Taking as point of departure the need for a strong public health care sector in developing countries the article firstly outlines how in sub-Saharan Africa enhanced scarcity has characterized the content and quality of health care in the public sector. This has eroded the trust among the public in the government as provider of health care and guardian of public health. Secondly, it describes how workers in the public health domain have dealt with the implications of scarcity by etching out a "puvate" zone in health care provision and how these informal activities need to be interpreted as "muddling through".
Public-Private Mix
Public health care under pressure in sub-Saharan Africa
Health Policy. 2005
Public-private mix for DOTS: towards scaling up
This report from the World Health Organization summarises proceedings from an international working group meeting on public-private sector mix (PPM) programmes for expanding DOTS (directly observed treatment, short-course), the internationally recognised TB control strategy. The meeting stressed that effective scale-up of PPM DOTS must ensure access to TB care for all population groups. Key barriers to scaling up PPM DOTS included lack of capacity for technical support at national, regional and global levels, and weak advocacy and promotion.
Draft Charter on Private and Public Health Care in South Africa
Critical Health Perspectives
The Department of Health’s recently released Draft Charter of the Public and Private Health Sectors (CPPHS) aims to address the legacy of apartheid restraint on access to health care for all South Africans. It commits public and private sectors to create “a health care system that is coherent, cost-effective and quality driven … for the benefit of the entire population” and to work together “to improve the scope, accessibility and quality of care at all levels”. For these laudable goals we give our wholehearted support. The CPPHS specifies four “key areas” of transformation: access to health services, equity in health services, quality of health services, and Black Economic Empowerment (BEE). The first three – access to, equity in, and quality of health care services, are essential (though not enough) to meet the goal of health for all South Africans. The fourth area is problematic.
Further details: /newsletter/id/31148
The Impact of Privatization on developing countries
John Nellis and Nancy Birdsall, eds.
"The privatization of state-owned enterprises has been among the most controversial of market reforms. This new edited volume brings together a comprehensive set of country studies on the effects of privatization on people-and answers the overarching question: who are the winners and losers of the wave of privatizations that swept across the developing world in the 1980s and 1990s? The studies are sophisticated and careful, and address the big questions: Are the poorest households paying more for water, power, and other basic services? Did those who lost jobs suffer permanent declines in income? Were state assets sold at prices that were too low, and who benefited from the resulting windfalls? Was the process, in laypersons' terms, fair?"
Public/Private partnerships and mobilising resources
World Economic Forum
The United Nations-sponsored Financing for Development conference in Monterrey in 2002 concluded that greater cooperation between public and private actors will be required to overcome the inadequacies of development finance and achieve internationally agreed development goals. As a follow-up to this conference, the World Economic Forum's Global Institute for Partnership and Governance in cooperation with the UN Department of Economic and Social Affairs (UNDESA) and the Swiss Agency for Development and Cooperation (SDC) convened a series of nine separate practitioner-driven, multistakeholder roundtable discussions during the period 2004-05. These two day expert roundtables, supplemented by individual meetings and other research, sought to identify where the greatest opportunities and obstacles lay.
Removing user fees for primary care in Africa
User fees are once again a topic of hot policy debate in Africa. They were introduced relatively recently in many countries, but the current call is for their removal, particularly at primary care level. As analysts who have consistently argued against user fees, we broadly support this call. However, we recognise that this action cannot be introduced overnight and, if weakly implemented, may exacerbate the problems facing African health systems.
Contracting for health service delivery in developing countries
The Lancet, Volume 366, Number 9486, 20 August 2005
To achieve the health-related Millennium Development Goals, the delivery of health services will need to improve. Contracting with non-state entities, including non-governmental organisations (NGOs), has been proposed as a means for improving health care delivery, and the global experience with such contracts is reviewed here, in this Lancet article. The ten investigated examples indicate that contracting for the delivery of primary care can be very effective and that improvements can be rapid. (requires registration)
Public- public partnerships in health and essential services
The paper first discusses the concept of PuPs and proposes a two-dimensional typology for categorising the various forms of partnership so described. The range of types of PuPs is then discussed with reference to specific sectors (water and healthcare), international associations, and six case studies. The final section draws general conclusions and makes recommendations for future research into the subject.
The case for abolition of user fees for primary health services
This issues paper, published by the DFID Health Systems Resource Centre (HSRC), was one of several feeding into Department for International Development (DFID) policy discussions in mid-2004. It examines evidence on the impacts of user fees for primary health care, evaluates the cost implications of abolishing user fees, and considers what line donors should take on the issue. The paper argues that the case for abolishing user fees is strong: they raise little money, rarely meet their stated efficiency and equity goals.
Mapping global health partnerships: what they are, what they do and where they operate
Department for International Development Health Systems Resource Centre (DFID HSRC), 2004
This paper, from the DFID Health Resource Centre (HRC) aims to provide a common understanding of what Global Health Partnerships (GHPs) are, how they might be classified and how they operate. The document reviews definitions of GHPs, outlines a classification system used in the Resource Centre’s broader GHP project, describes the key findings, and provides a detailed list of GHPs with their missions, aims and/or objectives. It also details a global GHP mapping exercise, which examined prevalence or cases of specific diseases of interest to target GHPs, poverty, and political and health systems characteristics.