Fostering Partnerships Between Governments and the Private Sector for Better Healthcare in Africa

By: Madeline Taskier, Strategic Partnerships Associate at Women Deliver

Housing 12 percent of the world’s population, sub-Saharan Africa bears 26 percent of the global disease burden. For women, the lifetime risk of maternal death in sub-Saharan Africa is 1 in 31 compared with 1 in 4,300 in industrialized nations. Despite the narrowed focus on healthcare access for girls and women, the public health sector alone cannot adequately provide services for the continent.

In response to a report published by the International Finance Corporation (IFC) and the Bill and Melinda Gates Foundation, IFC established the Health in Africa Initiative to strengthen the connection between the public sector healthcare system and the private sector’s vast networks. Experts estimate that 50 percent of health services in sub-Saharan Africa are delivered by the private sector (both for-profit and not-for-profit).

The Health in Africa Initiative analyzed different interactions between the public and private sector health systems in 45 African countries, resulting in the report Healthy Partnerships: How Governments Can Engage the Private Sector to Improve Health in Africa. It examines policies that countries have in place to work with the private sector, information exchange, how ministries of health are documenting private sector health care, and public-private health financing schemes.  

Here are some of the key issues:

• Policies to work with the private sector are in place, but few countries implement them. Out of 45 countries, 39 have policies, but only 12 apply them. This gap is especially relevant when it comes to transferring patients between the public and private systems and the costs incurred to low-income patients.
• Information exchange between governments and private sector health systems is weak. Only 13 percent of countries have a comprehensive registry of for-profit and not-for-profit health facilities. There are few private sector representatives serving as the contact with ministry of health.
• Quality control of private facilities is poor. Only 5 out of 45 countries conduct inspections in private health facilities monitoring the quality of care for patients.
• Health financing through insurance coverage is increasing in availability. One third of countries provide some sort of insurance program for their citizens. Sudan gives private providers land grants to set up clinics outside Khartoum. More countries are rolling out insurance packages with reproductive health vouchers in countries like Kenya and Uganda.  

There is tremendous potential for both sectors to better communicate and coordinate various pieces of the health system to reach the larger population, but also girls and women. Stronger collaboration leads to fewer wasted resources and duplicated efforts. Governments must lead in this process by following who is doing what, expanding insurance access, establishing dialogue, and working on implementing policies, not just creating them. And the private sector can be more organized, appointing designated representatives to speak for private sector facilities and programs. With the proposed strategy and support from IFC, we hope to see changes in access and better health outcomes for Africa’s mothers.   

Check out the Healthy Partnerships report here.