The document discusses the private health sector in developing countries. It notes that the private sector is a large and diverse group comprising formal providers like private clinics and hospitals as well as informal providers like traditional healers and drug shops. The private sector delivers a significant portion of healthcare, even for the poor. Ministries of health are increasingly recognizing the importance of partnering with the private sector to improve healthcare access and achieve health goals. Some benefits of public-private partnerships include leveraging private sector resources and expertise, expanding access to underserved groups, and improving efficiency. The document discusses various partnership models like contracting and discusses strategies for improving quality of care in the private sector through regulatory frameworks and certification programs.
Public Healthcare vs Private Healthcare in India A Systematic Review Unnati Kalwani
Today the healthcare system stands at the crossroads. Nevertheless, the last decade has seen a bloom in the healthcare industry especially in areas like telemedicine, medical tourism.
The delivery system, both private and public remains elusive to the sections of society requiring healthcare
This presentation reflects on the current state of the Indian healthcare system.
“Function of a health system concerned with the accumulation, mobilization and allocation of money to cover the health needs of the people, individually and collectively, in the health system.” (WHO)
Revenue collection :
Taxation-most equitable system of financing
Health insurance contributions
User pays (out of pocket, no reimbursement)
Donor funding/Grants
Healthcare is a major part of every country's development platform. By healthcare we are in fact protecting the most important driver of development. Healthcare systems are primarily safe guarding the development core engine and are the best means of sustainable development.
Declaration: The materials incorporated in this document have come from variety of sources and compiler bears no responsibilities for any information contained herein. The compiler acknowledges all the sources although references have not been explicitly cited for all the contents in this document.
Public Healthcare vs Private Healthcare in India A Systematic Review Unnati Kalwani
Today the healthcare system stands at the crossroads. Nevertheless, the last decade has seen a bloom in the healthcare industry especially in areas like telemedicine, medical tourism.
The delivery system, both private and public remains elusive to the sections of society requiring healthcare
This presentation reflects on the current state of the Indian healthcare system.
“Function of a health system concerned with the accumulation, mobilization and allocation of money to cover the health needs of the people, individually and collectively, in the health system.” (WHO)
Revenue collection :
Taxation-most equitable system of financing
Health insurance contributions
User pays (out of pocket, no reimbursement)
Donor funding/Grants
Healthcare is a major part of every country's development platform. By healthcare we are in fact protecting the most important driver of development. Healthcare systems are primarily safe guarding the development core engine and are the best means of sustainable development.
Declaration: The materials incorporated in this document have come from variety of sources and compiler bears no responsibilities for any information contained herein. The compiler acknowledges all the sources although references have not been explicitly cited for all the contents in this document.
Social Determinants of Health InequitiesRenzo Guinto
Lecture given during the pre-APRM workshop on Social Determinants of Health and Global Health Equity, September 11, 2012, Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur
Healthcare system, Various Indian Healthcare system, Health policies, Health Programme, Five year Plan, Health Manpower.
A healthcare system can be defined as the method by which healthcare is financed, organized, and delivered to a population. It includes issues of access (for whom and to which services), expenditures, and resources (healthcare workers and facilities).
India has a mixed healthcare system, inclusive of public and private healthcare service providers.
Private HCPs are concentrated in urban India providing secondary and tertiary care healthcare services.
Public healthcare infrastructure in rural areas has been developed as a three tier system based on population norms.
Launched on 12th April, 2005.
Decentralization of village and district level health planning and management.
Appointing ASHA (Accredited Social Health Activist) for facilitating the access to healthcare services.
Strengthening public healthcare delivery services at primary and secondary level.
Mainstreaming AYUSH.
Improve management capacity to organize health systems and services.
Improve intersectoral coordination.
Social Determinants of Health InequitiesRenzo Guinto
Lecture given during the pre-APRM workshop on Social Determinants of Health and Global Health Equity, September 11, 2012, Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur
Healthcare system, Various Indian Healthcare system, Health policies, Health Programme, Five year Plan, Health Manpower.
A healthcare system can be defined as the method by which healthcare is financed, organized, and delivered to a population. It includes issues of access (for whom and to which services), expenditures, and resources (healthcare workers and facilities).
India has a mixed healthcare system, inclusive of public and private healthcare service providers.
Private HCPs are concentrated in urban India providing secondary and tertiary care healthcare services.
Public healthcare infrastructure in rural areas has been developed as a three tier system based on population norms.
Launched on 12th April, 2005.
