Overcoming organizational barriers to support governance of mixed health systems
Guidance for Implementation of WHO Strategy Report: Engaging the Private Health Service Delivery Sector Through Governance in Mixed Health Systems
Responding effectively to COVID-19. Making progress towards UHC. Increasing access to quality RMNCH services. For each of these issues, many countries across the globe require the support of both public and private health sectors. This is because the private sector plays a prominent role in healthcare services, particularly for primary health care amongst the underserved.
WHO’s Strategy Report for Engaging the Private Sector in Health Service Delivery outlines six governance behaviors:
Engagement of the private sector is challenging but can be supported by the adoption of six behaviors outlined in WHO report; however to make a meaningful impact on the adoption of these behaviors, the strategy needs to be backed by WHO teams and external partners, such as donors and implementing agencies. The governance behaviors need to be incorporated in reports, strategies, program design, and more so that they reach country level.
All implicated stakeholders face barriers to implementation of the Strategy Report. A series of interviews and co-creation sessions allowed for a deep understanding of motivators and inhibitors to movement along the “user journey” of Strategy Report implementation – from awareness, to interest, to use, to promotion.
Major barriers were identified within five levels of organizational change.
“Means of engaging with the private sector comes with many assumptions, many of which differ between teams. Without same theory of action, it is difficult to collaborate actively. We end up talking past each other because we aren't talking about the same thing.”
To move stakeholders to the “use” phase, the WHO Health Systems Governance and Financing team must overcome these challenges by implementing a key set of recommendations.
Recommendations garnered from this process are not suitable for a classic “how to” document - what is needed and requested is an approach to allow for a more responsive, evolving agenda. Establishment of a Community of Practice is a clear first step to address many of the recommendations laid out by the implicated stakeholders, while bringing everyone along in the process.
"There's a lot going on in the space of private sector engagement and nobody knows who is doing what. A coordinating mechanism would be a great first step."
”Within my scope of work, there are a plethora of working groups focused on different areas. However, there is a gap when it comes to focus on the private sector. We need to think about how we can coordinate to better support countries using tangible collaboration.”
This is in the works! Stay tuned for more information coming out of WHO’s newly established private sector engagement Hub.
We would like to thank those who took the time to participate in key informant interviews and co-creation sessions, as well as the Advisory Group, who provided support throughout this process.