The Role of the Private Sector in Health Systems

The Challenge

Throughout the developing world, most health systems are characterized by mixed public and private financing and delivery of care. Greater quality and access calls for further thinking on the role of the private sector into health systems and a broader systems perspective on how public and private sectors can work together to address the challenges of affordability, quality, and availability of care.

The Opportunity

In January 2008, the Rockefeller Foundation asked the Results for Development Institute (R4D) to lead an effort to better understand the role of the private sector in health systems in developing countries. In partnership with the International Health Policy Program of the Thai Ministry of Public Health and other health policy research organizations, R4D worked to identify opportunities to strengthen public/private health systems through the collection, analysis, and dissemination of information and evidence on non-state health care providers and funders, and on public stewardship mechanisms designed to better harness these private actors.

Our Work

Drawing on the work of a wide range of academic, think tank, and consulting partners, the project included the following activities:

  • Analysis of Demographic and Health Survey data on where people seek care for various health issues.
  • Cataloguing and analysis of private sector health delivery and financing models that some have characterized as “innovative.”
  • A global scan and survey of countries about their regulatory models.
  • A web-based survey and in-depth interviews of attitudes toward the private health sector.
  • Analysis of how purchasing and contracting models can support health systems goals.
  • New thinking on stewardship and how to make health markets work better for the poor.
  • Macroeconomic analysis of national public and private health spending
  • An analysis of the potential of the private sector to enhance health product supply chains.

The project was completed in January 2009 and resulted in two synthesis reports by the Results for Development Institute and 13 technical papers by various institutions:

Building upon the findings of the Private Sector in Health Systems effort, R4D has continued to work with the Rockefeller Foundation on the Foundation’s initiative, Transforming Health Systems (THS).

Photo: Access Afya ©Center for Health Market Innovations/R4D

Global & Regional Initiatives

R4D is a globally recognized leader for designing initiatives that connect implementers, experts and funders across countries to build knowledge and get that knowledge into practice.