Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
BMJ Glob Health. 2023 Jan;8(Suppl 1). doi: 10.1136/bmjgh-2022-010742.
Many countries are adopting essential packages of health services (EPHS) to implement universal health coverage (UHC), which are mostly financed and delivered by the public sector, while the potential role of the private health sector (PHS) remains untapped. Currently, many low-income and lower middle-income countries (LLMICs) have devised EPHS; however, guidance on translating these packages into quality, accessible and affordable services is limited. This paper explores the role of PHS in achieving UHC, identifies key concerns and presents the experience of the Diseases Control Priorities 3 Country Translation project in Afghanistan, Ethiopia, Pakistan, Somalia, Sudan and Zanzibar. There are key challenges to engagement of the PHS, which include the complexity and heterogeneity of private providers, their operation in isolation of the health system, limitations of population coverage and equity when left to PHS's own choices, and higher overall cost of care for privately delivered services. Irrespective of the strategies employed to involve the PHS in delivering EPHS, it is necessary to identify private providers in terms of their characteristics and contribution, and their response to regulatory tools and incentives. Strategies for regulating private providers include better statutory control to prevent unlicensed practice, self-regulation by professional bodies to maintain standards of practice and accreditation of large private hospitals and chains. Potentially, purchasing delivery of essential services by engaging private providers can be an effective 'regulatory approach' to modify provider behaviour. Despite existing experience, more research is needed to better explore and operationalise the role of PHS in implementing EPHS in LLMICs.
许多国家正在采用基本医疗服务包(EPHS)来实施全民健康覆盖(UHC),这些服务包主要由公共部门提供资金和提供,而私营医疗部门(PHS)的潜在作用尚未得到开发。目前,许多低收入和中低收入国家(LLMICs)已经制定了 EPHS;然而,将这些服务包转化为高质量、可及和负担得起的服务的指导有限。本文探讨了 PHS 在实现 UHC 方面的作用,确定了关键问题,并介绍了疾病控制优先事项 3 国家翻译项目在阿富汗、埃塞俄比亚、巴基斯坦、索马里、苏丹和桑给巴尔的经验。私营医疗部门的参与存在关键挑战,包括私营提供者的复杂性和异质性、它们在卫生系统之外运作、人口覆盖范围的限制以及当留给私营医疗部门自己选择时的公平性,以及私人提供服务的整体护理成本更高。无论采用何种策略来让 PHS 参与提供 EPHS,都有必要根据其特征和贡献,以及它们对监管工具和激励措施的反应来确定私营提供者。监管私营提供者的策略包括更好的法定控制,以防止未经许可的执业行为、专业机构的自我监管,以维持执业标准和认证大型私立医院和连锁医院。通过让私营提供者参与提供基本服务,购买服务可能是一种有效的“监管方法”,可以改变提供者的行为。尽管已经有了现有经验,但仍需要进行更多的研究,以更好地探索和实施 PHS 在 LLMICs 中实施 EPHS 的作用。