Decentralization of village and district level health planning and management.
Appointing ASHA (Accredited Social Health Activist) for facilitating the access to healthcare services.
Strengthening public healthcare delivery services at primary and secondary level.
Mainstreaming AYUSH.
Improve management capacity to organize health systems and services.
Improve intersectoral coordination.
The following resources have been provided to help you learn mor.docxarnoldmeredith47041
The following resources have been provided to help you learn more about important concepts covered this week. Look for ways to apply these resources to this week’s activities and assignments. Ensure you:
· Read “Price Transparency Needed From All Stakeholders, HFMA Task Force Says” from Modern Healthcare.
https://www.modernhealthcare.com/article/20140416/NEWS/304169931/price-transparency-needed-from-all-stakeholders-hfma-task-force-saysCHAPTER 3
Current Operations of the Healthcare System
LEARNING OBJECTIVES
The student will be able to:
■ Identify the stakeholders of the U.S. healthcare system and their relationships with each other.
■ Discuss the importance of healthcare statistics.
■ Compare the United States to five other countries using different health statistics.
■ List at least five current statistics regarding the U.S. healthcare system.
■ Discuss complementary and alternative medicine and its role in health care.
■ Define OECD and its importance to international health care.
DID YOU KNOW THAT?
■ According to the Bureau of Labor Statistics, the projection for job growth in the healthcare industry over a 10-year period is 9.8 million jobs by 2024.
■ Most healthcare workers have jobs that do not require a four-year college degree but health diagnostic and treatment providers are the most educated workers in the United States.
■ Healthcare employment is found predominantly in large states such as California, New York, Texas, and Florida.
■ Approximately 40% of U.S. adults use some form of nontraditional medicine.
■ The healthcare industry and social assistance industry reported more work-related injuries than any other private industry.
■ Life expectancy and infant mortality rates are an indication of the health of a population.
▶ Introduction
The one commonality with all of the world’s healthcare systems is that they all have consumers or users of their systems. Systems were developed to provide a service to their citizens. However, the U.S. healthcare system, unlike other systems in the world, does not provide healthcare access to all of its citizens. It is a very complex system that is comprised of many public and private components. Healthcare expenditures comprise approximately 17.5% of the gross domestic product (GDP). Health care is very expensive and most citizens do not have the money to pay for health care themselves. Individuals rely on health insurance to pay a large portion of their healthcare costs. Health insurance is predominantly offered by employers. The uninsured rate remains at an all-time low with 9.1% of under 65 uninsured as of the end of 2015 according to CDC.Gov data. Generally, 2016 saw a rough increase of all the 2015 numbers. (Obamacare enrollment, 2016). The government believes this is the result of the universal mandate for individual health insurance coverage.
In the United States, in order to provide healthcare services, there are several stakeholders or interested entities that participate in the indust.
Are you planning to build or restructure or venture in any healthcare venture in India? Looking for information about the major healthcare players in Government, Private diagnostic centers that are available in India? Are you looking to find out which part of the of the city’s is best to venture in or what all facilities are available and what all should be planned for new setup? In this article Hospaccx Healthcare Consultancy has mapped all on major players in terms of medical facilities and healthcare scenario in India.
Universal health coverage was established in the WHO constitution of 1948 declaring health a fundamental human right.The goal of universal health coverage is to ensure that all people obtain the health services they need without suffering financial hardship when paying for them.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
2. Introduction
In any country, the healthcare system is comprised
of both the public and private sector.
The private sector is a large and diverse group that is
increasingly being recognized as a significant part of
developing country health systems.
3. Why Involve the Private Sector?
The major challenge for developing countries is how to
improve healthcare for all their people, especially the
poorest citizens.
The most common approach focuses almost
exclusively on the public health sector:
Building the capacity of public facilities
Training and recruiting staff
Expanding subsidized public services to the poor
High quality, well-funded public services are essential.
4. High quality, well-funded public
services are essential
A public sector-only approach fails to harness all the
resources available in the health sector.
While not seeking to detract from the government's
role in providing healthcare, it is important to dispel
myths and misconceptions, and reasons why
ministries of health should work with the private
health sector to achieve health goals.
5. Private health sector in action
Visiting the public hospital would cost a whole day in
lost pay to the factory's workforce.
In Gujarat, India, a private obstetrician /gynaecologist
delivers new baby. She does not have to pay for care
because the state government has created a voucher
program that pays a set fee to private doctors who join
the program and serve poor patients. Is this an
example of the private health sector in action?
