Document Abstract
Published:
2010
Innovative health service delivery models in low and middle income countries - what can we learn from the private sector?
The private sector's innovative health service delivery models
This review describes a study carried out to characterise innovative health service delivery models and identify areas of innovation that have led to effective provision of care for the poor.
A subset of private health organisations, some called social enterprises, have developed novel approaches to increase the availability, affordability and quality of health care services to the poor in low and middle income countries and respond to gaps in public services through innovative health service delivery models.
In the study, an environmental scan of peer-reviewed and grey literature was conducted to select exemplars of innovation. A case series of organisations was then purposively sampled to maximise variation. These cases were examined using content analysis and constant comparison to characterise their strategies, focusing on business processes.
After an initial sample of 46 studies, ten case studies of exemplars were developed spanning different geography, disease areas and health service delivery models.
Key findings from these ten case studies include:
A subset of private health organisations, some called social enterprises, have developed novel approaches to increase the availability, affordability and quality of health care services to the poor in low and middle income countries and respond to gaps in public services through innovative health service delivery models.
In the study, an environmental scan of peer-reviewed and grey literature was conducted to select exemplars of innovation. A case series of organisations was then purposively sampled to maximise variation. These cases were examined using content analysis and constant comparison to characterise their strategies, focusing on business processes.
After an initial sample of 46 studies, ten case studies of exemplars were developed spanning different geography, disease areas and health service delivery models.
Key findings from these ten case studies include:
- these ten organisations had innovations in their marketing, financing, and operating strategies. These included approaches such a social marketing, cross-subsidy, high-volume, low cost models, and process reengineering.
- they tended to have a narrow clinical focus, which facilitates standardising processes of care, and experimentation with novel delivery models.
- despite being well-known, information on the social impact of these organisations was variable, with more data on availability and affordability and less on quality of care.
- these private sector organisations demonstrate a range of innovations in health service delivery that have the potential to better serve the poor's health needs and be replicated.
- there is a growing interest in investing in social enterprises, like the ones profiled here.
- however, more rigorous evaluations are needed to investigate the impact and quality of the health services provided and determine the effectiveness of particular strategies.
