Efficiency and quality in the public and private sectors in Senegal

Abstract

It is often argued that the private sector is more efficient than the public sector in the production of health services, and that government reliance on private provision would help improve the efficiency and equity of public spending in health. A review of the literature, however, shows that there is little evidence to support these statements. A study of government and non-governmental facilities was undertaken in Senegal, taking into account case mix, input prices, and quality of care, to examine relative efficiency in the delivery of health services. The study revealed that private providers are highly heterogeneous, although they tend to offer better quality services. A specific and important group of providers--Catholic health posts--were shown to be significantly more efficient than public and other private facilities in the provision of curative and preventive ambulatory services at high levels of output. Policies to expand the role of the private sector need to take into account variations in types of providers, as well as evidence of both high and low quality among them. In terms of public sector efficiency, findings from the study affirm others that indicate drug policy reform to be one of the most important policy interventions that can simultaneously improve efficiency, quality and effectiveness of care. Relationships that this study identified between quality and efficiency suggest that strategies to improve quality can increase efficiency, raise demand for services, and thereby expand access.

Unmet healthcare needs and community health center utilization among the low-income population based on a nationwide community health survey

“…In addition, operational performance of CHC is low comparing to other private healthcare institutions [29][30][31][32]. Thus, CHC system must be improved quantitatively and qualitatively in this country, and the South Korean government must develop appropriate strategies to meet these needs of population.…”

Approaches to overcoming constraints to effective health service delivery: a review of the evidence

“…Two studies reported better quality in non-governmental services but pointed to the high level of heterogeneity among service providers (Bitran, 1995;Kanji et al, 1995). In Zimbabwe and South Africa, lower unit costs were found in privately run hospitals, but no substantive quality difference was found in the first country and slightly superior quality for non-governmental providers in the second country .…”

Health-Care-Seeking Patterns in the Emerging Private Sector in Burkina Faso: A Population-Based Study of Urban Adult Residents in Ouagadougou

“…Furthermore, formal private providers are a heterogeneous group. Previous studies have indicated that for-profit (FP) private providers differ substantially from not-for-profit (NFP) providers in incentives, motivation, patient perception, access, and quality of care [17], [29]–[31]. In low- and middle-income countries (LMICs), particularly in SSA, from decolonization until the 1970's, health care and service provisions were state-run [32] and gratuitous [33].…”