Innovative Pro-Poor Healthcare Financing and Delivery Models

The report describes 33 innovative pro-poor healthcare financing and delivery programs in South Asia and Sub-Saharan Africa that are led by or engage the private heath sector. The programs were selected based on their relevance to broader health systems and potential to achieve positive impact for poor people. While these programs range from donor-driven initiatives to large-scale government-subsidized efforts to for-profit businesses, they all involve the private health sector. These programs complement key elements of countries’ healthcare financing and delivery platforms, and national governments, donors, and development agencies may consider these or similar programs as stepping stones toward longer term health system reform.

In their efforts to improve health systems, developing countries face the challenge of integrating traditional government health resources with a large and growing private health sector,1 where many poor people seek care. In these “mixed health systems” centrally planned systems operated by government entities exist side-by-side with private markets for similar or complementary products and services.2 However, most developing country ministries of health and the donors and technical experts that support them have not fully engaged the private health sector in harnessing innovation or mitigating market failures.

Recognizing the extent and neglect of this important component of health systems, the Rockefeller Foundation in 2008 invited proposals for a review and landscaping of key topics related to the private sector in health. Thirteen reports were produced along with a synthesis document, Public Stewardship of Private Providers in Mixed Health Systems (available in print or at, a companion to this report.

A key component of this initiative was identifying innovative, pro-poor healthcare financing and delivery programs in South Asia and Sub-Saharan Africa that are led by or engage the private heath sector in the context of mixed health systems. This landscaping effort, anchored by the Results for Development Institute with key contributions from the William A. Haseltine Foundation for Medical Sciences and the Arts and other technical partners, had a twofold goal: support the project’s broader research objectives of better understanding the global landscape of existing private health sector programs and identify opportunities for potential support in future phases of the initiative

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.