Institute for Global Health Sciences, University of California San Francisco, 550 16th Street, 3rd Floor Box 1224, San Francisco, USA.
Department of Sociology University of California Davis, 1 Shields Avenue, Davis, USA.
Health Policy Plan. 2018 Sep 1;33(7):777-785. doi: 10.1093/heapol/czy053.
Social health insurance (SHI), one mechanism for achieving universal health coverage, has become increasingly important in low- and middle-income countries (LMICs) as they work to achieve this goal. Although small private providers supply a significant proportion of healthcare in LMICs, integrating these providers into SHI systems is often challenging. Public-private partnerships in health are one way to address these challenges, but we know little about how these collaborations work, how effectively, and why. Drawing on semi-structured interviews conducted with National Health Insurance (NHI) officials in Kenya and Ghana, as well as with staff from several international NGOs (INGOs) representing social franchise networks that are partnering to increase private provider accreditation into the NHIs, this article examines one example of public-private collaboration in practice. We found that interviewees initially had incomplete knowledge about the potential for cross-sector synergy, but both sides were motivated to work together around shared goals and the potential for mutual benefit. The public-private relationship then evolved over time through regular face-to-face interactions, reciprocal feedback, and iterative workplan development. This process led to a collegial relationship that also has given small private providers more voice in the health system. In order to sustain this relationship, we recommend that both public and private sector representatives develop formalized protocols for working together, as well as less formal open channels for communication. Models for aggregating small private providers and delivering them to government programmes as a package have potential to facilitate public-private partnerships as well, but there is little evidence on how these models work in LMICs thus far.
社会健康保险(SHI)是实现全民健康覆盖的一种机制,在中低收入国家(LMICs)中变得越来越重要,因为它们正在努力实现这一目标。尽管小型私营提供者在 LMICs 中提供了很大一部分医疗保健服务,但将这些提供者纳入 SHI 系统通常具有挑战性。卫生领域的公私伙伴关系是应对这些挑战的一种方式,但我们对这些合作如何运作、运作的效果如何以及原因知之甚少。本文借鉴了在肯尼亚和加纳与国家健康保险(NHI)官员以及来自几个国际非政府组织(INGOs)的工作人员进行的半结构化访谈,这些组织代表着社会特许经营网络,正在合作增加私人提供者的认证进入 NHIs,以考察实践中的公私合作的一个例子。我们发现,受访者最初对跨部门协同作用的潜力了解不完整,但双方都有动机围绕共同目标和互利的潜力进行合作。公私关系随后随着时间的推移通过定期的面对面互动、相互反馈和迭代工作计划的制定而发展。这一过程导致了一种合作关系,也使小型私营提供者在卫生系统中拥有更多的发言权。为了维持这种关系,我们建议公共和私营部门的代表都制定正式的合作协议,以及非正式的沟通渠道。将小型私营提供者集中起来并作为一个整体提供给政府计划的模式也有可能促进公私伙伴关系,但迄今为止,关于这些模式在 LMICs 中如何运作的证据很少。