Engagement with private sector.
AbstractA large and varied private sector plays a dominant role in health in the South-East Asia Region – in terms of both finance and provision of services. However, much of this activity is unregulated and does not contribute effectively to the national health agenda, including affordable universal coverage within an overall primary health care policy approach. Evidence indicates that households in SEAR rely on private provision even for essential services like maternal and child health care; and, that this is financed through high (and impoverishing) out-of-pocket payments – more than anywhere else in the world. A systematic approach to engaging the private sector has been neglected largely because of ideology: health is considered a merit good and a human right for which market based decisions are unacceptable, politically and socially. At a policy level, engaging the private sector has tended to be equated with privatization, constraining inclusion in the health effort. Country experience, while limited, especially in the Region, does indicate that the strategic use of contracting and payment mechanisms allow effective engagement of the private sector to advance on universal access; providing quality priority services to targeted population groups at affordable prices; and, in fact, enhancing overall health systems performance. Importantly, ‘more’ private sector has not meant ‘less’ government, rather, it implies strong government presence, only in a different role that emphasizes governance and financing rather than direct provision. Where the role of the private sector is already large, the relative costs and benefits of effective engagement for universal coverage compared with scaling-up public provision is an option for serious policy consideration. Such mixed strategies would need appropriate modalities for partnership and new capacities to be developed on both sides. Furthermore, this approach does not preclude political and social stands on the preferred roles of government and private sector in health based on ideology as well as the strengths and weaknesses of government. The attached working paper is submitted to the High-Level Preparatory (HLP) Meeting for its review and recommendations. These recommendations will be submitted to the Sixty-second Session of the Regional Committee for its consideration.
World Health Organization, Regional Office for South-East Asia. (2009). Engagement with private sector.. New Delhi: WHO Regional Office for South-East Asia.. http://www.who.int/iris/handle/10665/127740