How to Leverage the Private Sector to Improve Access to Health Care?

Agenda to mobilize the responsible development of private sector health care in sub-Saharan Africa:
1. Develop and enforce quality standards. Initial efforts at enhanced regulation could have large and immediate benefits. Financial and technical support is needed to strengthen the ability of public and private regulatory bodies to develop and enforce transparent and effective quality standards.
2. Foster risk-pooling programmes. Risk pooling arrangements— such as government-funded national payment schemes, commercial insurance, or community non-profit mutual schemes—have enormous potential to improve the financing of health care in the region, thereby encouraging the development of higher-quality, more organized private sector providers.
3. Mobilize public and donor money to the private sector. Donors can help build health-care capacity by earmarking some aid to fund private sector entities directly while also assisting local governments to expand their procurement capabilities and manage contracts with the private sector. Employers can foster the development of the local private health care sector by outsourcing provision of health care for their employees.
4. Modify local policies and regulations to foster the role of the private sector. Opportunities exist to reform the regulations that inadvertently block the development of the private health sector. The primary focus should be streamlining bureaucratic processes, liberalizing human resource regulations that perversely reduce the number of active health care workers, and reducing tariffs and other import barriers that impede access to or raise the cost of health supplies.
5. Improve access to capital. Entrepreneurs and business enterprises in Sub-Saharan Africa have trouble securing financing from established institutions. Three initiatives could tackle this issue: (i) educating local banks about the true risk profile of the health care sector; (ii) using international financial backing to encourage local financial institutions to lend to health care enterprises, including small and medium-sized enterprises (SMEs); and (iii) developing equity-focused financing vehicles for health care enterprises.

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