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The role of the private sector in delivering essential packages of health services: lessons from country experiences

Many countries are adopting essential packages of health services (EPHS) to implement universal health coverage (UHC), which are mostly financed and delivered by the public sector, while the potential role of the private health sector (PHS) remains untapped. Currently, many low-income and lower midd...

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Autores principales: Siddiqi, Sameen, Aftab, Wafa, Venkat Raman, A, Soucat, Agnès, Alwan, Ala
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9853132/
https://www.ncbi.nlm.nih.gov/pubmed/36657810
http://dx.doi.org/10.1136/bmjgh-2022-010742
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author Siddiqi, Sameen
Aftab, Wafa
Venkat Raman, A
Soucat, Agnès
Alwan, Ala
author_facet Siddiqi, Sameen
Aftab, Wafa
Venkat Raman, A
Soucat, Agnès
Alwan, Ala
author_sort Siddiqi, Sameen
collection PubMed
description Many countries are adopting essential packages of health services (EPHS) to implement universal health coverage (UHC), which are mostly financed and delivered by the public sector, while the potential role of the private health sector (PHS) remains untapped. Currently, many low-income and lower middle-income countries (LLMICs) have devised EPHS; however, guidance on translating these packages into quality, accessible and affordable services is limited. This paper explores the role of PHS in achieving UHC, identifies key concerns and presents the experience of the Diseases Control Priorities 3 Country Translation project in Afghanistan, Ethiopia, Pakistan, Somalia, Sudan and Zanzibar. There are key challenges to engagement of the PHS, which include the complexity and heterogeneity of private providers, their operation in isolation of the health system, limitations of population coverage and equity when left to PHS’s own choices, and higher overall cost of care for privately delivered services. Irrespective of the strategies employed to involve the PHS in delivering EPHS, it is necessary to identify private providers in terms of their characteristics and contribution, and their response to regulatory tools and incentives. Strategies for regulating private providers include better statutory control to prevent unlicensed practice, self-regulation by professional bodies to maintain standards of practice and accreditation of large private hospitals and chains. Potentially, purchasing delivery of essential services by engaging private providers can be an effective ‘regulatory approach’ to modify provider behaviour. Despite existing experience, more research is needed to better explore and operationalise the role of PHS in implementing EPHS in LLMICs.
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spelling pubmed-98531322023-01-21 The role of the private sector in delivering essential packages of health services: lessons from country experiences Siddiqi, Sameen Aftab, Wafa Venkat Raman, A Soucat, Agnès Alwan, Ala BMJ Glob Health Analysis Many countries are adopting essential packages of health services (EPHS) to implement universal health coverage (UHC), which are mostly financed and delivered by the public sector, while the potential role of the private health sector (PHS) remains untapped. Currently, many low-income and lower middle-income countries (LLMICs) have devised EPHS; however, guidance on translating these packages into quality, accessible and affordable services is limited. This paper explores the role of PHS in achieving UHC, identifies key concerns and presents the experience of the Diseases Control Priorities 3 Country Translation project in Afghanistan, Ethiopia, Pakistan, Somalia, Sudan and Zanzibar. There are key challenges to engagement of the PHS, which include the complexity and heterogeneity of private providers, their operation in isolation of the health system, limitations of population coverage and equity when left to PHS’s own choices, and higher overall cost of care for privately delivered services. Irrespective of the strategies employed to involve the PHS in delivering EPHS, it is necessary to identify private providers in terms of their characteristics and contribution, and their response to regulatory tools and incentives. Strategies for regulating private providers include better statutory control to prevent unlicensed practice, self-regulation by professional bodies to maintain standards of practice and accreditation of large private hospitals and chains. Potentially, purchasing delivery of essential services by engaging private providers can be an effective ‘regulatory approach’ to modify provider behaviour. Despite existing experience, more research is needed to better explore and operationalise the role of PHS in implementing EPHS in LLMICs. BMJ Publishing Group 2023-01-18 /pmc/articles/PMC9853132/ /pubmed/36657810 http://dx.doi.org/10.1136/bmjgh-2022-010742 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Analysis
Siddiqi, Sameen
Aftab, Wafa
Venkat Raman, A
Soucat, Agnès
Alwan, Ala
The role of the private sector in delivering essential packages of health services: lessons from country experiences
title The role of the private sector in delivering essential packages of health services: lessons from country experiences
title_full The role of the private sector in delivering essential packages of health services: lessons from country experiences
title_fullStr The role of the private sector in delivering essential packages of health services: lessons from country experiences
title_full_unstemmed The role of the private sector in delivering essential packages of health services: lessons from country experiences
title_short The role of the private sector in delivering essential packages of health services: lessons from country experiences
title_sort role of the private sector in delivering essential packages of health services: lessons from country experiences
topic Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9853132/
https://www.ncbi.nlm.nih.gov/pubmed/36657810
http://dx.doi.org/10.1136/bmjgh-2022-010742
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