Publication: For Better Quality and More Integrated Primary Health Care Services through Harnessing the Private Sector in Sindh Province: Options Paper
Loading...
Published
2019-06-01
ISSN
Date
2019-07-01
Author(s)
Editor(s)
Abstract
Achieving universal health coverage (UHC) in Pakistan, as in most countries, will require strengthened collaboration between the public and private sectors, as the public sector often does not have the flexibility nor the fiscal space to grow service delivery capacity at sufficient pace and quality. However, successful partnering with the private sector through various forms of contracting and service agreements including public-private partnerships (PPPs), requires the appropriate analysis and identification of the gaps in service provision. To that end, this study aims to assist the government of Sindh (GoS) in identifying opportunities to engage the private health sector more effectively, to help provide affordable, quality primary health care (PHC) services to the urban poor whilst also creating evidence for the better integration of the private health sector in health service delivery. As part of the initial phase of this advisory work, and operating within a limited time-frame and funding environment, this policy note presents the initial set of observations and recommendations, based on the information collected via questionnaires and informant interviews, as well as secondary data or existing studies.
Link to Data Set
Citation
“World Bank Group. 2019. For Better Quality and More Integrated Primary Health Care Services through Harnessing the Private Sector in Sindh Province: Options Paper. © World Bank. http://hdl.handle.net/10986/32005 License: CC BY 3.0 IGO.”
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Improving Universal Primary Health Care by Kenya : A Case Study of the Health Sector Services Fund(World Bank, Washington DC, 2013-01)This case study describes the Government of Kenya's initiative to expand the supply of health care and strengthen primary health care through implementation of the Health Sector Services Fund (HSSF), which provides direct cash transfers to primary health facilities. This initiative, launched in 2010, is a direct response to challenges identified by the Public Expenditure Tracking Surveys in making funds for operation and maintenance available to the health facilities, and builds on lessons from initiatives supported by the Danish International Development Agency (DANIDA) in the Coastal Region.Publication Health Care in Sri Lanka : What Can the Private Health Sector Offer?(World Bank, Washington, DC, 2014-06)This review represents an attempt to bridge the significant knowledge gaps on the private health sector in Sri Lanka, and foster a dialogue on opportunities for collaboration between the government and the private sector. It accomplishes this through a systematic collection and analysis of primary and secondary data on the provision, financing, and regulation of health care services. On health service delivery, the review finds that the private sector: includes a range of providers; focuses primarily on curative and outpatient services rather than preventive services; is heavily dependent on the public sector for its supply of human resources; and is concentrated in urban areas. The quality of health care services in Sri Lanka in both the private and public sectors, while better than in most developing countries, still lags behind those in more advanced countries. There is also little systematic dialogue and collaboration between the public and private sectors. On financing, the review finds that private health expenditure is more than half of total health expenditure, mostly in the form of out-of-pocket payments by households, with clear implications for Sri Lanka's progression toward universal health coverage. On stewardship and regulation, there is a clear and urgent need to bridge the existing gaps in the legal and regulatory framework, and in the enforcement of health regulations applicable to the private sector, as well as to create an enabling environment for more effective private sector participation in the health sector. The review demonstrates that the private health sector in Sri Lanka is a growing force, due both to greater investment from private players as well as greater demand from the population. The review highlights areas where a more effective engagement with the private sector could ensure that Sri Lanka is able to offer its citizens universal access to good quality health service while also stimulating economic growth.Publication Costa Rica Case Study : Primary Health Care Achievements and Challenges within the Framework of the Social Health Insurance(World Bank, Washington, DC, 2013-01)The objective of this paper is to assess the key interventions Costa Rica has developed to expand health coverage for the poor and other vulnerable groups, with an emphasis on its approach to primary health care. Universal health coverage in Costa Rica is provided through a single national health insurance program. This program, which protects the poor without the pitfalls of a fragmented system, and the sustained policies that have enabled the building of a solid primary health care system, is broadly recognized as a success story. At the same, time new challenges are emerging to sustaining the success of Costa Rica's universal health coverage. Social Security of Costa Rica (Caja Costarricense de Seguridad Social, CCSS) faces increased production costs and demographic and epidemiological changes in a rapidly aging population. This report is divided into three broad sections: (1) objective of the case study and health system overview; (2) primary health care and the organization of health services within CCSS; and (3) agenda of key policy decisions for a renewed primary health care approach as part of a more responsive and sustainable health insurance system.Publication Arab Republic of Egypt : Management and Service Quality in Primary Health Care Facilities in the Alexandria and Menoufia Governorates(Washington, DC, 2010-06-25)This report provides an assessment of the performance of public primary facilities in the Alexandria and Menoufia governorates. The performance is evaluated against the standards introduced with the Health Sector Reform Program; analyzes the quality perceptions, health situation, utilization and economic situation of households living in the catchment areas of the facilities; and examines the management processes of different institutions involved in