private health sector and hiv

8/8/2019 Private Health Sector and HIV

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Strengthening health SyStemS by engaging thePrivate health Sector: PromiSing hiv/aiDS PartnerShiPS

h

i v / a i D

S

P o l

i c y

b r i e f introDuction

r s wd

pss p f

w-f ss

d s ss

ss ss ss,

d hiv/aiDS. a s, s w

p s ps

k sss f

dp s. t

s, d 60 p f

pd

s-S af 2005 ws

fd p ss, s

-f-pk ps.

epds p pds

d f f f s

pd (i Fcp, 2007). i

s p s s

ps sz pp f

ss dd

d ss—

ssss K fd

60 p f

pds wk

p s (bs

, 2009).

as sss spd sd d f hiv/

aiDS, s d

d p s

ppp s ss

hiv/aiDS s

(PePFar rz, 2008;

unaiDS, 2009). F d s

s ssd pps

p ss fd

p s—skd wk

f, f, s d

fs— hiv/

aiDS s. m,

ss p s p

p s f

ss p

s s s dd sff

d wk ds s.

m , s

ss hiv sps

k f

w p s,

s s f kd f s d d f

hiv/aiDS.

Dsp s, p

s—p f-pf

s—ds kd

sss s

s d

fsd p s. a

k p f s s

p s ds

wd s d s

f pzd

sss fwk. ts f

sks ddss s p d

hiv/aiDS pks d

ps w

d p s

hiv/aiDS d

sss s s

• e s Wdh oz (Who)

sss sd ks s fwk df p ss dffps f ss

• is f p-p sd psps s sss w s p

dsd hiv/aiDS sW p p s

s s p

hiv/aiDS js, s pp

fss w p-p

ss

sss

s. S ss-s

s w sp

f f f dd

d: pks d

ps p s d

d s.



2

each health SyStem

builDing blocK

incluDeS Private

Sector actorS

W s fwks s

p ps d

f f sss, s

pp ss s s s p Who ‘d ks’: g,

if, F, S

D, h rss, d

md d ts. t

p s s

s

d k. if w d ‘pk’

k, w wd s

f p d p s

w p w ss.

F 1 pss s

f p s s d k. t f

ss w ‘ks’

ps f ss,

w ps dfd fwk

F 1.

e d w

p s

ss s :

• bd s-wd p d -q ss dpds

• is dds f psw sks d dd ss,p dsdps

• ip ,dss, d s f f f skds sd spp ds-k s s s

• e ’s s f -q d pds,s, d s

• mz ss f ssss, ps sk p,d zs pdsppp, d

• S s f s, p

f f s dp w s

Dsp ps f p

s, p-p psps

ws sw. Ds d

psp w

p d p ss

q sd d ,

s dps ‘ks’ sd

k s

s w p ff sf pd ffs

s (bs, 2010). i f,

s ssd fw

f

s psp: fs, sd

Figure 1: Illustrative range of private sector actors organized by the WHO building blocks



dd pss

ps ss

k ddssd

s; d sd, sd

ssd psp w

s ff, ss

q ss (bs,

2010).

ass s ssfd, s pp dss

s f p s

, s w s pps

f

d ks f ss,

d js

.

Private Sector

engagement aS

an aPProach to

Strengthening the

health SyStem

t dff s f p

s . t s

sd ps f wk

w p s s p-

p psps “PPPs.”

b “PPP” s

dff s, f

s w

p ps

dp d f s f

d dsss,

d ps d -

kd spps ps,

- p pds d

ss. as d f

p-p s s,

PPP dff

s dff pp. bsd

fd p wk w

p s,

s f p s

:

• Pubic-PivaeDiaogue pz d df ss

w p s ddss ss ps s f ss ss,dd , ss ffd , f d psf, d s

• Pubic-PivaeIneacion p d sss f p f ps d s sdds d ps f s s

Figure 2: Illustrative range of policy instruments and approaches to dialogue, interact and partner with private

sector actors organized by the WHO building blocks



4

• Pubic-PivaePaneships pz ps– f pss s s s, s, d , fw– pss ss d/

pds f dsd ps

F 2 pds w f d d sp f s w

p s

p s s

sss. as f ss,

wk w p s

s f s s

pss df p s

skds (p-p d)

dsss w

pd p (p-p

s) kwd

p s s

s sd s

(PPPs). i s s w

s d ff p s

, p-p d

d/ s

pss d fd

w s s

wd pz PPPs.

