PHA-Exch> Is Private Health Care the Answer to the Health Problems of the World's Poor?

[Claudio Schuftan]

Do *you* have comments?
 Claudio
From: Ruggiero, Mrs. Ana Lucia (WDC) ruglucia at paho.org


 *Is Private Health Care the Answer to the Health Problems of the World's
Poor?*



Kara Hanson*, Lucy Gilson, Catherine Goodman, Anne Mills, Richard Smith*,
Richard Feachem, Neelam Sekhri Feachem, Tracey Perez Koehlmoos, Heather
Kinlaw



*PLoS Med 5(11): e233*
*doi:10.1371/journal.pmed.0050233<http://dx.doi.org/10.1371/journal.pmed.0050233>November
2008
*

* *

Available online at:
http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0050233





"….The global burden of disease falls disproportionately upon the world's
low-income countries, which are often struggling with weak health systems.
Both the public and private sector deliver health care in these countries,
but the appropriate role for each of these sectors in health system
strengthening remains controversial. This debate examines whether the
private sector should step up its involvement in the health systems of
low-income countries…"



*Viewpoint by Kara Hanson, Lucy Gilson, Catherine Goodman, and Anne
Mills: There
Is No Alternative to Strengthening the Public Role in the Health System*

* *

*Viewpoint by Richard Smith, Richard Feachem, Neelam Sekhri Feachem, Tracey
Perez Koehlmoos, and Heather Kinlaw: We Must Engage the Private Sector to
Improve Health Care in Low-Income Countries*

* *

*Hanson and Colleagues' Response to Smith and Colleagues' Viewpoint*



"…..Policy makers and thought leaders in low- and middle-income countries,
confronted with continuing failures in the public sector, growing evidence
of the effectiveness of the private sector, and energetic non-state
organisations, are already working to harness the power of the private
sector to achieve better health care for all. Evaluation will be crucial,
but the most important research question is not "Can the private sector
help?" but "How can public–private partnerships be made most effective and
equitable?"



As Hanson and colleagues rightly urge, we must innovate and learn by doing.
In well-structured public–private partnerships, the private partners are
fully accountable for the delivery of specified services and outcomes, and
arrangements for financial rewards and penalties require that there is
rigorous measurement of process and outcomes. None of this is true in a
public system. A poor woman with an obstetric emergency in a rural area of a
low-income country is likely to die. Her death and its cause go unrecorded.
No inquiry is made about this preventable loss of life. No one is held
accountable. No question is asked in parliament. Her death is a silent
tragedy. The private sector can help us do better….."
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