Moving towards in-depth knowledge on the private health sector in low- and middle-income countries

posted Sep 2, 2012, 1:38 PM by Jeff Knezovich
Birger C Forsberg, Dominic Montagu and Jesper Sundewall

The past two decades have seen a steady growth in attention to the private sector role within the overall health systems of low- and middle-income countries. Since the 1990s researchers have worked to call attention to the previously unrecognized scale of private medical services in the developing world (Berman and Rose 1996; Brugha and Zwi 1998;Hanson and Berman 1998; Preker et al. 2000; Uplekar 2000; Berman 2001; Mills et al. 2002; Harding and Preker 2003). As cross-country datasets have become available, the evidence has become increasingly clear that the private sector plays a major role in financing and provision of care in low- and middle-income countries (LMICs) (Zwi et al. 2001; Haet al. 2002; Liu et al. 2006; Konde-Lule et al. 2010). In parallel, a half-dozen multi-centre projects supporting research on the private sector in LMICs have been implemented (De Costa and Diwan 2007; Access Health International, n.d.; PSP, n.d.; PSP-One, n.d.; Results for Development Institute, n.d.). Evidence and analysis has also pointed to the challenges and opportunities that the private sector poses to health and health sector development (Lonnroth et al. 1998; Lonnroth et al. 2001; Travis and Cassels 2006).

The result of this growth in evidence is a general acknowledgement of the private sector and acceptance of its existence and important role in health care for many people in low- and middle-income countries. Consequently, the focus in research and policy development has moved from measurement to nuanced assessment of policy options and interventions for engagement of the private sector in public policy goal attainment (Montagu 2002; De Costa et al. 2008; Dimovska 2009; Lagomarsino 2009;Kangwana et al. 2011).