t fw s pss

f p s

f f sss

s d ks. b

s s sds ds,

w p

s f s

s p d ks

ss, f s

w s k s f

ss.

examining Private Sector

aSPectS oF the builDingblocKS

SeviceDeivey

i s, hiv pd

s sd d pd

pd f hiv/aiDS-

d ss s s sd s,

(art), d tb dd

p ss.

i ss, p s

sd s d .

P w p s

s d s

pd f

ss d ds

s d p

p s, s

PivaeSeco

Acos

Pubic-PivaeEngageen

oSenghenHeah

Syses

IneediaeHeahSysesOucoes

Who Wha Why

P f-pf,ngo, d Fbo

pds

S d s, s, d

ds-f-pf s

is financia access p ps f ppdd ss d ff pds s kd

ss dd

is physicaaccess w pds dsd s

ip coveage ff pds s kd

ip quaiyandsafey d d pds,ff pds q-kd s, d

s f q

Pd sss r fsd d, s, df, f sp f p

q sdds

is physicaaccess df sps f wk f wks d d ds

P pds

is financiaaccess ff p ssds fd d s

cps

cp fd f ps d

ip financiaaccess d coveage pfd f s d s p s

Fd f sss df k ks

pd s dip quaiyandsafey ddss k ss

Table 1: Private sector engagement that strengthens the health system: Service delivery



6

contracting With Private Sector PhySicianS For hiv treatment:broaDreach healthcare in South aFrica

i 2005, p bdr h, S af’s Dp f h (Doh), d p s ds’ wk d PPP s - s p ms ds f n Ws p. S art ps w

art f s s (p s) ds sp dfd f ‘dw-f’d p d p s p (gP) (bdr h, 2010). tsp gP s sps f f art ps. gPs s ‘p-f’ art ps ds sp f dd. D p, d ds, s, d f ‘p-fd’ ps sps f Doh. bdr h pds pd d d d spps gPs pp ds, ps, p k, d d ds ss. t Doh d sp spd s s f PPP. Ps w s PPP p fs; fd s pdd PePFard Doh.

c w p gPs d art ddsss k S af ss. W 80 p f pp s p s f , 30 p f S af’s ds d p s (n, 2010). F, dd f artsd wd d pss p s art fs. ts p s ddssd s p s ss pd p d art. t PPP ss dff

ss d ks d ps s w . i ps s d f p Doh ss f w ps d ds p d p s s. t PPPs ss f p s. t PPP s pp gPs w ds art f p d d . gPs p w ds s PPP art ps s f . i fs s f p, 918 ps d f art dw-f p s gPs (bdr h, .d.).r s fd PPP d p s (94 p . 75 p), sppss s (88 p . 67 p), d ws s s-ff. Ps s pd f PPP d (n, 2010).

Heahsysebuidingbocks:Sevicedeivey,heahwokfoce,andgovenance

ExAmPlESFrOmtHEFIElD

contracting-out For conStruction anD Service Delivery in leSotho

ls s p f s wd- psps af s. i o2008, f ls d ts’p cs (d n, f Saf’s s p pds) ds, d, d qp 425-d f spd f p s s ms, ls’s p . i dd, ps–d sd f hiv/aiDS d tb– s fs d- ts’p cs. Fds s sp f f p d ss, w fds s dd dd p 100--d Q ez ii sp. tfsd f s p f m 2010 d ss, d hiv/aiDS d tb , pdd p p. t w sp w pd m 2011.

P ps f p pdd ss pf-sd s s p pd f ss ss w pd d q f ss. P s ts’p-pd fs fw p s s, d p sd w f p. t 18- w ts’p cs s pf-sd d

d d p: ps pdfd s d s.

bs ts’p cs s sps f f sp d s ms, ts’p ss ss f ffs– s ps wds f ffs–ss f . as s, s s d f s d d d d s p f ss d ss. ts s d: sss ls n D S oz w s p d spp sss s, d pp-sdp ds ds pds d ss p f, d p q f f f pk d p. t s p w n h t c spzd pfsss (t g h gp, 2009).

