Iqbal Meesha, Shahil Feroz Anam, Siddeeg Khalid, Gholbzouri Karima, Al-Raiby Jamela, Hemachandra Nilmini, Saleem Sarah, Siddiqi Sameen
UTHealth School of Public Health Houston, United States of America.
Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
East Mediterr Health J. 2022 Sep 29;28(9):638-648. doi: 10.26719/emhj.22.057.
The private healthcare sector in the Eastern Mediterranean Region (EMR) is active and growing, providing curative, preventive, and promotive services related to reproductive, maternal, newborn, child, and adolescent health (RMNCAH).
To understand the contribution of formal for-profit private health-care sector in delivering RMNCAH services and explore best practices for improvement.
Desk review of available literature from Saudi Arabia, Oman, Iraq, Egypt, Sudan, Yemen, Pakistan, and Islamic Republic of Iran, followed by stakeholder interviews in Iraq, Pakistan, and Oman were carried out. Directed content analysis using Maxqda 2020 was performed, and information was triangulated according to a priori themes: governance, health information systems, financing, and service delivery related to RMNCAH.
Formal and informal public-private partnerships exist in RMNCAH but lack a strategic roadmap to guide collaboration. The private healthcare sector is minimally represented in the main policy stream at national and subnational levels due to resistance from the private and public sectors. They are weak in collecting, maintaining, and sharing health information. Data on abortion and postabortion complications are scarce. Various models of supply and demand financing (voucher schemes, private and social health insurance) related to antenatal care and contraception have been implemented in the EMR. Despite the higher cost of care in the private sector, limited training of providers, ill-defined service delivery packages, and lack of continuity-of-care and team-based approaches, the private sector remains the predominant sector providing RMNCAH services in the EMR.
Partnering with the private sector has huge untapped potential that should be harnessed by national governments for expanding RMNCAH services and progressing towards Universal Health Coverage.
东地中海区域的私立医疗保健部门活跃且不断发展,提供与生殖、孕产妇、新生儿、儿童和青少年健康(RMNCAH)相关的治疗、预防和促进服务。
了解正规营利性私立医疗保健部门在提供RMNCAH服务方面的贡献,并探索改进的最佳实践。
对来自沙特阿拉伯、阿曼、伊拉克、埃及、苏丹、也门、巴基斯坦和伊朗伊斯兰共和国的现有文献进行案头审查,随后在伊拉克、巴基斯坦和阿曼进行利益相关者访谈。使用Maxqda 2020进行定向内容分析,并根据先验主题对信息进行三角测量:治理、健康信息系统、融资以及与RMNCAH相关的服务提供。
RMNCAH领域存在正式和非正式的公私伙伴关系,但缺乏指导合作的战略路线图。由于私营和公共部门的抵制,私立医疗保健部门在国家和次国家层面的主要政策流中代表性极低。它们在收集、维护和共享健康信息方面较为薄弱。关于堕胎和堕胎后并发症的数据稀缺。东地中海区域已实施了与产前护理和避孕相关的各种供需融资模式(代金券计划、私人和社会医疗保险)。尽管私营部门的护理成本较高、提供者培训有限、服务提供包定义不明确以及缺乏连续护理和基于团队的方法,但私营部门仍然是东地中海区域提供RMNCAH服务的主要部门。
与私营部门合作具有巨大的未开发潜力,各国政府应利用这一潜力来扩大RMNCAH服务并朝着全民健康覆盖迈进。