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What is the private sector? Understanding private provision in the health systems of low-income and middle-income countries

What is the private sector? Understanding private provision in the health systems of low-income and middle-income countries
What is the private sector? Understanding private provision in the health systems of low-income and middle-income countries
Private health care in low-income and middle-income countries is very extensive and very heterogeneous, ranging from itinerant medicine sellers, through millions of independent practitioners—both unlicensed and licensed—to corporate hospital chains and large private insurers. Policies for universal health coverage (UHC) must address this complex private sector. However, no agreed measures exist to assess the scale and scope of the private health sector in these countries, and policy makers tasked with managing and regulating mixed health systems struggle to identify the key features of their private sectors. In this report, we propose a set of metrics, drawn from existing data that can form a starting point for policy makers to identify the structure and dynamics of private provision in their particular mixed health systems; that is, to identify the consequences of specific structures, the drivers of change, and levers available to improve efficiency and outcomes. The central message is that private sectors cannot be understood except within their context of mixed health systems since private and public sectors interact. We develop an illustrative and partial country typology, using the metrics and other country information, to illustrate how the scale and operation of the public sector can shape the private sector's structure and behaviour, and vice versa.
0140-6736
596-605
Mackintosh, Maureen
b4fcd4d9-b25e-43ac-bb63-6044f1cc76f4
Channon, Amos
5a60607c-6861-4960-a81d-504169d5880c
Karan, Anup
1d17a70e-f030-4bb1-a15d-1fe4eccf42a3
Selvaraj, Sakthivel
53ca2ba0-375e-4265-b574-d8dd17acfee7
Cavagnero, Eleonora
74a838f8-084f-4827-b51e-9810d8afeb99
Mackintosh, Maureen
b4fcd4d9-b25e-43ac-bb63-6044f1cc76f4
Channon, Amos
5a60607c-6861-4960-a81d-504169d5880c
Karan, Anup
1d17a70e-f030-4bb1-a15d-1fe4eccf42a3
Selvaraj, Sakthivel
53ca2ba0-375e-4265-b574-d8dd17acfee7
Cavagnero, Eleonora
74a838f8-084f-4827-b51e-9810d8afeb99

Mackintosh, Maureen, Channon, Amos, Karan, Anup, Selvaraj, Sakthivel and Cavagnero, Eleonora (2016) What is the private sector? Understanding private provision in the health systems of low-income and middle-income countries. The Lancet, 388 (10044), 596-605. (doi:10.1016/S0140-6736(16)00342-1).

Record type: Article

Abstract

Private health care in low-income and middle-income countries is very extensive and very heterogeneous, ranging from itinerant medicine sellers, through millions of independent practitioners—both unlicensed and licensed—to corporate hospital chains and large private insurers. Policies for universal health coverage (UHC) must address this complex private sector. However, no agreed measures exist to assess the scale and scope of the private health sector in these countries, and policy makers tasked with managing and regulating mixed health systems struggle to identify the key features of their private sectors. In this report, we propose a set of metrics, drawn from existing data that can form a starting point for policy makers to identify the structure and dynamics of private provision in their particular mixed health systems; that is, to identify the consequences of specific structures, the drivers of change, and levers available to improve efficiency and outcomes. The central message is that private sectors cannot be understood except within their context of mixed health systems since private and public sectors interact. We develop an illustrative and partial country typology, using the metrics and other country information, to illustrate how the scale and operation of the public sector can shape the private sector's structure and behaviour, and vice versa.

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Mackintosh_FINAL - Accepted Manuscript
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Accepted/In Press date: 10 February 2016
e-pub ahead of print date: 26 June 2016
Published date: 6 August 2016
Organisations: Social Statistics & Demography

Identifiers

Local EPrints ID: 411067
URI: https://eprints.soton.ac.uk/id/eprint/411067
ISSN: 0140-6736
PURE UUID: 285e9752-82d1-4780-b594-1b7cc9d14c42
ORCID for Amos Channon: ORCID iD orcid.org/0000-0003-4855-0418

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Date deposited: 13 Jun 2017 16:33
Last modified: 15 Oct 2019 04:58

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