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The Private Sector in Health

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The Private Sector in Health (PSIH) Thematic Working Group examines the growing role of the non-state sector in delivering health care to people in developing countries and the related challenges and opportunities.

The private health sector is a prominent player of health service delivery and access, providing over 50% of all healthcare in Sub-Saharan Africa and over 80% of all healthcare in Asia. It is now well-accepted that many countries have mixed health systems with a wide variety of formal and informal service providers. The COVID 19 crises has shown private sector drive and innovative strength essential to health systems, calling for newer approaches to health governance, regulation and partnerships but also presents challenges in accountability, quality and participation in public health activities.

A primary aim of the group’s work is to explore and evaluate interventions to include the private sector in a constructive collaboration for reaching Universal Health Care (UHC), while avoiding negative unintended outcomes. WHO has recently emphasised the lack of systematic evidence on the factors that influence the performance of mixed health systems and on strategies to influence their provision of safe, effective and affordable health services. The TWG will focus on addressing this gap.

Objectives

Provide an interdisciplinary and inter-regional forum for researchers, students, policymakers, and international organizations to collaborate and share research evidence, methods, innovative interventions, and capacity building issues related to the operation of the private sector in health.
Ensure that research on the private health sector is a regular feature in the global HSG conferences.
Facilitate exchanges of research evidence to support the rapid development and adaptation of knowledge on mixed health systems.

Activities

Many TWG activities will focus on the following specific themes on which members from different regions have offered to play a leadership role:

Design and architecture of new types of Public Private Partnerships
Research and mutual learning on the management of mixed health systems
Governance and regulation of the private sector for UHC.
Role of non-profits in bridging health system capacity gaps
Quality of care in the private sector – going beyond vertical silos and adopting new metrics
Private sector development – scale and evolution of the private sector
Access to data from the private sector and ethical issues
Health financing and private sector
Commercial determinants of health
Private sector and resilient health systems

News and views

Access the latest blog posts and news items from the PSIH TWG.

Priya Balasubramaniam

Coordinating committee member

Desta Lakew

Coordinating committee member

Mostafa Hunter

Coordinating Committee member

Sarbani Chakraborty

Coordinating Committee member

Phyllis Awor

Coordinating committee member

Meenakshi Gautham

Coordinating committee member

Birger Forsberg

Advisory committee member

Gerry Bloom

Advisory committee member

Gina Lagomarsino

Advisory committee member

Barbara Profeta

Advisory committee member

Anagha Rai

Research Associate at the Public Health Foundation of India

Priya Balasubramaniam

Coordinating committee member

Priya Balasubramaniam is a Senior Public Health Scientist, PHFI, and Director, Centre for Sustainable Health Innovations, Singapore. Her current work is driven by health market disruptions and connecting new types of evidence to health system interventions. Her interests are in health technology and innovation, universal health coverage, role of the Private Sector in ‘mixed’ health systems and implications of health market disruptions in health care access and delivery. She is co-founder of the tripartite- Innovation for Universal Health Collaborative to initiate south-south dialogues around leveraging low-cost technological innovations and new models of healthcare in Asia and Africa.

@PriyaBeKay

@priya-balasubramaniam-72446998/

Desta Lakew

Coordinating committee member

Desta Lakew leads global partnerships for Africa. In this role, she has been engaged in securing high level strategic global partnerships for Amref Health Africa. She was instrumental in the establishment and leadership of the first bi-annual Africa Health Agenda International Conference in 2014; leading a global south dialogue knowledge exchange platform on Universal Health Coverage in Africa and Asia; and the launching of Communities at the Heart of UHC global advocacy campaign.

@DestaLakew

@desta-lakew-5284866

Mostafa Hunter

Coordinating Committee member

Mostafa Hunter is passionate about policy innovations to advance equity and integrity in healthcare systems and fight corruption. Mostafa has developed several innovative approaches, conceptual frameworks and guides in fields of governance and anticorruption, and has been an advisor to several UN agencies.

@HunterMostafa

@mostafa-hunter-63a61529/

Sarbani Chakraborty

Coordinating Committee member

Dr. Sarbani Chakraborty is a recognized global health leader with over 20 years of experience shaping resilient and sustainable health systems in Africa, Europe, and Central Asia, the Middle East, and Asia working with the public and private sectors. She is a senior program director at Results for Development (R4D), where she oversees the mixed health systems (MHS) practice area. In this role, she manages partner and donor relationships, thought leadership, and program design and implementation for mixed health systems, including for the Frontier Health Markets Global Technical Assistance program, a 5-year USAID-funded initiative that aims to increase private sector engagement to improve voluntary family planning, maternal and child health, malaria and HIV/AIDS, for which R4D is the technical co-lead.

@https://www.linkedin.com/in/sarbani-chakraborty-02a72310/

Phyllis Awor

Coordinating committee member

Phyllis Awor is a Public Health Physician with over ten years conducting health systems and operational research. At Makerere University School of Public Health she focuses on improving both the public and private health sector in low-income settings; and social innovation in health care among other areas.

Meenakshi Gautham

Coordinating committee member

Meenakshi’s research at LSHTM traverses the private formal and informal health sectors, public-private partnerships, and the role of the private sector in reproductive as well as maternal and child health services.

