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

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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