Private sector engagement for advancing universal health coverage
This document discusses private sector engagement in health care in Eastern Mediterranean countries to advance universal health coverage. It finds that out-of-pocket health expenditures are highest in the poorest countries. While private health workforces are concentrated in urban areas, data on their distribution, salaries, and multiple job holding is limited. Utilization of private clinics is highest among the richest populations in countries like Pakistan, Egypt, Morocco, and Jordan. Ministries of Health lack clear vision and strategy toward private sector partnerships and have weak regulatory capacity due to inadequate information collection. Moving forward, reliable information gathering, effective engagement, strategy development and capacity building are needed to further develop private sector involvement and advance universal health coverage in the region.
Private sector engagement for advancing universal health coverage
- 1. 9 September 2017 64th Session of the Regional Committee for the Eastern Mediterranean Islamabad, Pakistan 9–12 October 2017 Private Sector Engagement in EMR for Advancing Universal Health Coverage
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- 3. Share of Out-of-Pocket Payment (OOP) in Total Health Expenditure (THE) by Country Group, 2014 Group 1: Bahrain, Kuwait, Qatar, Saudi Arabia, Oman and United Arab Emirate Group 2: Egypt, Iran, Iraq, Jordan, Lebanon, Libya, Morocco, Palestine, Syria and Tunisia Group 3: Afghanistan, Djibouti, Pakistan, Somalia, Sudan and Yemen 3
- 4. Duality of practice between public and private sectors Concentration of private workforce in urban areas Limited data on workforce distribution, salary structure and multiple job holding Private Health Workforce – Issues and Challenges 0 10 20 30 40 50 60 70 80 90 100 Saudi Arabia Oman Kuwait UAE Jordan Iran Percentage Public Private Percentage of physicians working in public and private sectors in selected EMR countries
- 5. 5 Utilization of Private and Public Sectors Outpatient Clinics in Selected Countries Assessment of private health sector in 12 countries. Cairo: WHO Regional Office for the Eastern. Mediterranean; 2013 (unpublished). 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% private sector Public sector
- 6. Percent Source: Demographic and Health Surveys 85.1 62.8 63.6 0 10 20 30 40 50 60 70 80 90 100 Public Private Public Private Public Private Public Private Pakistan Egypt Morocco Jordan Poorest Middle Richest Use of outpatient clinics (private and public providers) 6
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- 8. • Absence of MoH vision • Weak political will • Lack of comprehensive strategy toward PHS • Lack of the capacity in formulating policies • No official recognition of poor quality in public sector • Public services is MOH priority • It is considered a “blind spot” in most countries • Reporting is sporadic and incomplete • Inadequate information on human resources or outcomes • Limited MoH enforcement capacity of PHS regulations (PHS taking advantage of such situation) • Outdated regulations governing PHS MoH vision toward PPP Enforcement of PHS regulations MoH capacity for engagement with PHS Information 8
- 9. Reliable information gathering; effective engagement; strategy development and capacity building. We seek Member States’ guidance for developing this area further to advance UHC in the region. Way Forward 9
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- 11. Hassan Salah 9 September 2017 64th Session of the Regional Committee for the Eastern Mediterranean Islamabad, Pakistan 9–12 October 2017 Private Sector Engagement in EMR for Advancing Universal Health Coverage