Supply

The principal quantitative measures of private sector healthcare supply include the number of private hospitals, clinics, nursing homes, and outpatient clinics; the number of private hospital beds; the number of private pharmacies, drug shops, and drug sellers; and the number of medical personnel at each level of specialization: doctors, physician’s assistants or clinical officers, nurses, pharmacists, and lab technicians. From the total numbers the more useful ratio of private to public in each of these areas is calculated.

In 1998 Kara Hanson and Peter Berman compiled published and grey-literature source information from the World Bank and WHO to detail supply of private doctors, nurses, and hospital beds in 35 countries. Their data sources were already at that time more than 10 years old on average. Since their study, there has been one published summary of private providers for nine countries in Africa (Jefferies 2004). While individual data exists for most countries in their Ministry of Health, national statistics office records, or in some cases, WHO or World Bank studies, we are not aware of any other multi-country summaries on health service supply.

This is largely due to the difficulty of finding credible data on private providers in low and middle-income countries. Certification or registration is almost always a one-time event for both providers and facilities, and what data exists is of questionable quality because of high and often uncounted dual private and public practice by government-employed providers. The absence of standardized measures applied across countries reduces the confidence in what national data exists, though we note that in some countries national data may be highly accurate.

Private Health Care Provision in Developing Countries*
Country % Private Hospital Beds % Private Physicians
Morocco N/A 41
Algeria N/A 24
Pakistan 17 32
Tunisia N/A 36
Oman N/A 43
Turkey 4 42
Jordan 25 69
Egypt 8 N/A
Middle East Crescent Average 12 35
Indonesia 31 6
Papua New Guinea N/A 25
Thailand 14 18
Malaysia 14 57
India 31 73
South Korea N/A 86
Sri Lanka 3 N/A
Philippines 45 N/A
Korea 82 N/A
Nepal 28 N/A
Bangladesh 15 N/A
Asia Average 31 60
Paraguay 8 5
Panama N/A 10
Mexico N/A 36
Jamaica N/A 67
Chile 24 62
Costa Rica 2 N/A
Bolivia 13 N/A
Columbia 20 N/A
Ecuador 18 N/A
Argentina 32 N/A
Latin America & Caribbean Average 21 46
Burundi N/A 7
Malawi 41 25
Zambia N/A 13
Kenya 31 40
Senegal 17 38
Liberia N/A 41
Zimbabwe 56 67
South Africa 29 56
Tanzania 49 N/A
CAR 14 N/A
Africa Average 34 46
All Average 28 55

*Adapted from: Kara Hanson & Peter Berman. Private Health Care Provision in Developing Countries: A Preliminary Analysis of levels and Composition. Health Policy & Planning: 13(3): 195-211. 1998.