Prohibit, constrain, encourage, or purchase: how should we engage with the private health-care sector?


Montagu, D; Goodman, C; (2016) Prohibit, constrain, encourage, or purchase: how should we engage with the private health-care sector? Lancet. ISSN 0140-6736 DOI: https://doi.org/10.1016/S0140-6736(16)30242-2

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Abstract

The private for-profit sector's prominence in health-care delivery, and concern about its failures to deliver social benefit, has driven a search for interventions to improve the sector's functioning. We review evidence for the effectiveness and limitations of such private sector interventions in low-income and middle-income countries. Few robust assessments are available, but some conclusions are possible. Prohibiting the private sector is very unlikely to succeed, and regulatory approaches face persistent challenges in many low-income and middle-income countries. Attention is therefore turning to interventions that encourage private providers to improve quality and coverage (while advancing their financial interests) such as social marketing, social franchising, vouchers, and contracting. However, evidence about the effect on clinical quality, coverage, equity, and cost-effectiveness is inadequate. Other challenges concern scalability and scope, indicating the limitations of such interventions as a basis for universal health coverage, though interventions can address focused problems on a restricted scale.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Global Health and Development
PubMed ID: 27358250
Web of Science ID: 380756600034
URI: http://researchonline.lshtm.ac.uk/id/eprint/2572518

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