Engaging the Private Sector

In recent years, there has been a movement for low- and middle-income countries (LMICs) to engage the private sector in their healthcare systems for the purposes of financing and delivery of services. The article entitled, “Moving towards in-depth knowledge on the private health sector in low- and middle-income countries,” written by Forsberg, Montagu and Sundewall this year (2011), offers a metanalysis of research that highlights the advantages and disadvantages in collaborating with the private sector, and the potential need for this movement.

Although there is a great deficiency in research supporting the efficacy of involving the private sector, the authors cite a number of articles that have examined the current involvement of this sector and areas lacking a strong private sector presence. An example of the positive impact of this sector has been private sector’s being largely responsible for improving the access to and provision of immunizations in many developing countries. Conversely, there has been a considerable amount of concern over the financially problematic needs of private healthcare providers, as they have an interest in making a profit based on the services they render. For many low-income countries, such as Vietnam, which was cited by the authors, this interest of private providers can make access and provision of healthcare services financially difficult for the patients.

In addition to both of the aforementioned examples demonstrating the positive and negative impacts of the private sector on healthcare, it also helps to bring to light a structural barrier to the development of sound and effective collaborations between the public and private structures. Since both sectors have varying needs to their organizations (i.e. profit making), it can be extremely difficult for the private world to find an incentive in working with the public sector. However, if proper assessment were conducted to identify program strengths in existing private sector programs, the public sector would then be able to propose structural changes that align well with and based upon the private sector that would help to meet the needs of the population. Furthermore, proposing collaboration between the public and private sectors based on the existing structure of these private entities could help reach common goals that serve the already identified needs of society across nations (i.e. Millennium Development Goals) without overburdening either sector.

Relationships that will use the strengths of the private (i.e. franchising services) and public sector (i.e. program evaluation and regulation) sectors are much needed. And as mentioned in the article, progress can be made for the overall strengthening of healthcare systems, particularly in LMICs when strong efforts are made to create these innovative alliances between sectors.

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