Heahsysebuidingbocks:Financing,sevicedeivey,andHIS



the health inSurance FunD: Strengthening health Financing innigeria

t Pass Fd s fdd g f nds s sss af. i 2007, fd’s h is Fd, D s psd s, pd w h, n’s s z, p

s- h c h P (hchP). t psp dpd s d fw- wks d fs ls d Kw s. hchP d w f s pd 13 p s s d sps pd ss, d hiv/aiDS-d ss.i Kw s, pp w wk d f S . i ls,hchP s w w wk ks d fs.

i s, w- dds f ssds s p. D p, sd ps 5 13 p f w p, w his Fd ssdzs d. F s, Kw s, s p s q f $27 p ps p . i fs , s Kw sps f 5 p f p, $1.35 p ps p . a f f wd p $13.50 f fs d f f d. as f 2008, 50,000 pp ss s w sd hchP p. Pp s pdd hchP d pd ss d-q hiv f hchP s (unaiDS, 2009).

i dd p s p s f p sp spd ds f ss ss, hchP pds f pds d ss w p d p pds. m, hchP s ps s d dds d p f sff d fs (Pass Fd, .d.).

Heahsysebuidingbocks:Heahfinancing,heahwokfoce,andsevicedeivey

PPP unitS in health: Strengthening governance anD leaDerShiP

Within the health SyStema w f s-S af s—d ep, g, K, n, S af,ud, d Z— ssd PPP s w ss. PPP s s s f p f p s . a p PPP s psd f s psw df, k, d spp s PPPs p s. t s d sff w dff ps— s s s sss ds, w, s—w sp s p. t k f PPP s s s s s f sff, ff ss d d, s d, sss, p spp, spp, d p d p s d PPPs . t PPP s f p swdsp s.

W PPP s s s s, w ds s f .t f PPP fs ds f p , d fs ss dwksss f . F s, Z d S af, PPP s d w n

Dp f F. ts, s s p ssss s ffss f ppsd PPPs.a, ud’s PPP sds Fd ms f h’s Dp f P. ts s PPP d p k dsks w ss. F, PPP s f dzd d f .

i n, PPP s s fd d s , w s ss k f PPPs. PPP s fs PPPs f ws : s d p pds; ds sss, s s, sw p fs; pd ss, p fs, z; p pds d p z; d f d d sd psps w p d p s (o’h, 2009).

Heahsysebuidingbock:Govenance



8

ds k s,

dd f ss

f ss . Wk

w p ps

s ds d d

s p

s p d ps f p

. t 3 pss s

s f w p s

p d d

f .

medicaPoducs,Vaccines,and

technoogies

t f d-q

s, d ds,

d s s fd

q f d ff

ss. Wdspd ss

f ds, s, d d

ds ssps f p f

ss, d s

p p

dp s. P w

p s ddss s

s s spp d

w ss f ds, s,

d d pds,

p spp

w sks d s

p s ssd,

d dp ff ds

d s. t 4 pss

s s f PPPs

sss s

d pds, s, d

s d k.

HeahFinancing

t js f d

f ss s dq

s f , s d

f ss ss,

p s ss fps d s s,

d ppp s

f s d d s. ts

fs sk w

wd f hiv/aiDS s. t

s, ds hiv/aiDS

d () ps

d qd p

s, s ds hiv/aiDS

d k dss.

F, f s

q f f d fsp f pp

w hiv/aiDS (Plhiv)

f w d s

dpd

p ps. h

f ss p

w hiv-d ds d ps,

pd f ffd

ds d ss, d p

Plhiv f f sp

ssd w s ss

hiv-

p s. t 5 pss s s f w p

s p

f.

