STRATEGIC ENGAGEMENT OF THE PRIVATE SECTOR FOR GLOBAL HEALTH GOALS

Transcription

1 STRATEGIC ENGAGEMENT OF THE PRIVATE SECTOR FOR GLOBAL HEALTH GOALS A total market approach for UHC Presenters: Sean Callahan & John Campbell Jr. October 22 nd,

2 IN SEVERAL LOW- AND MIDDLE-INCOME COUNTRIES, THE PRIVATE SECTOR SERVES AS THE FIRST POINT OF CARE ESPECIALLY FOR RH AND FP SERVICES & PRODUCTS In general, 1. Private providers include: primary health care centers, pharmacies, drug shops, clinics, hospitals 2. Users often pay OOP for care, experiencing varying service quality 3. Additionally, access may be limited to those who can afford to pay leaving behind primarily lower income quintiles and/or increasing financial hardship on beneficiaries who pay OOP for care. Sources of contraceptive FP products, Nigeria Other 5% Public Sector 23% Private Clinic 4% Pharmacy/PPMV 68% 2

3 IN ORDER TO CREATE MIXED HEALTH SYSTEMS TO IMPROVE ACCESS, AFFORDABILITY, & QUALITY OF SERVICES, GOVERNMENTS NEED TO START ENGAGING AND WORKING WITH THE PRIVATE SECTOR Strong public sector stewardship and active strategic purchasing Organized private + = sector Well-Functioning Mixed Health Systems Universal Health Coverage Harnessed for 3

4 THIS MEANS NAVIGATING MAJOR FACTORS FOR EFFECTIVE PRIVATE SECTOR ENGAGEMENT 4

5 ACTIVITY 1: CHALLENGES TO PUBLIC-PRIVATE ENGAGEMENT Each table (assigned either private or public sector) has been given a scenario. Working together with your table, please read through the scenario and identify key challenges that relate to the proposition described in your respective scenario. Group discussion: each table will describe 1-2 challenges they identified. Timing: 15 minutes 5

6 WHAT DOES SUCCESSFUL PUBLIC-PRIVATE ENGAGEMENT LOOK LIKE? AN EXAMPLE FROM HONDURAS In 2009, Honduras began preparing to graduate from USAID assistance for FP in 2012 With USAID support, the government formed a Contraceptive Security Committee to address two questions: How would government ensure continued access to FP without donated commodities? How would country further reduce unmet need for FP and increase contraceptive prevalence rate (CPR)? With inputs from government, donors, and private sector, committee developed transition plan that leveraged resources from all sectors of health system By graduation, unmet need declined (16.8% to 10.7%) and CPR increased (65.2% to 73.2%) Improvements most significant among poorest wealth quintiles and in rural areas But how were they able to do this?? 6

7 DELIBERATIVE PUBLIC-PRIVATE ENGAGEMENT THROUGH A TOTAL MARKET APPROACH A government may take a Total Market Approach to consider and support the comparative advantages and complementary roles of all sectors of the market in order to foster long-term, sustainable provision of information, products and services to all market segments or population groups who want to use them This will mean creating space for all providers/sources of care to in total serve all interested clients 7

8 A TMA CAN INCLUDE INTERVENTIONS AT MULTIPLE POINTS OF THE HEALTH SYSTEM 8

9 THESE INTERVENTIONS ADHERE TO OVERARCHING PRINCIPLES Principle 1 Principle 2 Principle 3 Preserve client choice for source and type of care Use data to inform and measure TMA strategies Empower local champions 9

10 AND CAN TARGET SEVERAL WELL-DEFINED OBJECTIVES INCREASE ACCESS TO/USE OF PRIORITY GOODS OR SERVICES Increase sustainability of a health market Increase efficiency in the health system Increase equity in a health market 10

11 SO WHAT DID HONDURAS TMA LOOK LIKE? Gathered qualitative and quantitative data to understand the market, including current users and non-users of FP Developed and implemented targeted distribution strategies Government subsidies targeted in rural areas where need to expand access was greatest Private sector stepped up to fill in gaps created in urban markets to sustain access 11

12 KNOWLEDGE CHECK: PUBLIC- PRIVATE ENGAGEMENT, UHC, AND THE TOTAL MARKET APPROACH 12

13 GAME TIME! Public-Private Engagement Total Market Approaches Universal Health Coverage

14 Public-Private Engagement Which of the following is not a major factor in public-private engagement? a) Government b) Political c) Organizational d) Geographic e) A and D

15 Public-Private Engagement True or False: It is often easier for governments to engage with private providers on an individual basis. False Fragmentation adds time and money costs. Public-private engagement is easier with a well-organized private sector.

16 Public-Private Engagement How can economic factors affect public-private engagement? a) Payment mechanisms create incentives for providers to deliver care in certain ways b) Credentialing and accreditation can help assure quality in the private sector c) Political ideologies can shape perspectives on engagement. d) All of the above

17 Total Market Approaches True or False: A total market approach involves the government or donor serving the total market of all users. False a total market approach utilizes the comparative advantages of ALL sources of care to serve all segments of a market.

18 Total Market Approaches -200 Which of the following is not a TMA principle? a) Phase out all subsidies to clients with the ability to pay for care b) Use data to inform and measure programs c) Empower local champions d) Preserve client choice e) B and C

19 Total Market Approaches Which of the following is not an area in which a TMA typically intervenes? a) Policy and regulation development b) Health financing programs c) Service delivery d) Human resources training e) A and D

20 Universal Health Coverage Three common dimensions of UHC include: a) Financial protection, facilities included, payment mechanisms b) Payment mechanisms, health management information systems, services covered c) Population covered, financial protection, facilities included d) Population covered, financial protection, services covered UHC focuses on increasing the number of people able to access a greater range of services with increased financial protection

21 Universal Health Coverage True or False: UHC programs always include benefits for FP. False. Benefits are often limited, and may focus on inpatient services

22 Universal Health Coverage Government contracting with private sector may support UHC by: a) Encouraging efficient use of financing resources b) Establishing a range of services that each provider must offer c) Expanding access to subsidies and reducing financial barriers for underserved groups d) Increasing the number of health facilities delivering covered services e) All of the above

23 THANK YOU! Populations Services International Pierre Moon, Director of SIFPO2 Rebecca Husband, Technical Advisor for SIFPO2 Results for Development Institute Cicely Thomas, Program Director Adeel Ishtiaq, Senior Program Officer John Campbell, Jr., Program Officer SHOPS PLUS Sean Callahan, Private Sector Specialist