primary care. Despite Egypt's health sector reform efforts, evidence suggests that issues remain in the quality of service and management in both reformed and non-reformed public primary care facilities, including availability of supplies, correct co-payment exemptions for the poor, and consequently, utilization through the population. There is also increasing evidence that the demand-side empowerment of beneficiaries could improve the governance of health care, which would lead to a quality increase and higher utilization of health care. This suggests the need to explore the potential for demand-side mechanisms to improve service delivery and help ensure improvements in individual and population health.Publication Toward Synergy and Collaboration to Expand the Supply of and Strengthen Primary Health Care in Nigeria’s Federal Context, with Special Reference to Ondo State(World Bank, Washington DC, 2013-01)This study examines an innovative example of the expansion of supply and the strengthening of primary health care to improve key health-related Millennium Development Goal, or MDG indicators through synergy and collaboration between the federal Government of Nigeria (FGN) and state governments in an extreme federal context, and with particular reference to Ondo State. That is, the Nigerian Federal Constitution grants the federal government only very limited and indirect influence or control over the fiscal and financial affairs of state and local governments, such that 'plans, budgets, accounts and procurements are not subject to federal control and scrutiny'. Nor must the lower tiers account to the federal level for how funds transferred to them from the central level are used. The rest of case study is organized as follows. Section two describes the design of the HCP, including its interaction with the rest of the health system; section three discusses the targeting, identification, and enrolment system; section four examines the management of public funds within the HCP; section five analyses the management of the benefits package; section six reviews the information environment and monitoring systems of the HCP; section seven summarizes and analyses the evidence on the key theme of the study, which is the extent to which the HCP is expanding access to, and strengthening, primary health care within the federal system; and section eight looks at the pending agenda for action, drawing on the lessons learned and challenges for the HCP's future. The annexes present the country and health system context; a general overview of health system financing and delivery; a brief description of primary care and key supply-side efforts; and key data on Ondo State, including a description of the state's health system.
Users also downloaded
Showing related downloaded files
Publication Digital Africa(Washington, DC: World Bank, 2023-03-13)All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.Publication World Development Report 2006(Washington, DC, 2005)This year’s Word Development Report (WDR), the twenty-eighth, looks at the role of equity in the development process. It defines equity in terms of two basic principles. The first is equal opportunities: that a person’s chances in life should be determined by his or her talents and efforts, rather than by pre-determined circumstances such as race, gender, social or family background. The second principle is the avoidance of extreme deprivation in outcomes, particularly in health, education and consumption levels. This principle thus includes the objective of poverty reduction. The report’s main message is that, in the long run, the pursuit of equity and the pursuit of economic prosperity are complementary. In addition to detailed chapters exploring these and related issues, the Report contains selected data from the World Development Indicators 2005‹an appendix of economic and social data for over 200 countries. This Report offers practical insights for policymakers, executives, scholars, and all those with an interest in economic development.Publication Classroom Assessment to Support Foundational Literacy(Washington, DC: World Bank, 2025-03-21)This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.Publication Argentina Country Climate and Development Report(World Bank, Washington, DC, 2022-11)The Argentina Country Climate and Development Report (CCDR) explores opportunities and identifies trade-offs for aligning Argentina’s growth and poverty reduction policies with its commitments on, and its ability to withstand, climate change. It assesses how the country can: reduce its vulnerability to climate shocks through targeted public and private investments and adequation of social protection. The report also shows how Argentina can seize the benefits of a global decarbonization path to sustain a more robust economic growth through further development of Argentina’s potential for renewable energy, energy efficiency actions, the lithium value chain, as well as climate-smart agriculture (and land use) options. Given Argentina’s context, this CCDR focuses on win-win policies and investments, which have large co-benefits or can contribute to raising the country’s growth while helping to adapt the economy, also considering how human capital actions can accompany a just transition.Publication Lebanon Economic Monitor, Fall 2022(Washington, DC, 2022-11)The economy continues to contract, albeit at a somewhat slower pace. Public finances improved in 2021, but only because spending collapsed faster than revenue generation. Testament to the continued atrophy of Lebanon’s economy, the Lebanese Pound continues to depreciate sharply. The sharp deterioration in the currency continues to drive surging inflation, in triple digits since July 2020, impacting the poor and vulnerable the most. An unprecedented institutional vacuum will likely further delay any agreement on crisis resolution and much needed reforms; this includes prior actions as part of the April 2022 International Monetary Fund (IMF) staff-level agreement (SLA). Divergent views among key stakeholders on how to distribute the financial losses remains the main bottleneck for reaching an agreement on a comprehensive reform agenda. Lebanon needs to urgently adopt a domestic, equitable, and comprehensive solution that is predicated on: (i) addressing upfront the balance sheet impairments, (ii) restoring liquidity, and (iii) adhering to sound global practices of bail-in solutions based on a hierarchy of creditors (starting with banks’ shareholders) that protects small depositors.