Private Sector Participation in Health Care in Zimbabwe: What's the Value-Added?

Julius T Mugwagwa

doi:10.4172/2472-1654.100050

Abstract

This paper analyses the private healthcare sector’s role in Zimbabwe’s health delivery system, especially after economic challenges reduced in real terms fiscal support for public health system funding. This paints a sharp contrast between practicalities of achieving affordable and accessible public healthcare on one hand, and the economic and social realities of underfunded and skills-constrained health systems. Using as empirical models and analytical lenses the country’s 2009–2013 National Health Strategy and the WHO’s health system building blocks, we examine the role played by private sector health delivery actors in the last 10 years and suggest that although the private sector added value, there is a bigger challenge of weak macro-level coordination and communication within the health sector which create problems for systemic design, strategy formulation and feedback mechanisms, important for institutional innovation and timely responses to changing dynamics. Macro-level coordination can be aided by documentation and standardisation of procedures, processes and approaches by different health delivery actors to align with national health delivery goals, allowing more predictable and measurable impact from interventions by different actors.

Highlights

The private sector can be broadly defined as the part of a country's economic system that is owned, controlled and run by private entities, notably privately-owned enterprises incorporated under law that are geared to making profits, or privatelyowned non-profit organizations and households [1]
Using Zimbabwe’s 2009-2013 National Health Strategy and the WHO’s 6-factor health system building blocks, we focus on policy levers and frameworks that enable us to unpack and understand motivations, processes and impacts of private sector interventions in healthcare delivery
Through the Ministry of Health and Child Welfare (MOHCW) Ministry of Health and Child Care (MOHCC), the country put in place measures to ‘give strategic direction in health sector [re]development’, notably the National Health Strategy 1997-2007, which was succeed at the end of 2009 by the National Health Strategy 2009-2013

Summary

Introduction

The private sector can be broadly defined as the part of a country's economic system that is owned, controlled and run by private entities, notably privately-owned enterprises incorporated under law (corporations) that are geared to making profits, or privatelyowned non-profit organizations and households [1]. The role and impact of the for-profit private sector in healthcare delivery, especially in low income countries, remains a highly-debated and contentious issue both from an ideological and practical perspective, with particular regard to healthcare equity and access issues. Proponents of the private sector argue that it improves access and equity, and more efficient delivery practices by bringing in much needed resources whilst creating the space for government public health systems to increase focus on underserved populations. This argument overlooks its impact on “healthcare market” segmentation as it selects for those who can afford against citizens who cannot.

Methods

Results

Discussion

Conclusion