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

Mackintosh, Maureen; Channon, Amos; Karan, Anup; Selvaraj, Sakthivel; Zhao, Hongwen 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) pp. 596–605.

URL: http://www.thelancet.com/series/private-sector-hea...
DOI (Digital Object Identifier) Link: https://doi.org/10.1016/S0140-6736(16)00342-1
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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.

Item Type: Journal Item
Copyright Holders: 2016 Elsevier Ltd.
ISSN: 1474-547X
Extra Information: This paper is part of the Global Health content from The Lancet and is freely available to all users upon free registration to the website.
Keywords: private sector; health systems; low and middle income countries; metrics
Academic Unit/School: Faculty of Arts and Social Sciences (FASS) > Politics, Philosophy, Economics, Development, Geography
Faculty of Arts and Social Sciences (FASS)
Interdisciplinary Research Centre: Innovation, Knowledge & Development research centre (IKD)
International Development & Inclusive Innovation
Item ID: 46811
Depositing User: Maureen Mackintosh
Date Deposited: 18 Jul 2016 08:45
Last Modified: 09 Feb 2017 13:05
URI: http://oro.open.ac.uk/id/eprint/46811
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