Private Healthcare in Developing Countries
Private Sector Health Services
In developing countries and areas of limited healthcare access, private providers act on the front line and are often the only form of healthcare available. Although the private sector plays an increasingly important role in healthcare in developing countries, it remains a new area of study and innovation. As governments of developing countries fall short of providing widespread access to care, and traditional charity-focused NGOs offer limited or temporary solutions, the private sector presents an opportunity for sustainable scale-up of healthcare services alongside social and economic development. Included in the scope of private sector agencies are both for-profit private providers, and NGOs that apply market-based approaches to service delivery.
Our Goal
The aim of this website is to present a brief and up-to-date review of the pertinent issues in private sector healthcare delivery. This work is not biased by outside funding sources or agendas, and the content is intended not only to serve as a resource, but also as a springboard for sharing information. Welcome.
This Site
Private sector topics are organized into two major categories: Service Delivery and Disease. Within this framework this site presents topics related to the delivery of private sector health services and goods in general, and disease-specific private sector services, respectively. For each topic, we provide a summary review of the issues at hand, current programs and approaches, and links to additional resources. The Resources page presents links organized according to topic area.
This site is still in testing mode. We welcome your feedback.
Pre-iHEA Symposium on the Private Sector: The 2009 Congress of the International Health Economics Association will be held in Beijing in July and will include a one-day symposium on the private sector. To attend, sign up through the iHEA congress website here.
Newsletter: as a new service we will be consolidating the most important article summaries, news stories, and event announcements into a two-page newsletter which will be distributed electronically every two months. If you would like to receive this bi-monthly update please fill in your email address here. Current or prior newsletters can be downloaded as pdf documents from here.
Publications
A study of the private sector’s role in maternal care delivery to vulnerable populations in Nairobi, Kenya.
Dropout analysis of community-based health insurance membership at Nouna, Burka Faso
An analysis of the factors causing individuals in rural Burkina Faso drop out of a community-based health insurance scheme.
A population-level comparative analysis reveals a national health insurance program more effective than a social franchise in reaching prenatal care standards, but neither effective in increasing institutional birth delivery in the Philippines.
An experiment with community health funds in Afghanistan
An assessment of a CBHI scheme piloted in five provinces in Afghanistan on several performance measures, including: enrollment, cost-recovery, financial protection, service utilization, and community perceptions of the program.
A meta-analysis of pharmacy quality in low and middle-income countries
A meta-analysis of 30 studies finds widespread concern over the quality of pharmacist practice, yet notes the potential for pharmacies to contribute to successful primary health care.
Government hospitals were found to have low levels of sterile gloves (20%), eye protections (20%), sterilizers (50%), and sharps containers (50%), all of which were present at the private hospitals.
Building a public-private collaborative model for reproductive health serviceprovision in Vietnam
A case analysis of the development and launch of a social franchise network of community public health clinics in VietNam.
Data from retail market for anti-malarials in Tanzania suggest that without policies to reduce the market power of individual shops, new, heavily subsidized treatments may not reach poor populations.
An examination of differences in enrollment and utilization in two community-based insurance schemes in Nigeria.
News
New Strategies to Increase TB Drug Compliance Using Cell Phones Tested
1/06/09 - The Lancet reports on three pilot developing world projects where cell phones are being used to increase patient adherence to tuberculosis medications. The SIMpill is a small pill bottle with a unique SIM-card that automatically delivers a unique identification to a central server when opened and calls the patient or caregiver if it does not receive the code within a proper time frame. SIMmed, a competing method, asks patients to dial a number to record medication events, and similarly reminds patients if they forget a dose. Finally the “X out TB” initiative requires patients to urinate on a filter paper each day after taking medication. The paper detects metabolites of isoniazid in urine and subsequently reveals a code that the patient sends via SMS to a central server. If a patient accumulates enough correct answers by the end of the month, they receive a modest financial reward. All of these projects are intended to reduce the cost of monitoring adherence, normally conducted through direct observation by a health worker.
Oxfam releases anti-private sector report
12/10/08 - An Oxfam report, "Blind optimism: challenging the myths about private health care in poor countries", finds that evidence in favour of private-sector solutions to health care is weak. Yet a growing number of international donors are promoting private-sector health-care delivery in the poorest countries, while neglecting expansion of government provision of free health services. No comparative assessment of evidence in favor of a public-sector solution to health care is given. Evidence included in the pre-release report is highly selective. Formal release is scheduled for February 11 following a debate at the World Bank.
FDA Panel Confirms Effectiveness of Malaria Drug
12/1/08 - In a major step toward full approval, an advisory panel for the Food and Drug Administration issued a report confirming positive results for the drug Coartem in treating malaria. Coartem, an artemisinin-based combination therapy, has been used extensively in places where malaria has developed resistance to traditional anti-malarial drugs. The drug’s maker Novartis has provided it to public health systems in developing countries at no cost in conjunction with the WHO and Global Fund, including over 62 million treatment courses in 2006. Novartis may receive a priority review voucher from the FDA for future drug development as part of Congress’ new system to incentivize drug maker research on tropical diseases.
Gates Foundation to Support Development of an X-Prize for Effective TB Diagnosis
The Gates Foundation has provided a planning grant to the X-Prize Foundation to develop a competitive research prize (similar to its previous prize for a manned spaceflight) for an effective and accurate diagnosis tool for tuberculosis. The foundations hope that the financial incentive will spur biotechnology entrepreneurs to develop a rapid, low-cost, and sensitive diagnostic test to help reduce the burden of disease in developing countries.
UN and DSM Nutritional Products Win Award for Micronutrient Power
ICIS, a leading chemical and petroleum industry magazine, awarded the UN World Food Program and Netherlands-based DSM Nutritional Products a prize for their joint initiative in producing a cost-efficient micronutrient packet for distribution in the developing world. The MixMe tasteless powder packet, which is now being distributed in Nepal, Kenya, and Bangladesh, contains vitamins and trace minerals which, when added to normally micronutrient deficient foods like corn and rice, helps avert numerous childhood and adult morbidities. The non-profit arm of DSM, Sight and Life, provides the WFP with expertise, high nutrient products, and financial assistance in the initiative, currently in its second year.