PHA-Exch> Is Private Health Care the Answer to the Health Problems of the World's Poor? (4)

[Claudio Schuftan]

>
>   From David Zakus <davidzakus at cs.com>
>
>

>     I just can't get over how much we continually hear about the
> importance of the private sector in improving the health of poor countries.
>  Sure, enough, there is a role for it in delivering perhaps higher standard
> care to those who can afford it, but what about the majority who continually
> suffer at the mercy of their private health services in their local towns,
> villages and communities; these services usually being nothing like what you
> can imagine them being, especially when you read about them in published
> papers.  In reality, for the vast majority in my experience from many
> countries, they basically the same low quality services as in the public
> sector, and in most cases they are delivered by the same persons, who are
> just trying to eke out a living in the afternoon, after they leave their
> horribly paid public sector position to provide the same service to the same
> people in the same villages and towns, but from their home or private clinic
> for which they charge much more than would have been charged for the same
> service in the morning at the local MOH place.  What's this about?  Why
> can't health care professionals be treated with dignity and given an
> adequate salary to perform their jobs?  Why must they rely on their private
> (clandestine?!?) practices?  Why must they rely on perdiems, just to keep
> their families afloat?  In addition, those who advocate the private sector
> have really no idea how poor these services are, in general, even at more
> formal clinics in capital cities.  There are, in most every poor country, no
> laws regulating the private sector, no accreditation commissions, no JCI
> approval (except for some elite institutions in Thailand, India, the
> Caribbean and the like).  The private sector in Cambodia, where I was a few
> days ago, is just as likely to see over the death of a pregnant woman as the
> public.  And, where are immunization programs given from?  I just can't
> understand why, in this era of huge global health investments, especially
> from private donors, the funds aren't going to encourage and work on the
> development of the public sector, which is what keeps most of all us living
> longer in the West, except that is, for my friends to the south of my
> homeland.  For the majority of people living in this world, those who live
> on the brink of life, surviving on $1-2 dollars a day, I am convinced that
> the public sector remains their only real hope for accessing needed health
> services, even in the short term, even with corruption, even with
> indifference, even with...Let's try to find ways, and use our energy,
> developing and improving the public sector services, and especially trying
> to find ways to pay health professionals what they deserve and what they
> need to make a decent living, thereby motivating and freeing them to provide
> the services for which they are trained and which are so needed.
>
>
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