Non-state provision
Blind optimism: challenging the myths about private health care in poor countries
Increasing private for-profit provision of health services
Authors:
A. Marriott
Publisher:
Oxfam, 2009
To get back on-course and achieve universal and equitable health care for all requires a massive expansion of health services. For over two decades, the World Bank advocated a solution based on investment and growth of the private health-care sector. This paper by Oxfam examines the arguments made in favor of increased private for-profit provision of health services as a means of scaling-up to achieve health care for all. It finds the evidence in favour of private-sector solutions is weak. There is considerable and increasing evidence that there are serious failings inherent in private provision which make it a very risky and costly path to take. The author argues that all too often these risks are not taken into account.
The document shows how a growing body of international research reaffirms that despite their serious problems in many countries, publicly financed and delivered services continue to dominate in higher performing, more equitable health systems. The most common arguments made in support of private-sector health-care provision are examined in this paper. The author argues that the private sector provides no escape route for the problems facing public health systems in poor countries. They highlight a role for civil society organisations to play as distinct actors from the for-profit private sector and advise that existing private providers must be integrated into public health systems.
[adapted from the author]