6. Who is the Commercial Sector in
Health? Most of the people never goes to the doctor. When he
or his family get malaria, they walk to the local drug
shop, get medicine, and treat their illness at home.
If they get sicker, they call in a traditional healer. Is
this an example of the private health sector in action?
7. The Health Sector
The private sector in health is also called
the "non-state sector" and is typically
defined as comprising "all providers
who exist outside of the public sector,
whether their aim is philanthropic or
commercial, and whose aim is to treat
illness or prevent disease“.
(WHO, 2005)
8. Private Health Sector
The private health sector is a large and diverse group that
covers a wide range of health sector entities, including:
Private practitioners, clinics, hospitals, and laboratories
and diagnostic facilities
Non-profit non-governmental organizations (NGOs) and
faith-based organizations (FBOs)
Shopkeepers and traditional healers
Pharmacies and pharmaceutical wholesalers, distributors,
and manufacturers
Private companies not engaged in health who provide
health care services to their employees and communities
10. Did You Know?
In any country, the healthcare system comprises public
and private sectors. The public sector, which in many
developing countries is the largest healthcare provider,
includes the Ministry of Health and its network of
healthcare staff and infrastructure.
Who are the principal private sector players in your
own country? Can you name examples of NGOs, FBOs,
and for-profit providers in your country?
11. Overview of the For-Profit Private
Sector
The for-profit private sector comprises a wide range of
actors, some of which are in the informal health sector.
The two primary health activities in which the private
entities engage are:
Direct provision of private health services
Provision of health products through private channels
12. Private Sector Providers
Private healthcare is delivered in both
the formal and informal health sectors.
Even the poor pay for health services in
the private sector
The private sector share of healthcare
markets varies from region to region
and within regions, based on political,
historical, and economic factors.
13. The formal sector
The formal sector includes a wide range of trained and licensed private
healthcare providers such as:
Private doctors
Nurses
Midwives
Paramedical staff, including clinical officers and
physician assistants
Private pharmacists and drug sellers also play a critical
role in developing countries, as they are often the first-
line providers in the formal health sector that serve
remote population groups.
The dynamic private health sector also includes a wide
range of support services such as private laboratories
and other diagnostic services
14. Informal Sector Private Providers
The informal health sector comprises:
Traditional healers
Traditional birth attendants
Market drug sellers
In India, care and treatment of sexually transmitted
infections, including HIV/AIDS, is provided not only
by physicians, but also by registered medical
practitioners and other qualified homeopathic and
traditional healers.
15. Private providersPrivate providers, whether formal or
informal, deliver their services in a
variety of locations:
Single room in the provider's home
State-of-the-art clinic
Privately owned hospital that offers a
broad array of health services
(International Finance Corporation Report,
2007)
16. Private Provision of Health
Products
The pharmaceutical industry boasted global sales of
US$643 billion in 2006. (IMS, 2007)
The pharmaceutical industry (both internationally and
locally) plays a key role in the manufacture and
distribution of health products.
In the private sector, product distribution is more
complicated and involves more marketing and detailing
than in the public sector.
17. Pharmaceutical Companies
International pharmaceutical companies, also known as
research and development (R&D) companies or "Big
Pharma," manufacture many of the healthcare products
used in both the public and private sectors.
These R&D companies often deal directly with private
healthcare providers, either through their own company
representatives located in-country or through a local
distributor, to satisfy existing demand and to create new
demand.
There are also a growing and significant number of
pharmaceutical manufacturers in developing countries
that produce generic versions of "R&D" or "priority"
medicines (such as those used for the treatment of
HIV/AIDS and malaria).
18. International standards for generic
medicines
Because of the importance of ensuring
the quality, consistency, and
authenticity of generic and otherwise
new medications, the World Health
Organization (WHO) and other
multilateral organizations have joined
together to create standards for their
manufacturing and distribution.
19. Highlights
China, India, and Brazil are the powerhouses of
local pharmaceutical manufacturers, and supply
many parts of Africa and Asia with generic and
low-priced pharmaceutical products.
20. Retailers in Health Sector
Retailers are an important segment of the private health
sector because they are often the de facto health advisors in
many communities that are difficult to reach.
Retail outlets sell medicine and other health-related products
and include such places as:
Pharmacies
Over-the-counter drug shops
Medicine and chemist shops
Supermarkets and corner groceries
Market stalls and kiosks
21. Unregulated Sector presents many
health challenges
The poor quality of some drug products, whether
distributed in the formal or informal health sector, is
creating health problems such as increased drug
resistance in the treatment of malaria and HIV/AIDS.
