This report from War on Want looks at how conditionalities and pressures from aid agencies and development banks force developing countries to adopt privatisation policies in public services. It focuses specifically on the sectors of water, electricity, and healthcare, in six countries: Colombia; El Salvador; Indonesia; Mozambique; South Africa; and Sri Lanka. It examines the impact of the requirements and policies of the International Monetary Fund (IMF), World Bank (WB), and other agencies including regional development banks, the European Commission (EC) and donor countries. It includes a specific examination of the various ways in which the UK’s Department for International Development (DFID) supports privatisation in these services.
Public-Private Mix
The Impact of HIV/AIDS on the Health Sector
This report emanates from the results of a study that examined the impact of HIV/AIDS on the public and private health facilities in South Africa, and outlines the subsystems that are affected. Both public and private sector health facilities have reported an increase in the number of patients seeking clinical care for people living with HIV/AIDS, leading to increased admissions to medical and paediatric wards and increased workloads. This study addresses these issues and makes recommendations for managing the HIV/AIDS case load.
Can developing countries achieve adequate improvements in child health outcomes without engaging the private sector?
The private sector exerts a significant and critical influence on child health outcomes in developing countries. This article in the Bulletin of the World Health Organization reviews the available evidence on private sector utilisation and quality of care. It provides a framework for analysing the private sector’s influence, extending its analysis to include nongovernmental organisations (NGOs), pharmacies, drug sellers, private suppliers, and food producers. The article analyses some of the most promising strategies for improving child health, and suggests a number of possible constraints to emulating these approaches more widely.
Policy options to improve the economic access of low-income households to state-provided health care
The purpose of this paper is to review a set of key policy options that aim to improve access to state-provided health care for poor households in low and middle income countries. It has been developed as part of a broader initiative that seeks to improve understanding of how to tackle the cost-related burdens influencing low income households’ access and use of health care.
Developing countries and the private sector: What chances for improving child health?
The private sector exerts a significant and critical influence on child health outcomes in developing countries. This article in the Bulletin of the World Health Organisation reviews the available evidence on private sector utilisation and quality of care. It provides a framework for analysing the private sector's influence, extending its analysis to include nongovernmental organisations (NGOs), pharmacies, drug sellers, private suppliers, and food producers. The article analyses some of the most promising strategies for improving child health, and suggests a number of possible constraints to emulating these approaches more widely. The article suggests that improving the impact of child health programmes in developing countries requires a more systematic analysis of the presence and potential of the private sector, including actors such as professional associations, producer organisations, community groups, and patients' organisations.
Impact of Public-Private Partnerships: addressing access to pharmaceuticals
The UK Department for International Development (DFID) funded the Initiative on Public Private Partnerships for Health (IPPPH) to conduct a pilot study in Uganda to assess the health and health systems impact of public private partnerships (PPPs) for improving access to pharmaceuticals in relation to leprosy, lymphatic filariasis, onchocerciasis, sleeping sickness, and HIV/AIDS. The specific remit was to examine issues of ownership, integration, coordination, implementation and impact, with a particular focus on the unique strengths and problems of these access PPPs as distinct from other comparable programmes where drugs are competitively procured.
Probing the public purse - the role of public funds in reducing child mortality
What chance do poor countries have of reducing child mortality by two thirds between 1990 and 2015? What contribution can public spending make to meeting this Millennium Development Goal (MDG)? Research by the Overseas Development Institute suggests the need for a greater pro-poor focus in public health expenditure. The author argues that the state’s role is to provide public goods, to regulate healthcare and health insurance, and to offer a safety net for the poor. Good health itself and many preventative and curative interventions have broader benefits for society. This justifies state funding of health.
REGULATING FOR DEVELOPMENT
Developing countries are now being asked to follow developed countries in the privatisation of goods and services previously provided by the state. It is argued that these countries will gain from the creation of efficient markets which offer their best chance to establish competitiveness, leading to economic growth. But critics claim that privatisation damages the quality of public services and undermines public accountability. Conventional forms of regulation address these two issues; but is it also possible to regulate for development that reduces poverty?
The role of public funds in reducing child mortality
What chance do poor countries have of reducing child mortality by two thirds between 1990 and 2015? What contribution can public spending make to meeting this Millennium Development Goal (MDG)? Research by the Overseas Development Institute suggests the need for a greater pro-poor focus in public health expenditure. Over the last 40 years child mortality has halved in low-income countries. However, it is increasing in sub-Saharan Africa and there are also large differences between the health status of poor and non-poor children within countries. What can governments do to improve child survival?
WAIVERS AND EXEMPTIONS FOR HEALTH SERVICES IN DEVELOPING COUNTRIES
World Bank 2003
This paper asks how to make a much needed system of user fees for government health services compatible with the goal of preserving equitable access to services. It demonstrates that different countries have tried different approaches and that those which have carefully designed and implemented waiver systems have had much greater success in terms of benefits incidence than countries that have improvised such systems.