PHM-Exch> Public stewardship of private providers in mixed health systems

[Claudio Schuftan]

From: Ruggiero, Mrs. Ana Lucia (WDC) <ruglucia at paho.org>
crossposted from: EQUIDAD at listserv.paho.org


 *Public stewardship of private providers in mixed health systems*

*
**Synthesis report from the Rockefeller Foundation—sponsored initiative on
the role of the private sector in health systems

*Lagomarsino Gina, Stefan Nachuk, and Sapna Singh Kundra. 2009.

*Washington**, DC**: Results for Development Institute. ISBN
978-0-9788790-8-2*


Available online PDF [74p.] at: http://bit.ly/1gpmsq

“……..This report summarizes the findings from research commissioned in 2008
by the Rockefeller Foundation, in collaboration with the Results for
Development Institute and the Thai Ministry of Public Health’s International
Health Policy Program. This research—resulting in 14 papers by various
institutions, examining the role of the private sector in health systems in
developing countries— draws on multiple data sources, including, a global
survey of countries’ regulatory models, a scan of innovative private sector
financing and delivery models, a survey of attitudes toward the private
health sector, and evidence on where people receive health services.



The Foundation sponsored this work as part of broader repositioning of its
health strategy to address the emerging challenges of the 21st century. The
repositioning led, in late 2008, to adoption of a new Foundation initiative
on Transforming Health Systems to achieve high-quality, accessible, and
affordable health coverage for all.



One key theme emerging from this analysis is the importance of public
stewardship of the nonstate sector (that is, the private sector, broadly
defined). Effective government stewardship is crucial for achieving broader
health objectives, given the reality that many countries already have large,
complex markets for healthcare, presenting major challenges and significant
opportunities.

A second key theme is that many governments are not performing that
stewardship role particularly well at present. Policy dialogue and
decisionmaking—within government and with donors— are often not well
informed about the huge scale and diversity of health services that exist
beyond government-run facilities. Those in the public sector who should be
overseeing the entire health system—state and nonstate—are not monitoring
what is happening in the nonstate sector and have imperfect understanding of
the forces at work in the health system in its entirety. Nor is there
adequate appreciation of the fact that private out-of-pocket payments by
households account for a large proportion of total health spending.



Compounding these problems are severe limitations in the data available on
the nonstate sector. Basic information on what kinds of services the private
sector provides, to whom, and with what results is not readily at hand for
policymakers…..”
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