There is also an informal sector for health products,
particularly for drugs. This unregulated sector presents
many health challenges.
22. Private Services to Sell Healthcare
ProductsMany private sector companies support product
distribution and sales of healthcare products through
private channels including:
Advertising agencies
Market research firms
Public relation companies
Communication companies
Health communications campaigns can increase sales of
pharmaceutical products and encourage healthy
behaviours.
23. Why ministries of health work with
the private sector.
In most countries, people already use the private sector
or pay for government health services. Individuals
paying out-of-pocket for both public and private
health services make up the majority of healthcare
expenditures.
The percentages of public and private expenditures
vary widely, but consumers in all countries spend a
substantial amount of personal resources in the
private health sector.
(Rosen, 2000).
24. “Despite all the
evidence showing the
significant amount of
money being spent by
populations on
services from the
private sector, most
governments and aid
organizations still
focus quasi-exclusively
on public delivery of
health services”.
(Marek, 2005)
25. A study in Kenya found that
poor family planning clients
receive a variety of benefits by
choosing private sector facilities
over public sector facilities.
Benefits include a much greater
proximity of services and better
quality of interpersonal care.
When the cost of transportation
and wages lost was factored in,
the private sector facilities were
in fact cheaper than those in the
public sector.
(Agha and Keating, 2008)
26. With the right market incentives (
i.e., governments' policies and
actions) the private for-profit health
sector can become sustainable
enterprises that also serve the poor.
As part of the health system, the for-
profit sector can also help
governments achieve priority health
goals.
27. The base of the
economic
pyramid (BOP)
are the 4 billion
people in the
world living on
less than US$2
per day.
29. Why individuals choose private
providers rather than public ones.Many consumers perceive that the quality of care they receive at
private sector facilities is high. Key factors driving the
perception of private sector facilities include:
Cleanliness
Convenience
Wait time
Friendliness
There is much debate about the quality of private sector
services. Many of the patient-perceived benefits do not
necessarily translate into higher standards of care or better
health outcomes.
Although these concerns about private sector quality of care are
legitimate, publicly provided care also falls short of
acceptable standards.
Clearly there is room to improve quality in both sectors.
30. The private sector can deliver, often at a lower
cost, priority services and products that are not
available through the ministry of health.
For example, by contracting out to the private
sector, the public sector can extend its reach to
underserved populations at a lower cost.
To deliver key services for distribution of health
products, social marketing and other private
sector partnerships can ensure wider and more
reliable availability to urgently needed health
products.(IFC, 2007).
31. Working with the Private Sector
can Strengthen Resources
The private health sector employs a large proportion of
medical personnel all over the world.
The public sector can greatly increase the number of
trained professionals working in the country by simply
including private providers in its training programs.
Private providers have their own infrastructure and
clientele, where they can apply their new knowledge
and skills.
The public sector can also create more flexible
regulations, thereby allowing more private providers to
set up practice
32. Strategies to strengthen quality in
the Health Sector
Improving the quality of private health services is
often a priority for governments and donors.
Creating an effective regulatory framework
Working through professional associations
Voluntary certification and quality improvement
programs
Supportive supervision
34. Quality healthcare has many different dimensions,
including provider technical competence, efficiency,
effectiveness, safety, access to services, physical
infrastructure, and strong communication skills.
A successful quality improvement process should result
in:
Increased provider compliance with evidence-based
protocols and guidelines
Reduced number of medical errors
Improved patient satisfaction
Efficient use of healthcare resources
Improved health status of the population.
(Fischer, 2009)
35. Governments and donors have
legitimate concerns about the
quality of services in the private
health sector, due to:
Diverse and fragmented nature
Weak regulations
Poor enforcement
Informal private providers
Counterfeit unregulated drugs
36. Government in its role as a health
steward can improve quality in the
private health sector and protect
consumers by updating laws and
procedures. This can create a "level
playing field" in which all
healthcare providers (public,
private, NGO) abide by the same
rules and standards of quality.
37. Major legal and Regulatory Areas
Quality that governments can address include:
Qualifications for medical practice
Scope of practice for different professions
Facility licensing
Provider relicensing
Continuing education
Criteria to establish private practices
Regulations are only as effective as the systems that are
available to monitor and enforce them. Strengthening
regulatory agencies and political commitment to
sufficiently fund these institutions are also important
components of quality improvement. (Ravenholt, 2006)
38. Factors that Affect Private
Provider Quality Policy and program interventions can encourage and
inhibit quality in the private sector.
