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Public sector engagement of private healthcare providers during the COVID-19 pandemic in Uttar Pradesh, India

The COVID-19 pandemic has strained public health resources and overwhelmed health systems capacity of countries worldwide. In India, the private sector is a significant source of healthcare particularly in large states like Uttar Pradesh (UP). This study sought to examine: (i) the government’s appro...

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Autores principales: Meghani, Ankita, Hariyani, Shreya, Das, Priyanka, Bennett, Sara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021290/
https://www.ncbi.nlm.nih.gov/pubmed/36962201
http://dx.doi.org/10.1371/journal.pgph.0000750
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author Meghani, Ankita
Hariyani, Shreya
Das, Priyanka
Bennett, Sara
author_facet Meghani, Ankita
Hariyani, Shreya
Das, Priyanka
Bennett, Sara
author_sort Meghani, Ankita
collection PubMed
description The COVID-19 pandemic has strained public health resources and overwhelmed health systems capacity of countries worldwide. In India, the private sector is a significant source of healthcare particularly in large states like Uttar Pradesh (UP). This study sought to examine: (i) the government’s approach to engaging the private health sector in the COVID-19 response in UP; (ii) the effects of government’s engagement on private providers’ practices and (iii) the barriers and facilitators to effective private sector engagement during the period. While the literature acknowledges weaknesses in private sector engagement during emergencies, our study provides deep empirical insight into how this occurs, drawing on the UP experience. We reviewed 102 Government of UP (GOUP) policy documents and conducted 36 in-depth interviews with government officials, technical partners, and private providers at district- and state-levels. We developed timelines for policy change based on the policy review and analyzed interview transcripts thematically using a framework analysis. We found that GOUP’s engagement of the private sector and private providers’ experiences varied substantially. While the government rapidly engaged and mobilized private laboratories, and enlisted private hospitals to provide COVID-19 services, it undertook only limited engagement of solo private providers who largely acted as referral units for suspected cases and reported data to support contact tracing efforts. Informal private providers played no formal role in the COVID-19 response, but in one district supported community-level contact tracing. Allopathic, alternative medicine, and diagnostic private providers faced common barriers and facilitators affecting their engagement relating to provider fear, communication, testing capacity, case reporting, and regulations. The establishment of mixed diagnostic networks during COVID-19 demonstrates the potential for public-private collaboration, however, our study also reveals missed opportunities to engage smaller-scale private health providers and establish mechanisms to effectively communicate and mobilize them during the pandemic, and beyond.
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spelling pubmed-100212902023-03-17 Public sector engagement of private healthcare providers during the COVID-19 pandemic in Uttar Pradesh, India Meghani, Ankita Hariyani, Shreya Das, Priyanka Bennett, Sara PLOS Glob Public Health Research Article The COVID-19 pandemic has strained public health resources and overwhelmed health systems capacity of countries worldwide. In India, the private sector is a significant source of healthcare particularly in large states like Uttar Pradesh (UP). This study sought to examine: (i) the government’s approach to engaging the private health sector in the COVID-19 response in UP; (ii) the effects of government’s engagement on private providers’ practices and (iii) the barriers and facilitators to effective private sector engagement during the period. While the literature acknowledges weaknesses in private sector engagement during emergencies, our study provides deep empirical insight into how this occurs, drawing on the UP experience. We reviewed 102 Government of UP (GOUP) policy documents and conducted 36 in-depth interviews with government officials, technical partners, and private providers at district- and state-levels. We developed timelines for policy change based on the policy review and analyzed interview transcripts thematically using a framework analysis. We found that GOUP’s engagement of the private sector and private providers’ experiences varied substantially. While the government rapidly engaged and mobilized private laboratories, and enlisted private hospitals to provide COVID-19 services, it undertook only limited engagement of solo private providers who largely acted as referral units for suspected cases and reported data to support contact tracing efforts. Informal private providers played no formal role in the COVID-19 response, but in one district supported community-level contact tracing. Allopathic, alternative medicine, and diagnostic private providers faced common barriers and facilitators affecting their engagement relating to provider fear, communication, testing capacity, case reporting, and regulations. The establishment of mixed diagnostic networks during COVID-19 demonstrates the potential for public-private collaboration, however, our study also reveals missed opportunities to engage smaller-scale private health providers and establish mechanisms to effectively communicate and mobilize them during the pandemic, and beyond. Public Library of Science 2022-07-22 /pmc/articles/PMC10021290/ /pubmed/36962201 http://dx.doi.org/10.1371/journal.pgph.0000750 Text en © 2022 Meghani et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Meghani, Ankita
Hariyani, Shreya
Das, Priyanka
Bennett, Sara
Public sector engagement of private healthcare providers during the COVID-19 pandemic in Uttar Pradesh, India
title Public sector engagement of private healthcare providers during the COVID-19 pandemic in Uttar Pradesh, India
title_full Public sector engagement of private healthcare providers during the COVID-19 pandemic in Uttar Pradesh, India
title_fullStr Public sector engagement of private healthcare providers during the COVID-19 pandemic in Uttar Pradesh, India
title_full_unstemmed Public sector engagement of private healthcare providers during the COVID-19 pandemic in Uttar Pradesh, India
title_short Public sector engagement of private healthcare providers during the COVID-19 pandemic in Uttar Pradesh, India
title_sort public sector engagement of private healthcare providers during the covid-19 pandemic in uttar pradesh, india
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021290/
https://www.ncbi.nlm.nih.gov/pubmed/36962201
http://dx.doi.org/10.1371/journal.pgph.0000750
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