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  • Writer's pictureKatherine Jennings

Moving from planning to implementation: insights on private sector engagement in 18 LMICs

Katherine Jennings

In 2012, the World Bank published a report which assessed and compared the ways in which African governments were engaging with their private health sectors. Based on the findings, they identified five main domains that constitute private sector engagement:

  1. Policy and dialogue

  2. Information exchange

  3. Regulation

  4. Financing

  5. Provision of services

When the World Health Organization set out to develop a strategy on how to effectively engage the private health service delivery sector in mixed health systems, a more recent and wide-reaching landscape assessment was required. Impact for Health assessed the level of private health sector engagement in 18 low- and middle-income countries with highest overall utilization of private health providers in the six WHO regions, using the five engagement domains as a framework.


Countries included

Uganda, Nigeria, Eswatini, Egypt, Pakistan, Jordan, Albania, Kyrgyzstan, Armenia, Mexico, Suriname, Dominican Republic, India, Indonesia, Bangladesh, Cambodia, Lao PDR, Philippines.


The review analyzed a variety of indicators and activities within each of the five domains. The following figures indicate the percentage of countries where documentation or policy exists in each of the activities.


Policy & Dialogue

Key Takeaway: All countries acknowledge the importance to engage private health sectors in achieving their national health goals, yet few have implemented polices for public-private collaboration or formal mechanisms for dialogue.


Information exchange

Key Takeaway: Despite mandating the private sector to report health information to government using designated systems, level of implementation differs between countries, specific private health sectors, different reporting systems, and types of health information.



Key Takeaway: The role of regulation is predominantly focused on the administrative and bureaucratic process of registration and licensing in LMICs, and enforcement remains a challenge.



Key Takeaway: Strategic purchasing, most commonly in the form of contracting, is utilized to address the lack of financial risk protection in the private health sector, which is one of the major concerns and impediment towards UHC.


Engagement in vertical service provision

Key Takeaway: Many disease specific programs engage with private health providers because they are often the first point of contact for these diseases or prevention service.


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