Governments interested in improving private sector quality
need to leverage factors that motivate, and mitigate those
that inhibit, private providers.
Countries that have successfully improved quality in the
private health sector have consistently included a wide
range of key health sector actors outside the MOH.
Involving these multiple stakeholders in policy
considerations provides the MOH a wide range of
perspectives on factors that motivate the private
sector.(Brugha and Zwi 1998)
41. Continuing professional
development
In addition to provider training and skill
development, innovative approaches to change
provider behaviour include:
Job aids (e.g. worksheets, checklists, decision tables)
On-the-job training
Modularized training
Distance learning
Web-based approaches
42. Studies in India show that training private
medical practitioners can address some of these
quality barriers by improving private providers‘
technical knowledge
and
perception
43. An Effective Strategy to Improve
Quality of Care
Clinical guidelines, based on WHO, International
Planned Parenthood Federation, and US Centers for
Disease Control and Prevention (CDC) standards
and revised by a committee of leading physicians from
different sectors
Training of private physicians
Ongoing development of an assessment tool (Quality
Improvement Package)
Orientation for physicians on steps in the certification
process
44. Quality of CareProfessional health associations offer:
Organizational umbrella and structure
Credibility to influence professional standards and
scopes of practice
Ability to provide input into pre-service education and
training policies
Advocacy for their patients and profession.
45. To Improve QualityMost professional associations in developing countries need capacity
building and organizational strengthening to be effective in working
with the private sector to improve quality.
Such support can include:
Strategic planning
Leadership development
Training
Peer support and supervision programs
Information systems
Institutional growth and sustainability
Many US- and European-based professional organizations are
establishing partnerships with "sister" organizations in developing
countries to transfer skills, help build systems, and share experiences.
46. Partnership Model
Identify critical stakeholder members
Explore different associations’ interests and potential
contributions
Agree on the policy focus
Determine how the partners will work together
Identify actions to work on together as group
47. Supportive supervision
Supportive supervision has the following advantages
for the private health sector:
Promotes quality by improving communication
Focuses on problem-solving
Facilitates teamwork
Provides leadership and support to empower health providers
to monitor and improve their own performance
For supportive supervision to work well in the private
sector, there must be:
Group or network of identified private providers
Entity or organization to coordinate and provide the
supportive supervision
Challenges with this approach include:
Costs associated with providing supportive supervision
Scheduling difficulties for busy providers.
48. Public-private partnerships(PPPs) in
health involve government and
the private sector working
together
to achieve common goals,
share risks and rewards,
leverage each partner's
comparative advantage, and
use each partner's resources
effectively (O'Hanlon, 2008).
49. Some of the most common forms
of PPPs for health service delivery
include:
· Contracting out
· Subsidies
· Vouchers
· Health insurance
· Risk pooling
50. Public-private partnerships Improve health outcomes among target populations
such as poor and rural groups
Remove barriers to healthcare (access, economic,
quality)
Reduce government spending (eliminating large up-
front investments of scarce public funds)
Improve efficiency (due to private partners'
operational efficiency)
Leverage technical or management expertise
Spur technology transfer (Nikolic and Maikisch, 2006)
51. ContractingTo increase access to health services and improve
performance of the health system, driven by the
following factors:
Need to rapidly scale up coverage or range of services
Frustrations regarding the availability, quality, and
efficiency of centralized publicly provided services
Shortages of public healthcare personnel
Client preference for private care.
52. Contracting to Increase Access to
Primary Health Services
There are two main types of contracting:
Contracting-out, or a "service delivery contract." In a
service delivery contract, the contract specifies that
the contracted entity will both manage and supply the
production infrastructure such as personnel,
equipment, and drugs.
Contracting-in. The government contracts a private
sector entity to manage existing government services
in a specific area (a "management contract") or to
provide some other support service with existing staff,
logistics arrangements, and infrastructure.
53. Benefits of Contracting-out
Benefits of contracting-out include the following:
Taps the private sector's greater flexibility to improve
services and strengthens the focus on measurable results
Provides for competition among private providers,
which increases the efficiency and effectiveness of
health service delivery (Loevinsohn and Harding, 2004)
Builds the capacity of NGOs that often deliver these health
services, in areas such as clinical services, nutrition and
immunization programs, and consumer education
campaigns