PivaeSecoAcos

Pubic-PivaeEngageenoSenghenHeahSyses

IneediaeHeahSysesOucoe

Who Wha Why

Pps

P d p sd ss ds

is ss d f ss dp w s

d f

cpd

dss dks as d s sss,

d pds, ds ksis ps ss d

p f ss d,d/ p f ss p ss hiS p/ d

ss

Pps

P pds

c p dfps

as f s s p

dpd p/ f s d p p f f

9P d p sd ss dpd d / p pfs

Pfsssss

P s spp f pfss sss pd d f pfsss

ip q d sf pdd pdd pd kwd

adss

cs p d d d z s pfs d sk

d ss s

is ps ss d p s ps f

d mk sps

Table 3: Private sector engagement that strengthens the health system: HIS



Govenance

eff s d ,

d, ps f

ppp s d s

k w-f ss ,

s ss ss

p f p s

p js.

S dsp d d

sd s

p

f p

s s

p , d s sp

p d q f

p s ks p s. i f, s

pd dsp d

f p s s s

f s p

s w p s

s k

s d, f

pp f f

p ss pp

f ss. g

d d w

p d p ss ss ds d s

d ss, s

pps f PPPs .

t 6 pss s s f

w p s

p w

ss.

PivaeSecoAcos



Who Wha Why

Pps, d/

dss

P d p sd s p s df w s

s. ts d d fd sp s ss

is ps ss d dp ws s s d d

s-ff

ip f ss r&D ffs p s, w k p d s

spp f d ds

ip q d sf s q f dsd pds fd s

P d p sd ss f, .., s f

pp, f

ad k s p fd s f p

ps k ss f s d dp s

f s

c

pddss d

ks

as s k ds ds, s pds ks

is ps ss d sspp f ds, s, d d ds

is f ss w k p f ds, s, d ds

ip q d sf q f dsd pds

c p/fps

as f s sp dpd p/ fs f spp

p fs

is ps ss d s d p sk-s f ds, s,

d d ds

cs

as f s f ps f ds ss

is ps ss d p s sks d qp d

ds ss

ip f ss w s s (f ) w ss pd f s w s

ip q d sf ssdz s d q sdds d ff

pds pf s kd q

Table 4: Private sector engagement that strengthens the health system: Medical products,

vaccines, and technologies



10

PivaeSecoAcos



Who Wha Why

css dsds

Dd-sd ssds f p ssdd dd p pds.

is ss d s s sfs

is physicaaccessandcoveagepd f pds w ff

ssdzd p ss

P f-pfpds

ip financiaaccess w () -f-pk ps p f

s

n-f-pf pds

ip quaiyandsafey ssdz ssdd p pds w d

q sdds d ff pdspf s kd q

P sps

c-sd f zs

h s ss p sk. tp-p ss dpds dsf s. P d s

ss p pds dp s dss. o

d, p d ss d p d d s ps w- ps.md zs ff s

s sps

is physicaaccessandcoveagepd f pds w ff p

ss

mdzs

ip financiaaccess p sk dw ( ) -f-pk ps

p f s

css dsds

ip quaiyandsafey d ppds w d q sdds

d ff pds pf skd q

P f-pfpds

S d s, d/ s

is financia access p ps f p pdd ss d ff pds

s kd ss dd

is physicaaccess wpds d-sd s

ngo/Fbo pds

ip coveage ff pds skd

ip quaiyandsafey dd pds, ff pds qs d s f q

cp wkpscp p fd

f f ss

is financia access d s f wks d

p ss

is physicaaccess pd f pds d p ss

ip quaiyandsafey pd -q s pds

Pps

ad k s p fd s f p

ps k ss f s d dp s

f s

is physicaaccessandcoveagedp w s s

s d d s ff

ip financiaaccess r&Dffs p s, w k p

d s spp f d ds

ip quaiyandsafey s qf ds d pds fd d

fs

Table 5: Private sector engagement that strengthens the health system: Health financing



concluSionS

h sss s

ffs fs s

p s k

ss ss

ddss hiv/aiDS pd.

t p s—

d pf—ffs wd

f dd ss s s skd

sff, fs d qp,

fs, ps, d

s dd

s ps f Who

sss d ks.

