Public and Private Interactions in the Health Sector in Developing Countries. Phase 1: Review of Concepts and Literature, and Preliminary Field Work Design

摘要

This paper is the first phase of a three-phase HFS major applied research activity that examines public and private interactions in health sectors of developing countries. A review of literature and experiences is conducted on payment systems, organizational frameworks, multiple job-holding, and competition between sectors. The report outlines the proposed field and analysis work (Phases II and III) for the topic. To remedy government budget constraints in health care, an option for developing countries is to encourage the private sector to assume a greater role in financing and providing health services, increasing interactions between the public and private sectors. When considering this alternative, concepts such as sharing public resources with private providers and determining the division of service financing and provision by sector must be taken into account. Because many physicians in developing countries allocate their time between jobs held in both sectors, multiple job-holding is examined using behavioral equations for health personnel time allocations. This approach models how the two sectors are affected by the choices made. The review of literature on public-private interactions shows that such interactions are not well documented, although private sectors in general have the finances for large investments. Field data collection on public-private interactions is recommended in four countries: Egypt, Kenya, India, and Pakistan.