country assessments of private sector engagement in health in africa
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SHOPS is funded by the U.S. Agency for International Development.Abt Associates leads the project in collaboration withBanyan GlobalJhpiegoMarie Stopes InternationalMonitor GroupO’Hanlon Health Consulting
Country Assessments of Private Sector Engagement in Health in Africa
Dr. Nelson GitongaSHOPS Sr. Private Sector Policy Advisor, O’Hanlon Health Consulting
February 2013 - Tanzania
Content:
• Purpose
• Approach and Methodology
• Content
• Examples of PHSA
• Way Forward
Purpose: Collecting Information on the Private Sector Is Important
Provides objective information helping dispel myths and misperceptions of the private sector
Supplies an accurate idea of who the private health sector, what they are doing and where, and for which population groups
Presents ideas for what potential role(s) they play in the health sector
Helps policy and planning better integrate all resources and activities into one health sector
Private Sector Assessment: a Critical Tool for Engagement
Growing interest has prompted several approaches to assess the private sector
Private Sector Assessment (PSA) – USAID SHOPS, WB/IFC & R4D
Participatory Partnership Landscape Analysis (PLA) – GIZ
and others (e.g. provider mapping, PPP inventory, etc)
PSA’s Globally
USAID has supported 18 assessments since 2005 -12 in AfricaWorld Bank/IFC supported 6 in Africa
PSA Approach
1
23
Key Features of PSA:Flexible allowing counterparts to shape focus of assessment
Comprehensive pulling together data from multiple sources
“Snap shot” of private sector activities at one point in time
Participatory involving all stakeholders with a focus on commercial sector
Action oriented recommending policy reforms and PPPs
PSA Methodology
Participatory Public and private stakeholder involvement from start to finish
Participation formalized through working group
Technical Focus Area(s) Analyzes health and may focus on general or specific health markets
Focuses on supply and demand Analyzes all 6 HSS areas – depending on
scope Details PPPs
Analytical Approach Literature/desk review Stakeholder interviews Secondary and data analysis Support stakeholder dialogue fora
Action-oriented Strategic recommendations PPP opportunities Technical assistance
PSA Content
Landscape of all health sector actors and relationships
Comprehensive description of private health role in financing, services/products and other HSS areas
Overview of current PPPs and other forms of collaboration
Roadmap for policy reforms and dialogue
Strategic recommendations to expand and/or create new PPPs
Private Sector Actors throughout the All Health System
EXAMPLES
Private Health Sector Assessments
Tanzania PHSA
Malawi Private Sector At A Glance
Private sector Definition FBO still considered public, for-profit is very
small but starting to grow
HospitalsClinicsMD OfficesDiagnosticsPharmacies
Private sector HRH25% % of all physicians 44% of all nurses (35% CHAM, 10%PS)
Public manage largest share of health infrastructure – 63% vs to 37% private
Private commercial sector – 182 facilities and 220 drug stores
CHAM – 172 facilities
Namibia Private Sector At A Glance
Private sector major employer 47% of health workforce practices in the
private sector 72% of all physicians 90% of all pharmacists70% of all social workers
Private sector manages considerable infrastructure and equipment
More private than public facilities: 844 compared to 343
Some hospitals and clinics but majority are consultation rooms
Majority of private sector concentrated in urban centers
Not where the need is greatest
Vibrant private health insurance sector Private services not affordable to most
unless insured
HospitalsClinicsMD OfficesDiagnosticsPharmacies
Kenya Private Sector At A Glance
Health is a big market 27 billion KHS
Private sector is a major employer 3/4 of all physicians 3/4 of all nurses 9 out of 10 pharmacists
Commercial and FBO/NGO manage considerable infrastructure & equipment
More private than public facilities 2/3 of all health facilities 1/2 of all hospitals and nursing homes
Private services can be found everywhere
Cost of public & private biggest barrier Private services available at all price points Growing insurance but still insufficient
coverage
Hospitals, ClinicsMD Offices & NetworksIndividual/ Network Diagnostic Centers
Retail and Network Pharmacies
Pharma Mfg
Private Sector DefinitionIncludes FBO/NGO; commercial sector is one of largest and most diverse in region
Result: Critical Tools for Engagement
The different analyses have created ……
A new and important body of knowledge on the size and scope of the African private health sector
An opportunity to bring the sectors together to discuss needed policy reforms and identify new PPP opportunities
Fora for engaging private sector on the basis of shared goals and continuous trust building
Initiate partnership between public and private sector towards common goals
Interest in keeping the dialogue going and more importantly, implementation of PPPs together
Moving Forward………….
Need to expand and strengthen data collection on the private sector
Time to update data and continue updating it over time
Private sector data should be integrated into it all MOH policy and planning
Participatory processes should become common practice for all policy and planning in all countries
Capacity development for trust building and partnership between public and private sector is crucial
Keep the dialogue going long after analysis is completed
SHOPS is funded by the U.S. Agency for International Development.Abt Associates leads the project in collaboration withBanyan GlobalJhpiegoMarie Stopes InternationalMonitor GroupO’Hanlon Health Consulting
Dr. Nelson GitongaSr. Private Sector Policy Advisor, SHOPS/Kenya
www.shopsproject.org
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