Private versus public strategies for health service provision for improving health outcomes in resource-limited settings.

This is a systematic review

Abstract

Private healthcare providers deliver a significant proportion of healthcare services in low- and middle-income countries (LMIC). Poorer patients get sick and go without care more frequently, and spend more of their incomes on private healthcare than the wealthy.

This review is focused on comparing health outcomes in private versus public care settings. It seeks to summarize what is known regarding the relative morbidity or mortality outcomes that result from treatment by public or private providers in LMIC.

Conclusions
* More evidence is needed to compare health outcomes between the public and private sectors. Governments and researchers can play a critical role in improving the evidence base for decision making about the contributions of the public and private sectors in a given country’s health system.

  • Governments should encourage data collection in both public and private settings that would permit ongoing comparison of clinical data. When government facilities are absent or insufficient, contracting with private-sector facilities or providers would appear to be an acceptable option. Governments must consider appropriate profit margins, regulations and training for private providers.

  • Further research is needed in this area, and should include low-income countries and rural settings. Diseases of the poor – notably malaria and childhood illnesses – are largely absent from the current literature, with the exception of one study on HIV/AIDS and six on TB.

This is a protocol for this systematic review

Citation

Montagu, D.D.; Anglemyer, A.; Tiwari, M.; Drasser, K.; Rutherford, G.W.; Horvath, T.; Kennedy, G.E.; Bero, L.; Shah, N.; Kinlaw, H.S. Private versus public strategies for health service provision for improving health outcomes in resource-limited settings. Global Health Sciences, University of California, San Francisco, USA (2011) 73 pp. ISBN 978-1-907345-18-0

Private versus public strategies for health service provision for improving health outcomes in resource-limited settings.

Published 1 January 2011