners who are directly engaged in private health learning institutions as well those who are charged with making health and education public policy.

This is a retrospective study of the 2011 Abia state, Nigeria monthly immunization data. In the 4 local governments operating the PPP, 45% (79/175) of the health facilities that offered immunization services in 2011 were private health facilities and 55% (96/175) were public health facilities. [from abstract]

The objective was to study (a) the utilization of an emergency obstetric transportation service among women delivering in health facilities, (b) factors associated with usage, (c) the timeliness of the service. [adapted from abstract]

This study aimed to explore possibilities for public-private collaboration in the provision of ambulatory care at the primary level in the Mekong region, Vietnam. [from abstract]

This article describes a public-private partnership (PPP) between the Peter C. Alderman Foundation and Ugandan government institutions that demonstrated the feasibility of delivering low cost, evidence-based mental health care to massively traumatized populations in northern Uganda through PPPs. [adapted from author]

This report analyses the current situation of HRH training, recruitment, placement and retention in the health system of Nepal with an emphasis on role of public private partnership to address the HRH related gaps with suitable policy interventions. [from summary]

Engaging all relevant health care providers in TB care and control through public-private mix approaches is an essential component of the World Health Organization’s Stop TB Strategy. This toolkit provides specific guidance to national tuberculosis programs on working with diverse care providers based on country experiences. [adapted from author]

The Federal Ministry of Health, recognizing the complementary role of the market based private sector in the provision of quality health services at competitive price especially in the underserved areas, developed this policy document to define the role of private v/s public sector, to institute mechanisms for the regulation of health services delivery, setting up and monitoring of the minimum standards of care, and bring into fold the private sector in reporting within the defined parameters. [from author]

This paper complements several recently published discussions of options for influencing the private sector in low and middle-income countries. Its aim is to contribute to the development of common understandings of the realities of public and private provision and of policies for improving performance. It argues that we need to situate strategies towards private providers in the context of local relationships between the state, market and civil society. [from introduction]

This work is a comparative analysis of the reasons for the adoption of institutional public-private partnerships and the governance and managerial features necessary to establish them as appropriate arrangements for public health services provisions. [from abstract]

Through public-private partnerships, the government of Rwanda can make more efficient use of public resources by targeting and meeting the needs of specific populations and thus help ensure family planning services and products will be available to all Rwandans in the long term. This report aims to inform stakeholders working to strengthen family planning through multisectoral partnerships about Rwanda’s family market.

As demand for family planning services in Peru increases, there needs to be a shift in how the public and private sectors respond. Promoting partnerships between the public and private sectors is a strategy for ensuring that unmet needs for services and contraceptives is satisfied, particularly among vulnerable populations in rural and remote regions. [from summary]

While purely private sector initiatives can also help to achieve HIV/AIDS objectives, this paper focuses on how public-private engagement can more sustainably contribute to health systems strengthening. [from introduction]

This document is a response to a recommendation to compile best practices and lessons learnt to support and facilitate public-private partnerships with respect to their applicability for strengthening the public sector in low and middle income countries. This report focuses on the contribution of AIDS-related public-private partnerships to the six building blocks of health systems. [adapted from author]

This paper describes the promise and limitations of a strategy that uses training workshop to help non-governmental health organizations, governments and businesses to understand public-private sector partnerships in health and to provide them with tools for developing effective collaborations. [from author]

Establishing a Public Private Partnership (PPP) requires a legal framework acceptable to all the partners, clarity on the commitment of resources, roles and responsibilities of each partner, as well as accountability to provide a given set of services at a desired level of quality and affordable user charges. This paper describes the design, development and implementation of a PPP for managing urban health services in Ahmedabad city, Gujarat. [adapted from abstract]