Public-Private Mix

Social Protection For The Poor: Lessons From Recent International Experience

Governments and donor agencies increasingly recognise the need to provide protection for the poor against income fluctuations or livelihood shocks. In this context, ‘social protection’ is an umbrella term covering a range of interventions, from formal social security systems to ad hoc emergency interventions to project food aid (e.g. school feeding, public works). This paper synthesises current thinking and evidence on a number of issues around the design and impact of social protection programmes, including: the case for and against targeting resource transfers; alternative approaches to targeting; what form resource transfers should take (cash, food, agricultural inputs); the ‘crowding out’ debate; cost-efficiency of transfer programmes; whether these programmes meet the real and articulated needs of their ‘beneficiaries’; impacts on poverty and vulnerability, and fiscal and political sustainability.

Public versus private sector supply of contraceptives:
balancing conflicting objectives

Universal access to contraceptives is a key goal of sexual and reproductive health programmes. But what is the best way to supply them? Donated or subsidised contraceptive supplies raise questions of sustainability whereas there are concerns that market-based distribution has negative impacts on equity and access.

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?

Public versus private sector supply of contraceptives:
balancing conflicting objectives

Universal access to contraceptives is a key goal of sexual and reproductive health programmes. But what is the best way to supply them? Donated or subsidised contraceptive supplies raise questions of sustainability whereas there are concerns that market-based distribution has negative impacts on equity and access.

What price health?
User fees and the poor in Sierra Leone

User fees are an increasingly common component of public health financing. The intention is to provide patients with a cheaper but high quality alternative to private healthcare. But does it work? What is the impact on the poorest households? Do poor people still use public health services when they have to pay fees?

The globalization of public health:
the first 100 years of international health diplomacy

David P. Fidler. Bulletin of the World Health Organization Volume 79, Number 9, September 2001
Global threats to public health in the 19th century sparked the development of international health diplomacy. Many international regimes on public health issues were created between the mid 19th and mid-20th centuries. The present article analyses the global risks in this field and the international legal responses to them between 1851 and 1951, and explores the lessons from the first century of international health diplomacy of relevance to contemporary efforts to deal with the globalization of public health.

Towards a more sustainable globalisation:
the role of the public health community

DOUGLAS W BETTCHER and HEATHER WIPFLI - J Epidemiol Community Health 2001;55:617-8
In her article Fran Baum is correct in pointing out that the political complexities of our globalised world must be taken into account by public health professionals. Global health futures are directly or indirectly associated with the transnational economic, social, and technological changes taking place in the world. Issues such as poverty, equity, and justice must be firmly rooted in any discussions aimed at improving global public health. However, globalisation is a "janus faced" creature: the double face of globalisation, one promising and the other threatening, is a fact of life as humanity is being catapulted into a more interdependent future.

In the dark over privatisation?

The Congress of South African Trade Unions' (Cosatu's) strike action against privatisation has placed a large question mark over the effectiveness of South Africa's efforts to privatise parastatals - or at least communicate to the broader community the need to restructure.

Private health care in developing countries
If it is to work, it must start from what users need

BMJ September, 2001 )
Three objectives are recommended in relation to the private provision of care for conditions of public health importance: widening access, improving quality, and ensuring non-exploitative prices. None of these will be simple to achieve; and multifaceted interventions, involving policymakers, providers, and users will be required. Increasingly service users (or "consumers") are being highlighted as the key to driving improvements to achieve these goals. Their role has, however, been little evaluated in developing countries.

Public–private partnerships for health:
their main targets, their diversity, and their future directions

Roy Widdus, Public–Private Partnerships for Health, Global Forum for Health Research
Bulletin of the World Health Organization, August 2001, 79 (8)
A large variety of public–private partnerships, combining the skills and resources of a wide range of collaborators, have arisen for product development, disease control through product donation and distribution, or the general strengthening or coordination of health services. Administratively, such partnerships may either involve affiliation with international organizations, i.e. they are essentially public-sector programmes with private-sector participation, or they may be legally independent not-for-profit bodies. These partnerships should be regarded as social experiments; they show promise but are not a panacea. New ventures should be built on need, appropriateness, and lessons on good practice learnt from experience. Suggestions are made for public, private, and joint activities that could help to improve the access of poor populations to the pharmaceuticals and health services they need.

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