BlessWorld Foundation International

Affecting the World Through Health
A Global Health Initiative

Private Sector Engagement in Healthcare Services



To improve the quality of health and meet global health standards, many countries around the world continue to seek better ways of organizing, financing and delivering health care and services. Major components and concerns of health to be improved include equity, quality, accessibility, cost, efficiency and effectiveness. Consequently, privatization, globalization and liberalization have become important political agenda in these countries. Privatization may be achieved by a change in ownership, either by decentralization or dis-investment as well as by contracting public services to private agencies or by allowing the private sector to manage public health facilities. Liberalization or deregulation means the activities organized by the State would be provided by the private sector, an example is allowing government doctors to do private practice after office hours or allowing private doctors to use public facilities.

In recent years, private investments in healthcare have become essential for public health systems to meet present and future health challenges. The growing engagement of private sector investments has raised several concerns about equity, quality, accessibility, cost, efficiency and effectiveness. Thus, it is important to compare the aims and objectives of both as well as evaluate their relevance. Comparing the private and public health sectors is tough and involves several multidimensional factors given that their goals are significantly different. Private health sectors are exclusively individually-owned and profit oriented while the public sectors are government-run and social-service oriented. Since the aim of private sector is primarily profit, its focus is on the curative services, whereas, public sector provide preventive and highly specialized medical care services. The private sector is easier to manage and can be more efficient once the financial responsibilities of patients are met, they also such as in India, the private sector tends to focus on services which are easy to make quick profit and the public sector may have to carry the unprofitable activities. Public sector, on the other hand, aims to provide health care services for all citizens using a universal health system where contributions are made by citizens based on their income. This equity-based system enables the public sector to provide services irrespective of age, social class, income and geographical location.

Given the relevance of each sector, a mixed public and private system is obtainable in most countries- in India for example; the private sector plays significant roles in the health care delivery system- accounting for about 57% of the total number of hospitals and 32% of hospital beds. In this case, health care delivery is jointly provided by the public and private sector which requires a public-private partnership. The government must make efforts to use the private health sectors to achieve their aims through collaborations, support, subsidies and partnerships. Major policy concerns about private sectors include the existence of suitable regulations to monitor and control resource allocation, equal distribution of services in geographic locations, quality of services and funding. To address these issues, private healthcare facilities including hospitals, nursing homes and clinics must be registered by the appropriate authority so as to be properly monitored. In Addition, there is need to have regulations for equal distribution of services in different geographical regions as well as poor and underprivileged populations- this can be achieved by tax rebates on income or profit in these locations and licensing of private institutions. To ensure quality care, measures such as accreditation, laws that protect the rights of patients, periodic monitoring of facilities and services and continuing training of healthcare workers. Government should support private health systems dedicated to the improving public health by offering incentives that may include provision of logistics and supplies such as free or subsidized drugs, equipment, vaccines, IEC materials and maintenance of equipment related to national health programs. These will empower private health systems and enable them put patients, and not financial gains, at the forefront of their services.

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