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Effectively engaging the private sector through vouchers and contracting – A case for analysing health governance and context

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  • Nachtnebel, Matthias
  • O'Mahony, Ashleigh
  • Pillai, Nandini
  • Hort, Kris

Abstract

Health systems of low and middle income countries in the Asia Pacific have been described as mixed, where public and private sector operate in parallel. Gaps in the provision of primary health care (PHC) services have been picked up by the private sector and led to its growth; as can an enabling regulatory environment. The question whether governments should purchase services from the private sector to address gaps in service provision has been fiercely debated. This purposive review draws evidence from systematic reviews, and additional published and grey literature, for input into a policy brief on purchasing PHC-services from the private sector for underserved areas in the Asia Pacific region. Additional published and grey literature on vouchers and contracting as mechanisms to engage the private sector was used to supplement the conclusions from systematic reviews. We analysed the literature through a policy lens, or alternatively, a 'bottom-up' approach which incorporates components of a realist review. Evidence indicates that both vouchers and contracting can improve health service outcomes in underserved areas. These outcomes however are strongly influenced by (1) contextual factors, such as roles and functions attributable to a shared set of key actors (2) the type of delivered services and community demand (3) design of the intervention, notably provider autonomy and trust (4) governance capacity and provision of stewardship. Examining the experience of vouchers and contracting to expand health services through engagement with private sector providers in the Asia Pacific found positive effects with regards to access and utilisation of health services, but more importantly, highlighted the significance of contextual factors, appropriate selection of mechanism for services provided, and governance arrangements and stewardship capacity. In fact, for governments seeking to engage the private sector, analysis of context and capacities are potentially a more useful frame than generalizable outcomes of effectiveness.

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  • Nachtnebel, Matthias & O'Mahony, Ashleigh & Pillai, Nandini & Hort, Kris, 2015. "Effectively engaging the private sector through vouchers and contracting – A case for analysing health governance and context," Social Science & Medicine, Elsevier, vol. 145(C), pages 193-200.
    • Handle: RePEc:eee:socmed:v:145:y:2015:i:c:p:193-200
    DOI: 10.1016/j.socscimed.2015.05.021
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    References listed on IDEAS

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    1. Sima Berendes & Peter Heywood & Sandy Oliver & Paul Garner, 2011. "Quality of Private and Public Ambulatory Health Care in Low and Middle Income Countries: Systematic Review of Comparative Studies," PLOS Medicine, Public Library of Science, vol. 8(4), pages 1-10, April.
    2. Domberger, Simon & Jensen, Paul, 1997. "Contracting Out by the Public Sector: Theory, Evidence, Prospects," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 13(4), pages 67-78, Winter.
    3. Sanjay Basu & Jason Andrews & Sandeep Kishore & Rajesh Panjabi & David Stuckler, 2012. "Comparative Performance of Private and Public Healthcare Systems in Low- and Middle-Income Countries: A Systematic Review," PLOS Medicine, Public Library of Science, vol. 9(6), pages 1-14, June.
    4. Anna E Bauze & Linda N Tran & Kim-Huong Nguyen & Sonja Firth & Eliana Jimenez-Soto & Laura Dwyer-Lindgren & Andrew Hodge & Alan D Lopez, 2012. "Equity and Geography: The Case of Child Mortality in Papua New Guinea," PLOS ONE, Public Library of Science, vol. 7(5), pages 1-9, May.
    5. Nguyen, Ha T.H. & Hatt, Laurel & Islam, Mursaleena & Sloan, Nancy L. & Chowdhury, Jamil & Schmidt, Jean-Olivier & Hossain, Atia & Wang, Hong, 2012. "Encouraging maternal health service utilization: An evaluation of the Bangladesh voucher program," Social Science & Medicine, Elsevier, vol. 74(7), pages 989-996.
    6. Schmidt, Jean-Olivier & Ensor, Tim & Hossain, Atia & Khan, Salam, 2010. "Vouchers as demand side financing instruments for health care: A review of the Bangladesh maternal voucher scheme," Health Policy, Elsevier, vol. 96(2), pages 98-107, July.
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    1. Yeoh, Eng-Kiong & Yam, Carrie H.K. & Chong, Ka-Chun & Chow, Tsz-Yu & Fung, Valerie L.H. & Wong, Eliza L.Y. & Griffiths, Sian M., 2020. "An evaluation of universal vouchers as a demand-side subsidy to change primary care utilization: A retrospective analysis of longitudinal services utilisation and voucher claims data from a survey coh," Health Policy, Elsevier, vol. 124(2), pages 189-198.

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