Private hospitals are currently not participating in any processes which require the disclosure of the cost to themselves of providing health care services. For this reason, BHF and its members believe that it is necessary and appropriate to call for greater transparency in the area of hospital costs and the setting of hospital fees and prices of medical materials used by hospitals.
Public-Private Mix
Private hospitals driving healthcare inflation
Board of Healthcare Funders of Southern Africa, 2007
Private medical aid membership: What is the impact on health care use and out-of-pocket payments in South Africa?
Health Economics Unit, University of Cape Town: Policy brief, January 2013
This policy brief examines the extent to which private medical scheme membership shields South African members from out-of-pocket payments. This is important for the design of the National Health Insurance system in the country. The Health Economics Unit (HEU) found that medical scheme members have significantly more private health care visits and pay substantial out-of-pocket payments to use health services, in addition to their contributions to the medical schemes. Consequently, there is a need to move away from fee-for-service payments, which often leads to over-servicing, cost escalation, and assessment and regulation of less effective medications and interventions. There is also a need to limit, as much as possible, out-of-pocket payments that adversely affect scheme members and also address the rising contribution rates. A form of insurance that ensures adequate use of health services is needed. Ideally, this should be a form that ensures universal access to health care, for example, the proposed National Health Insurance, the policy brief concludes.
Private parts - treatment for STIs in Uganda
Effective treatment of curable sexually transmitted infections (STIs) is one of the few strategies available to reduce the spread of HIV in sub-Saharan Africa. Many people with STIs seek treatment from private practitioners. Why are patients turning to the private sector for help? Do they receive adequate care?
Private provision in its institutional context: Lessons from health
One characteristic of discussions about strategies for the provision of services to poor people has been the persistence of ideological debates about the relative roles of public and private sectors. These debates are strongly influenced by the experiences of the advanced market economies and often do not reflect the reality of countries where most poor people live. This paper’s aim is to contribute to the development of common understandings of this reality and to the formulation of practical strategies for meeting the needs of the poor.
Private sector 'not the answer to poverty'
Thornton P: Common Dreams Newscenter, 1 September 2006
Rich countries must deliver more money directly to poor nations to avert a growing health and sanitation crisis spreading across the southern hemisphere, according to Oxfam. The global charity said investment in health care, water, sanitation and education must be delivered by governments rather than the private sector. The report condemned the World Bank for forcing privatisation or inappropriate private sector projects on developing countries, and criticised Western governments for signing up to the so-called Washington agenda.
Private sector development
International Development Committee, 17 July 2006
This audit report examines the Department for International Development (DFID)'s approach, policies and financing mechanisms in support of private sector development (PSD). Some of the issues covered in the report include understanding private development, enabling investment climates, financing private sector development: public private partnerships, and how the private sector is contributing to development and how donors can support this work.
Private sector options to increase access to medicines for child health
This report, from Rational Pharmaceutical Management (RPM) Plus, examines a number of innovative field interventions to increase access to medicines for child health through the private sector in Tanzania. The first part of the report details a number of programmes and interventions that are currently in operation in Tanzania. These include projects on: shopkeeper interventions; low-interest loans to Accredited Drug Dispensing Outlets (ADDOs); voucher schemes; and microfinance schemes.
Private Sector Participation and Health System Performance in Sub-Saharan Africa
Yoong J; Burger N; Spreng C; et al: PLoS ONE 5(10), doi: https://doi.org/10.1371/journal.pone.0013243, 2017
The role of the private health sector in developing countries remains a much-debated and contentious issue. Critics argue that the high prices charged in the private sector limits the use of health care among the poorest, consequently reducing access and equity in the use of health care. Supporters argue that increased private sector participation might improve access and equity by bringing in much needed resources for health care and by allowing governments to increase focus on underserved populations. However, little empirical exists for or against either side of this debate. The authors examined the association between private sector participation and self-reported measures of utilization and equity in deliveries and treatment of childhood respiratory disease using regression analysis, across a sample of nationally-representative Demographic and Health Surveys from 34 SSA economies. To measure private sector participation, we computed the percentage of live births that took place in a private (for-profit or non-profit/mission) health facility and the percentage of children with ARI symptoms who were treated at a private health facility. Private sector participation was positively associated with greater overall access and reduced disparities between rich and poor as well as urban and rural populations, including after controlling for confounders including per capita income and maternal education. However, higher private sector participation may be affected by other variables that also affect access and equity. In addition to an increased level of overall service utilization, countries with a relatively large share of private sector participation tend to also have significantly higher levels of maternal education and also higher levels of GDP per capita, so the relationships may be confounded by differences in socioeconomic development (particularly maternal education, a well-established key determinant of health service utilization and child health outcomes). The authors controlled for maternal education and per capita income but report that other confounders such as better functioning transportation infrastructure may also influence both private sector participation and access. They further notes that the appropriate role of the private sector might depend on the capacity of governments to provide effective stewardship and regulation, the health care financing environment, and the organization of the public health sector.
Private sector participation deals: Evidence from the water and sanitation sector in developing countries
Jensen O, Blanc-Brude F: London School of Economics, June 2006
The study uses a negative binomial regression model to investigate the factors influencing the number of PSP projects in a sample of 60 developing countries with 460 PSP projects. The regression results provide support for the hypotheses that PSP is greater in larger markets where the ability to pay is higher and where governments are fiscally constrained. Several indicators of institutional quality are tested; these are found to be generally significant in determining the number of projects signed per country. Measures of the protection of property rights and the quality of the bureaucracy emerge as the most important institutions that encourage PSP. Rule of law and the control of corruption are significant, albeit at a lower level, while the quality of contract law and political stability are not robustly significant.
Private sector participation in water and sanitation:
promises and pitfalls
The perception that governments cannot efficiently provide water and sanitation (WSS) services has led to greatly increased private sector participation (PSP). Are regulatory regimes ensuring that service providers do not exploit their customers? Can PSPs save water and make it safer? Are the poor getting basic services?