@gautham_meen

@meenakshi-gautham-3b47994b/

Birger Forsberg

Advisory committee member

Birger Forsberg is an Associate Professor at the Department of Global Public Health, Karolinska Institutet. He is a Senior physician and health planner with experience working in operations and in research. Since 2001 engaged in work on the role of the private health sector in low income countries, for seven years as coordinator of the KI/Harvard research programme Private Sector in Health (PSP). He organized international workshops on the role of the private health sector in Jinan, 2006, Beijing 2009, Toronto 2011 and Sydney 2013.

@birger-carl-forsberg-5b701126/

Gerry Bloom

Advisory committee member

Gerry Bloom is a Fellow at IDS. His interests include the management of health system transition in the context of rapid social and economic change, changing roles of government, and health system innovations processes of institutional development.

@GerryBloom

@gerry-bloom-37172b32/

Gina Lagomarsino

Advisory committee member

Gina Lagomarsino is president and CEO of Results for Development (R4D). Throughout her career, Ms Lagomarsino has focused on expanding health coverage to low-income populations. As one of the original co-founders and managing directors at R4D, she helped galvanize energy and political will around a global push for universal health coverage by coordinating an early global task force convened by the Rockefeller Foundation, and co-authoring a frequently cited 2012 Lancet article on universal health coverage.

@LagomarsinoGina

@gina-lagomarsino-82ab648/

Barbara Profeta

Advisory committee member

Barbara Profeta is an experienced health policy specialist with a demonstrated history of working in programme development, public policy and technical consulting for the international aid industry in over 15 countries and across a number of public and private organisations.

@profeta_barbara

@barbara-profeta-7249b120/

Anagha Rai

Research Associate at the Public Health Foundation of India

Anagha received a Master of Public Health from New York University in 2017. Since then, she's managed a nutrition security focused community health program, and worked for a private healthcare company at the intersection of clinical research and digital health strategy. At PHFI, her work is primarily focused on the One Health Antibiotic Stewardship in Society (OASIS) study where she facilitates the stakeholder engagement strategy, intervention development and the feasibility assessment. She is particularly interested in implementation science and its potential to meaningfully impact public health.

@www.linkedin.com/in/anagha-rai-b7473b93

Publications and resources

La Contribución del Sector Privado en la Resiliencia y Reforma del Sistema de Salud: Más fuertes juntos después del COVID

Grupo de trabajo del sector privado en la salud sesion satelite @HSR2022

Plataforma de aprendizaje mutuo y sesión satélite del grupo de trabajo temático del sector privado en salud en HSR2022 - Contribución del sector privado en la resiliencia y reforma de los sistemas de salud: más fuertes juntos más allá de COVID. Nueva Delhi: Fundación de Salud Pública de la India; 2022.

Contribution of the Private Sector in Health Systems Resilience and Reform: Stronger together beyond COVID

Mutual Learning Platform and Private Sector in Health Thematic Working Group Satellite Session at HSR2022

The Mutual Learning Platform on Mixed Health Systems (comprising of the Public Health Foundation of India, Amref Health Africa and Institute of Development Studies Sussex) and the Private Sector in Health Thematic Working Group convened a full-day conclave on the Contribution of the Private Sector in Health Systems Resilience and Reform: Stronger together beyond COVID at the Seventh Global Symposium on Health Systems Research (HSR2022) on November 1, 2022 at the Agora Bogota International Convention Centre from 8:30 am to 5:00 pm.

A Voice From the Front Line: Reaching out of the box to engage private non-state healthcare actors in LMICs to combat COVID-19

P. Balasubramaniam, B. C. Forsberg, G. Bloom, et al

As the COVID-19 crisis unfolds across the globe, country health systems are being stretched to their limits. This blog post calls for extraordinary measures to coordinate and engage with the ‘other half of the health sector’ – the informal health sector, private health professionals and non-state actors in low- and middle-income countries (LMICs) with weak health systems to start with, where the pressure from the current pandemic has been especially tough. When state capacity has failed, the unorganized sector and local private practitioners are often the first line of contact for many vulnerable populations.

'Mobilising Informal Healthcare Providers in India May Help its Response to Covid-19'

Meenakshi Gautham, Gerald Bloom, Priya Balasubramaniam, Catherine Goodman, Birger C Forsberg and Amod Kumar

India has one of the most privatized health systems in the world, but the public sector is leading its response to Covid-19. An effective response to contain the impact of Covid-19 on the rural population must include informal providers.

‘Small Pharmacies to Private GPs: India Must Engage Informal Economies in Fighting Cronavirus’

Priya Balasubramaniam, Meenakshi Gautham and K. Srinath Reddy

Indian cities have shown resilience in overcoming challenges. Yet, resilience has not always resulted in improving urban governance and improving lives of urban poor.

'Knowledge and Recommendation of Oral Rehydration Solution and Zinc for Management of Childhood Diarrhoea Among Patent and Proprietary Medicine Vendors in Port Harcourt, Nigeria'

Emmanuel Firima and Birger Forsberg

An investigation into patent and proprietary medicine vendors’ knowledge of presentation, cause, treatment and prevention of childhood diarrhea, and their recommendation of oral rehydration solution and zinc in the treatment of sick children in Port Harcourt, Nigeria.

‘Availability, Prices and Affordability of Essential Medicines for Treatment of Diabetes and Hypertension in Private Pharmacies in Zambia’

A.H. Kaiser, L. Hehman, B.C. Forsberg, W.M. Simangolwa and J. Sundewall

A cross-sectional survey was conducted in 99 pharmacies across three Zambian provinces. Methods were based on a standardized methodology by WHO and Health Action International in order to explore availability, prices and affordability of essential medicines for diabetes and hypertension treatment in private pharmacies in three provinces of Zambia.