Private Sector Participation in Child Health : A Review of World Bank Projects, 1993-2002

Axelsson, Henrik ; Bustreo, Flavia ; Harding, April

World Bank, Washington, DC

关键词: CHILD HEALTH SERVICES;    CHILD HEALTH OUTCOMES;    PRIVATE SECTOR PARTICIPATION;    NONPROFIT ORGANIZATION;    CONTRACTING;   

RP-ID  :  28859

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

There is an increasing amount ofevidence to support the view that the private sectorsignificantly influences child health and nutrition outcomesthrough both service provision and supply of health relatedgoods. In this context, this paper analyzes World Bankprojects in Health, Nutrition and Population between fiscalyears 1993-2002. The paper identifies the range ofapproaches taken to involve the private sector in improvingchild health outcomes; the actors involved; the type ofactivities supported by the projects; and examples ofsuccessful private sector participation. The paper'sconcludes: As measured by the proportion of projects (morethan 50 perccent) that involved the private sector in childhealth, private sector participation was significant. Asmeasured by the magnitude of involvement (budget amounts andstated project objectives), the degree of private sectorparticipation was relatively small for most projects. Sincemost projects did not mention a systematic assessment ofpotential and opportunities to engage the private sector, itwas difficult to assess whether or not engagement of theprivate sector was intentional. It was not possible toanalyze how and if private sector participation resulted inbetter health for children, as private sector monitoringindicators measured process and not outcomes. The paperrecommends: Encourage engagement of the private sector inWorld Bank projects addressing child health outcomes.Increase support to World Bank staff and its clients, forexample through manuals or toolkits and field demonstrationsof successful strategies to engage the private sector inchild health programs. Conduct systematic assessments of thepotential of the private sector to contribute to improvedchild health programs. Develop indicators that can measurewhich approaches lead from private sector engagement tobetter health for children. Incorporate mechanisms, such ashealth insurance, risk sharing, subsidies and targetedpublic health expenditures, to protect the poor and ensurethat they are not further impoverished due to payments forhealth care services.