Private health care providers play a large role in developing countries and attitudes toward them are changing. The evidence is growing that working with private providers is better than ignoring them, and that cooperation can be an effective strategy for pursuing some important sector goals. More and more policymakers are attempting to incorporate private practitioners and facilities into overall sector policy, or are considering doing so. They are using, among other methods, contracting, regulation, training of private practitioners, franchising, and the integration of private practitioners into public referral networks.
This perspective on the public-private mix in well-performing health services has generated additional scrutiny of private providers in developing countries, scrutiny that has served only to underscore the urgency of making public policy toward private health care providers more effective. Indeed, they should look for ways of working with private providers as an integral means of achieving sector objectives. In many countries it is necessary to work with private providers to expand access, coverage, and clinical quality in order to improve health outcomes for a large portion of the population. Such policies, when supported by financial resources, may provide much-needed financial protection against the cost of illness. In addition to improving the responsiveness or consumer quality of services, governments are increasingly resourceful in reaching out to private providers to improve the technical quality of care.
However, developing-country experiences are rarely well documented, so policymakers and analysts are usually unable to learn from these initiatives. Rigorous evaluation of these efforts is even more rare, making it difficult, even perilous, to write policy guidelines based on those experiences. Mechanisms for working with the private sector in developed-country health systems are better understood, but the insights are not easily transferable. Therefore, the PPP Cluster aims to familiarize policymakers and sector experts in the Asia region with a wide range of strategies for enhancing the contributions of private health care providers by sharing knowledge and regional experience.