Partnership with private for-profit sector for universal health coverage in sub-Saharan Africa: opportunities and caveats

Nabyonga‐Orem, Juliet; Nabukalu, Joy Belinda; Okuonzi, Sam Agatre

doi:10.1136/bmjgh-2018-001193

Cited by 11 publications

(7 citation statements)

References 16 publications

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“…In this regard, we turn to the role of the private for-profit sector who are already significant players in health service provision. In embracing this potential resource, Nabyonga-Orem et al highlighted the caveats and caution us that there are prerequisites that must be in place 14. A large segment of the population in sub-Saharan Africa turns to the traditional sector when ill. Relatedly, advances in research on traditional medicines implore us to forge meaningful partnerships with the traditional medicine sector for better health outcomes.…”

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confidence: 99%

Resilient health systems for attaining universal health coverage

et al. 2019

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“…For instance, in the evaluation of the Africa Health Market for Equity (AHME) program, which focuses on social franchising, it was noted that the performance of the providers of the social franchise led to improved performance of Linda Mama policy with 79% of the social franchising facilities participating in Linda Mama service provision [60]. However, their contributions depend on appropriate governance prerequisites, including institutions, management capacities, and a collaborative culture to allow effective partnerships and delivery designs that target those in need and underprivileged [61].…”

Section: Discussionmentioning

confidence: 99%

The policy formulation process, and the role of actors in the policy formulation and implementation process: A policy analysis of the Kenyan free maternity policy

Oyugi,

Audi-Poquillon,

Kendall

et al. 2024

Preprint

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Kenya is one of the many African countries committed to advancing its health system reforms by providing affordable and equitable access to essential health services. In 2016, the Government of Kenya unveiled an expanded free maternity care policy called ‘Linda Mama’ to provide essential health services for pregnant women. We explored the agenda setting and the formulation of this policy to understand the processes, content and context, and the role of the actors in the formulation and implementation. We conducted an exploratory qualitative study, which involved document review, key informant interviews (KIIs) with national stakeholders, and in-depth interviews with County officials and health care workers (HCWS). We used a theoretical framework capturing the preliminary situation analysis of the policy, the processes, the content, and the stakeholders' roles in the formulation and implementation. This study was conducted in three facilities (levels 3, 4, and 5) in Kiambu County in Kenya. Data were audio-recorded, transcribed and analysed using a framework thematic approach. We found that the priorities of the policy were mainly to meet a political campaign agenda but also align them with the objectives of the country's legal and policy-guiding instruments and the global goals of SDGs that sought to improve the quality of maternal and neonatal care and eliminate financial barriers. The policy also sought to enhance access to skilled birth attendance (SBA), and its redesign filled the challenge of the previous policy. The stakeholders (bureaucrats, professional bodies, public and developmental partners) influenced the processes of the formulation and the content of the policy through their power to put forward and advocate for specific ideas through issues framed in a political and socioeconomic context. Several stakeholders played different roles in the formulation and implementation based on their interests, power and position in the ecosystem of the policy. Policy formulation or change requires the agents to work within the relevant context, stakeholder interests, power, ideas and framing of issues.

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“…A growing public policy gap has opened because governments have lost contact with the private sector 9 21. This situation creates significant challenges in meeting national health priorities, especially as the three dimensions of UHC—population coverage, access to essential services and financial risk protection—are unattainable without effective governance of all health actors 8 31 32…”

Section: Introductionmentioning

confidence: 99%

The governance behaviours: a proposed approach for the alignment of the public and private sectors for better health outcomes

Clarke,

Appleford,

Cocozza

et al. 2023

BMJ Glob Health

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Health systems are ‘the ensemble of all public and private organisations, institutions and resources mandated to improve, maintain or restore health.’ The private sector forms a major part of healthcare practice in many health systems providing a wide range of health goods and services, with significant growth across low-income and middle-income countries. WHO sees building stronger and more effective health systems through the participation and engagement of all health stakeholders as the pathway to further reducing the burden of disease and meeting health targets and the Sustainable Development Goals. However, there are governance and public policy gaps when it comes to interaction or engagement with the private sector, and therefore, some governments have lost contact with a major area of healthcare practice. As a result, market forces rather than public policy shape private sector activities with follow-on effects for system performance. While the problem is well described, proposed normative solutions are difficult to apply at country level to translate policy intentions into action. In 2020, WHO adopted a strategy report which argued for a major shift in approach to engage the private sector based on the performance of six governance behaviours. These are a practice-based approach to governance and draw on earlier work from Traviset alon health system stewardship subfunctions. This paper elaborates on the governance behaviours and explains their application as a practice approach for strengthening the capacity of governments to work with the private sector to achieve public policy goals.

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Partnership with private for-profit sector for universal health coverage in sub-Saharan Africa: opportunities and caveats

Cited by 11 publications

References 16 publications

Resilient health systems for attaining universal health coverage

Resilient health systems for attaining universal health coverage

The policy formulation process, and the role of actors in the policy formulation and implementation process: A policy analysis of the Kenyan free maternity policy

The governance behaviours: a proposed approach for the alignment of the public and private sectors for better health outcomes

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