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Future Health Systems is a research consortium working to improve access, affordability and quality of health services for the poor. We are a partnership of leading research institutes from across the globe working in a variety of contexts: in low-income countries (Bangladesh, Uganda), middle-income countries (China, India) and fragile states (Afghanistan) to build resilient health systems for the future. After a successful first five-year phase from 2006-2011 (see our success stories), we are entering a new six-year phase of research, funded mainly by UK aid.

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Making health markets work for the poor

Future Health Systems

From 7-9 November 2011, the M4P Hub hosted a conference in Brighton, UK, on making markets work for poor people. It was a key opportunity to discuss and promote the M4P approach, which effectively maps the public, private and non-governmental systems that comprise a sector within a country.

Dr Gerry Bloom from FHS participated in the conference focusing on health markets in developing countries. His presentation gave an overview of work from FHS partners in Bangladesh and Nigeria of the role of informal providers in health markets.

Although he noted the tension in the health sector between working through public systems and engaging health markets, he pointed out that many poor use the private sector as their first point of call when accessing health services. For example, our research in Bangladesh shows that 65% of people who visit a health provider visit private 'village doctors'. In Nigeria, more than half of those studied obtained treatment for malaria through private providers.

Of course, working with these informal providers had risks. Even after training, in Bangladesh village doctors still gave inappropriate and occasionally harmful prescriptions. But while Dr Bloom urged caution, he doesn't think this means we should not engage with the private sector and informal providers. On the contrary, he also pointed out that building capacity of the public sector carried its own set of risks. Rather, he suggested that we need to be aware of these strong incentives and work to improve the business model so that these private providers have the appropriate incentives to provide accurate care.