Should the private sector play a greater role in delivering health care in low-income countries?

Levels of two proteins in a woman’s ovarian cancer are strongly associated with her likelihood of survival, a research team led by scientists at The University of Texas M. D. Anderson Cancer Center reports in the Dec. 18 issue of the New England Journal of Medicine. The study shows that women with high levels of

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A provocative debate in this week’s PLoS Medicine examines whether the private sector should step up its involvement in delivering health care in low-income countries.

These countries suffer a disproportionate burden of disease, and often struggle with weak health systems. Both the public and private sector deliver health care in these countries, but the appropriate role for each of these sectors in health system strengthening remains controversial.

Richard Smith (Ovations Chronic Disease Initiative, London, UK) and colleagues argue that in the developing world “the private sector’s role in health care should be strengthened and more closely aligned with the public interest.” They discuss evidence showing that “private contractors can operate on a large scale, be more cost effective than government-provided services, and increase coverage in poor and remote areas.” The authors argue the case for supporting public-private partnerships for health system strengthening. Improving health care for the world’s poor, they say, “means harnessing everyone’s capacity, not just that of governments.”

But Kara Hanson (London School of Hygiene and Tropical Medicine, UK) and colleagues argue that “there is no alternative to strengthening the public role in the health system.” Even where private services are low cost, they say, they are not necessarily affordable - even short bouts of illness can have a catastrophic impact on welfare when households are poor. There is no evidence, say Hanson and colleagues, that private risk sharing schemes such as commercial insurance can reach the poorest groups. Public financing of health care, they say, “can help achieve protection both against the cost of care and also against loss of income caused by illness.”


The next generation of case management guidelines for childhood illness need to be more locally informed, rather than relying on those centrally generated by organizations like the World Health Organization (WHO), argues a new essay published in the open access journal PLoS Medicine. Mike English and Anthony Scott from the KEMRI-Wellcome Trust Programme in Kenya

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The government needs to rethink its approach to NHS reforms, says UNISON, in the wake of a new damning report on the cost of commissioning and outsourcing. It should concentrate on giving NHS patients the care they need - and value for money - rather than using reforms to outsource services and ‘throw precious money

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According to a new report more Australian privately insured patients used the public hospital system last year than previously and there are concerns that encouraging people to take out private health insurance is doing little to reduce the burden on the public health system. According to the report by the Private Health Insurance Administration Council

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Australian researchers say job stress is forcing many age care workers to leave and is jeopardising the industry. The researchers from the University of Melbourne warn that almost a third of registered aged care nurses are contemplating quitting their jobs because of job stress, created by excessive workloads, cost cutting, a hostile work environment and

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An alarming lack of availability of essential medicines in the public sector drives patients to pay higher prices in the private sector or go without, according to a WHO study reported in the online edition of The Lancet. The results confirm that governments must do more to improve access to essential medicines as part of

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