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SUB CATEGORIES General  |  HIV |  Medical Schemes | 

New thinking on health care in Africa opens window for public-private partnerships

25 February 2010 Alexander Forbes Health

As US President Barak Obama’s own struggles with congress illustrate, national healthcare is an extremely difficult and controversial issue, even in developed economies. Yet as the global recession bites ever deeper into most national fiscusses there seems to be a new willingness to revisit the thorny issue of public-private partnerships in the delivery of national health.

No more is this so than in Africa which, over the past 40 years has received around US$ 500 billion in aid, about 30% of which has been devoted to combating Malaria, HIV/Aids, Cholera and other diseases. With governments’ around the world focusing on keeping their own health systems afloat, funds for African healthcare are likely to become more scarce.

As such, “South Africa’s own National Health Insurance (NHI) debate is happening at an opportune and, hopefully, instructive time for the continent” says Bode Olajumoke, Health Actuary, Alexander Forbes Health.

Constitutional imperatives aside, the South African government correctly recognises that the economic potential of a nation is partly rooted in its ability to provide adequate healthcare to its people. Given the scale of this task, the funding required and the skills sets that need to be assembled, it is becoming obvious that all sources of investment, skills and technology, including those in the private sector, should be mobilized in the struggle to make African countries healthier.

To this end, and very fortunately for South Africa, several private healthcare providers and funders have already pledged their commitment to assist government design and implement a sustainable NHI model by leveraging the expertise of the private sector. A case in point is the collaborative effort between South African medical schemes to lobby the government to allow private medical schemes to assist implement the proposed the NHI system. Discovery and Momentum have been particularly active in this regard.

“Such collaborative effort is likely to revolutionise healthcare in South Africa and has already helped identify how other African governments can foster public-private cooperation in the health care sector” adds Olajumoke.

Steps that African governments can take to foster an environment suitable for the kind of public-private partnerships that will develop functioning health care sectors in Africa include:

• Increasing the proportion of GDP allocated to healthcare, focusing especially on education, preventative care and investment in community health centers.
• Focusing on limiting systemic wastage in the delivery of healthcare services.
• Ensuring that existing beneficiaries of private health care do not experience a disruption in service levels when public-private partnerships commence.
• Creating a regulatory environment that ensures quality service delivery while acting as a check against excesses in the industry.
• Sponsoring training programmes for up and coming medical practitioners to ensure that the nation’s health is not constrained by long term capacity issues.
• Creating policies that curb the brain drain by preventing the loss of vital skills like medical practitioners, educators, nurses etc.
• Creating an environment where few limits exist to cross border assistance with regard to essential health services.

Olajumoke also cautions private health providers in Africa to “remain aware of the limited purchasing power of their local populations when determining the costs of healthcare. “Given what people are able to pay and the very real cost of skills, technology, medical equipment and facilities this might appear an impossible task. If, however, the private sector works closely with the public sector across the whole country many of these hurdles can be overcome.

The challenge is to strike a balance between cost factors and the delivery of quality care, along with the broader national health objectives of each country. While neither state nor the private sector will ever be fully satisfied with such a partnership a national health system should be recognised as a compromise in the interests of all.

Certainly “a lack of proper balance between the public and private sectors could limit the scope for private sector involvement in health care, depriving African countries of much-needed investment, skills and technology” concludes Olajumoke.

 

 

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