Private Sector

This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients’ satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates.

This technical brief describes effective or promising practices that leverage the private health care sector in developing countries, taking advantage of existing infrastructure, financial resources, and expertise to better integrate HIV services and reduce the burden on public health facilities. [from introduction]

The objective of this research was to study prescribing practices of private practitioners in the treatment of tuberculosis, two decades after a similar study conducted in the same geographical area revealed dismal results. [from abstract]

A subset of private health organizations, some called social enterprises, have developed novel approaches to increase the availability, affordability and quality of health care services to the poor through innovative health service delivery models. This study aims to characterize these models and identify areas of innovation that have led to effective provision of care for the poor. [from abstract]

This document offers key concepts and definitions to establish a common language describing the private health sector. In addition, it integrates global demographic, economic, and policy data to provide a snapshot of the private health sector in selected developing countries. [from author]

India has the highest incidence of tuberculosis (TB) in the world. The Government’s TB programme uses Directly Observed Treatment Short course to supervise patients’ treatment. However an estimated 40-50 per cent of TB treatment is accessed through private pharmacists. A challenge is to engage these pharmacists in TB control. [from author]

This study uses data from the Demographic and Health Surveys and AIDS Indicators Surveys from 12 countries in Africa, Asia, and Latin America and the Caribbean to explore use of HIV testing and sexually transimitted infections care from the private for-profit sector, and its association with household wealth status. [adapted from abstract]

Information on health expenditure suggests that most poor countries have a large and growing private medical sector. Surveys indicate that the private sector is an important source of care, even for poor people and even where public services are widely available. Experts believe that private practitioners manage a large proportion of the unreported majority of tuberculosis cases. [adapted from author]

This report summarizes the findings from research examining the role of the private sector in health systems in developing countries and emphasizes the importance of effective stewardship by governments of their country’s health system, especially given the reality that the private (nonstate) part of the system is large and complex, with major challenges and significant opportunities. [adapted from author]

This brief outlines the barriers to overcome to improve the functioning of the private health sector, the impact, the pros and cons of engaging the privat sector, myths of using provate providers and policy options. [adapted from author]

This article reviews the available evidence on private sector utilization and quality of care. It provides a framework for analysing the private sector’s influence on child health outcomes. [from abstract]

The objectives of this study include documenting the role of the private for-profit sector in voluntary counseling and testing (VCT) service delivery; establishing whether there are significant differences in the quality of VCT services, particularly in counseling and referral practices, between public, private for-profit, NGO, and mission providers; measuring key VCT service statistics at facilities within each sector; and identify best practices from each sector. [adapted from introduction]

This report highlights how changes in the legal and regulatory environment can facilitate expanded access to family planning and reproductive health services through Africa’s private health sector. Using laws and regulations from three Africa countries - Ethiopia, Kenya and Nigeria - this report presents a road map on how to review the most important laws governing the private sector, as well as key issues to assess. [from introduction]

The report is the culmination of a work group tasked with exploring practical and feasible ways for donors and technical agencies to support improvements in public-private interaction in developing countries as a means to accelerate the achievement of widely agreed-upon social objectives: reduced mortality and expanded and more equitable access to health services and essential medicines and products. [from author]

This report presents the consolidated findings from the desk review and the in-country assessment, as well as recommendations for interventions that could strengthen the role private health care providers can play in achieving health sector objectives. [from summary]

The objective of this article was to determine the current practices of private practitioners for the management of STIs in Pulau Pinang, Malaysia, evaluation of pharmacotherapy for STIs in private clinics and to ascertain the management of STIs compared to standard guidelines. [from author]

This document discusses the outcomes of a qualitative study to describe the knowledge and practices of private clinic and laboratory service providers regarding HIV and HIV counseling and testing.

The study also identifies the characteristics of the stigma that private service providers place on female sex workers, men who have sex with men, people living with HIV/AIDS and describes the experiences of these groups regarding private counseling and testing services. [adapted from executive summary]

This study seeks to assess the role of private health facilities and pharmacies in HIV/AIDS service delivery in Ethiopia, and specifically to identify factors that could enable greater involvement of this sector in addressing the HIV epidemic.

This report is the result of a rapid assessment conducted to better understand the current and potential market for family planning products and services in the private health sector in Senegal, as well as to provide recommendations to strengthen the private health sector. [adapted from executive summary]

Governments in developing countries are challenged to meet the health needs of their populations because of financial constraints, limited human resources, and weak health infrastructure. The private sector can help expand access to and quality of reproductive health services through its resources, expertise, and infrastructure.

A growing number of international donors are promoting an expansion of private-sector health-care delivery to achieve universal and equitable access. But this paper shows there is an urgent need to reassess the arguments used in favour of scaling-up private-sector provision in poor countries. The evidence shows that prioritising this approach is extremely unlikely to deliver health for poor people. [adapted from author]

The goal of the assessment was to review the quality of HIV care, antiretroviral treatment and tuberculosis services provided in private-for-profits in Uganda in order to generate appropriate recommendations and inform the development of a strategy to improve the quality of those services. [from author]

This article describes issues raised by the deployment of civil servants through the public-private partnership for health to work in private-not-for-profit health facilities in Kibaale region of Uganda. [adapted from abstract]

This presentation was from the “Health Service Delivery in Fragile States for US$ 5 perperson per year: Myth or Reality?” conference. It discusses the limited public sector capacity to deliver priority services in fragile states and the opportunities and challenges of using non-state providers to increase coverage. [adapted from author]

Non-state providers (NSP) of healthcare, whether philanthropic or commercial, exist outside the public sector. Research by the London School of Hygiene and Tropical Medicine found evidence that NSPs provide the majority of primary contacts with the health system in all six countries, except possibly South Africa. [from author]

This brief synthesizes best practices in achieving reproductive health and family planning (RH/FP) goals for the Europe and Eurasia region, and highlights the role of the private sector in meeting these goals. [from author]

The use of private health care providers in low- and middle-income countries is widespread and is the subject of considerable debate. We review here a new model of private primary care provision emerging in South Africa, in which commercial companies provide standardized primary care services at relatively low cost. [from abstract]

In sub-Saharan Africa, the private health sector ranges from traditional healers, pharmacies, and shopkeepers selling health care products, to nonprofit and for-profit clinics and hospitals. There are a variety of reasons people use the private health sector including convenience, perceived quality, confidentiality, or because nothing else is available. Moreover, private health care in sub-Saharan Africa is not just for the rich. Africans of all socioeconomic backgrounds turn to the private sector for their health care needs. [from author]

The global burden of disease falls disproportionately upon the world’s low-income countries, which are often struggling with weak health systems. Both the public and private sector deliver health care in these countries, but the appropriate role for each of these sectors in health system strengthening remains controversial. This debate examines whether the private sector should step up its involvement in the health systems of low-income countries. [from author]

The purpose of this primer is to document and promote best practices gleaned from worldwide experience in training private sector providers. [from introduction]