Division of Global Health, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Perspect Public Health. 2012 Sep;132(5):245-52. doi: 10.1177/1757913911414770. Epub 2011 Aug 18.
Health systems strengthening (HSS) is being increasingly recognized as a strategic cross-cutting issue in all World Health Organization (WHO) work. Health systems comprise six building blocks: service delivery; medical products, vaccines and technologies; health workforce; health systems financing; health information system; and leadership and governance. Public-private mix (PPM) approaches or partnerships consist of initiatives aimed at increasing collaboration and improving the relationships between public-public, public-private and private-private health providers. An important component of PPM is the clear distribution of tasks between the different providers involved in the provision of health care. In practice, most PPM initiatives are disease-specific and are often related to the health service delivery block mentioned above. Although there is widespread consensus that PPM initiatives are typically of an HSS nature, efforts to make explicit the links between PPM and health systems building blocks are rather uncommon. The present paper aims to identify - in order to facilitate operationalization - potential aspects linking PPM to health systems building blocks, using a few experiences from tuberculosis control and beyond. The paper targets policymakers, donors and health systems scientists and ends with a call for more aware and innovative leadership, for increased support of PPM initiatives covering various building blocks, and for more operational research.
卫生系统强化（HSS）正日益被视为世界卫生组织（WHO）所有工作中的一个具有战略意义的跨领域问题。卫生系统由六大组成部分构成：服务提供；医药产品、疫苗和技术；卫生人力；卫生系统筹资；卫生信息系统；以及领导和治理。公私混合（PPM）方法或伙伴关系包含旨在增加合作和改善公共-公共、公共-私营和私营-私营卫生提供者之间关系的举措。PPM 的一个重要组成部分是明确参与医疗保健提供的不同提供者之间的任务分配。在实践中，大多数 PPM 举措都是针对具体疾病的，并且通常与上述卫生服务提供部分有关。尽管人们普遍认为 PPM 举措通常具有 HSS 性质，但明确 PPM 与卫生系统组成部分之间联系的努力却很少见。本文旨在确定——为了便于实施——将 PPM 与卫生系统组成部分联系起来的潜在方面，使用来自结核病控制等领域的一些经验。本文针对政策制定者、捐助者和卫生系统科学家，并呼吁更有意识和创新的领导力，为涵盖各个组成部分的 PPM 举措提供更多支持，并开展更多的业务研究。
