Citizens of many low- and middle-income countries rely on health financing and services from a wide range of providers outside of the public sector, often resulting in a complex health market system. Understanding messy health markets and how to engage with them to ensure better outcomes for the poor is our key aim.
Recent FHS publications on 'health markets'
Buckland Merrett GL, Bloom G, Wilkinson A and MacGregor H (2016) Towards the just and sustainable use of antibiotics, Journal of Pharmaceutical Policy and Practice, 9:31, DOI: 10.1186/s40545-016-0083-5
The emergence and spread of antibiotic resistant pathogens poses a big challenge to policy-makers, who need to oversee the transformation of health systems that evolved to provide easy access to these drugs into ones that encourage appropriate use of antimicrobials, whilst reducing the risk of resistance. This is a particular challenge for low and middle-income countries with pluralistic health systems where antibiotics are available in a number of different markets. This review paper considers access and use of antibiotics in these countries from a complex adaptive system perspective. It highlights the main areas of intervention that could provide the key to addressing the sustainable long term use and availability of antibiotics.
There is a growing appreciation and recognition of the role of the private sector in the development of better health systems and the improvement of healthcare worldwide.
This Health Policy and Planning supplement reflects contributions to a Symposium of the Health Systems Global Private Sector in Health Thematic Working Group during the 9th World Congress on Health Economics, held in Sydney in July 2013. Members of the PSIH TWG that convened the Symposium included FHS members David Bishai (JHBSPH) and Gerry Bloom (IDS), and was generously supported by Rockefeller, Gates, USAID, AusAid (DFAT), and DFID.
Rural households in India rely extensively on informal biomedical providers, who lack valid medical qualifications. Their numbers far exceed those of formal providers. Our study reports on the education, knowledge, practices and relationships of informal providers (IPs) in two very different districts: Tehri Garhwal in Uttarakhand (north) and Guntur in Andhra Pradesh (south).
The role for the private sector in health remains subject to much debate, especially within the context of achieving universal health coverage. This roundtable discussion offers diverse perspectives from a range of stakeholders - a health funder, a representative from an implementing organization, a national-level policy-maker, and an expert working in a large multi-national company - on what the future may hold for the private sector in health.
Given the rapid evolution of health markets, learning is key to promoting the identification and uptake of health market policies and practices that better serve the needs of the poor. However there are significant challenges to learning about health markets. We discuss the different forms that learning takes, from the development of codified scientific knowledge, through to experience-based learning, all in relationship to health markets.
The rapid evolution and spread of health markets across low and middle-income countries (LMICs) has contributed to a significant increase in the availability of health-related goods and services around the world. The support institutions needed to regulate these markets have lagged behind, with regulatory systems that are weak and under-resourced. This paper explores the key issues associated with regulation of health markets in LMICs, and the different goals of regulation, namely quality and safety of care, value for money, social agreement over fair access and financing, and accountability.
The bottom of the pyramid concept suggests that profit can be made in providing goods and services to poor people, when high volume is combined with low margins. To-date there has been very limited empirical evidence from the health sector concerning the scope and potential for such bottom of the pyramid models. This paper analyzes private for-profit (PFP) providers currently offering services to the poor on a large scale, and assesses the future prospects of bottom of the pyramid models in health.
Using data from a household survey in West Bengal, the purpose of this paper is to identify the relative risks of catastrophic healthcare expenditures for different types of health need, and the impact of such expenditure on household coping strategies. It concludes that Catastrophic health spending is an important problem for the population in West Bengal. More attention is needed on the poverty-inducing effects of long-term expenditures on chronic illness, given that existing schemes only address hospitalization.
Bangladesh has a serious shortage of physicians, paramedics, nurses, and midwives. The available qualified care providers are centred in urban areas, resulting in an inequitable access of the rural and disadvantaged sections of the population to healthcare. Under these circumstances, the use of mHealth meaning provision of healthcare services through mobile devices provides a new opportunity to ensure access to quality healthcare services for the population in general, and for people from poorer sections and hard-to-reach areas in particular. There are currently around 20 mHealth service initiatives in the country which are mostly telephone hotlines for consulting physicians and/or obtaining healthcare information. Effectiveness of these services depends on the evidence-informed development of appropriate programmes designed around people’s perceptions of mHealth and user feedback. To that end, FHS Bangladesh partner, ICDDR,B recently conducted a survey on mHealth in Chakaria, a rural area in the southeast coastal area of Bangladesh. This brief presents the findings from this survey.