P s s w

k p

hiv/aiDS s ds s

ps f PPPs. t s p

p s skds d

f d d sd p

pds s w s s

ps f ,

p ps ff hiv/

aiDS ss, p

ps pd

ds d d pds d

dss s d ss

ds.

t s f

p s :

• Pubic-PivaeDiaogue pz d df ss ddss ss ps

• Pubic-PivaeIneacion p d sss f

• Pubic-PivaePaneships pz ps p ss hiv/aiDS ss d pds dsd ps

P-p s d

s p s

sss f ddss

d k ss

d p s w

s d ks. hiv/aiDS

ps d w sss s sd

f sd s

p s p

ss, df -spf

pps p

s, d p PPPs

ff s

ss w hiv/

aiDS js.

PivaeSecoAcos



Who Wha Why

Pfsssss

P d ps

P fs d psss (.., s d pdws, s p) d s

p s ps

o ssp d d s sdd p p ss

ss p s p

Pfsssss

S d, s d/ ds, dfsps f pfss sps f p, p-s

d d sdds, d f sip quaiyandsafey df d

f q sdds d spd kwdP pdd f sss df

spp f f d

P d ps

S d d ss, sf ddss s ps, d d w

p s psip quaiyandsafey s

d d pss d d fsddsP fdd ( p-p -fdd) ps

f ss s k

Table 6: Private sector engagement that strengthens the health system: Governance and leadership



12

reFerenceS

bs, J, o’h, b, F, F,g, n, mK, K & Dk,c. 2009. Kenya Private Health Sector

Assessment . bsd, mD: PS Psps-One pj,a asss i.

bs, J. 2010 (df). Designing Public

Private Partnerships in Health.bsd, mD: Sh os P S pj, aasss i.

bdr h. 2008.Requirements for a Successful Treatment Model: The Down-Referral

Model as a Case Study . p://www.ds-./ss/df/fs/3p_ds/70/d-W-Wks---t-P.pdf

i F cp.2007. The Business of Health in

Africa: Partnering with the PrivateSector to Improve People’s Lives.

n, P. 2010. Implementation of aNovel Model to Enhance Routine HIV Care and Treatment Capacity in South

Africa: Outcomes, Costs, and Cost-effectiveness. PD tss, us

f cp tw.o’h, b d S, a. 2009. African

Public-Private Partnership Units inHealth: What Are They and What DoThey Do? bsd, mD: PS Psps-One pj,a asss i.

PePFar rz. 2008. h.r.rp. n. 5501, 110 c., 2dSss.

DiSclaimert s’ ws pssd s p d ss f ws f ud Ss a f i

Dp (uSaiD) ud Ss g.

AbouSHOPSt S h os P S pj (ShoPS) s

fdd u.S. a f i Dp (uSaiD) d c n.gPo-a-00-09-00007.ShoPS s d a asss i. d pd w f ps:b g i Jp i m Sps i i m gp i o’h hcs

F f ShoPS, ps :S h os P Se-: [email protected]://www.spspj.

F f h Sss 20/20, ps :h Sss 20/20

e-: [email protected].

a asss i.4550 m a,S 800 nbsd, mD 20814 uSa

t: (301) 347-5000F: (301) 913-6019www.sss.

n 2010

ts f ws ppd as a, S Sz, Jff bs, b o’h, d D a. i s j p f S h os P S (ShoPS) pj d h Sss 20/20 pj.

Pass Fd his Fd. p://www.fd./

t g h gp. 2009. Public-Private Investment Partnerships: Aninnovative approach for improving access, quality and equity inhealthcare in developing countries. S Fs: t g h

gp, g h Ss,us f cf, SFs.

unaiDS (J ud nsP hiv/aiDS).2009. HIV-related Public-PrivatePartnerships and Health SystemsStrengthening . p://d.ds./p/rp/2009/j1721_ pppsps_.pdf.

AbouHeahSyses20/20

h Sss 20/20 s f- (2006-2011) p (n. ghS-

a-00-06-00010-00) fdd u.S. a f i Dp (uSaiD). t

pj ss d pp ddss f, , p, dp ss ss pd ss d s f f-s p

ss.a asss i. ds f ps ds:

a K Fd i bá asds i brac us i bd b asss

D cs, llP i F o cs i rti i i t r-ss gp i t us S f P h

private health sector and hiv

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