Private health care in developing countries

This article, published in the British Medical Journal (BMJ), looks at issues surrounding private healthcare provision in low and middle income countries. It notes that private healthcare provision is growing in such countries. The poor, as well as the rich, often seek health care from private providers, including for conditions of public health importance such as malaria, tuberculosis, and sexually transmitted infections. International policymakers recommend greater use of private providers on the grounds that they offer consumers greater choice; increase competition in the health care market; and remove state responsibility for service provision, thereby encouraging its role as regulator and guarantor.

However, the article argues that the quality of care offered by many private providers is poor. It considers three strategies for widening access, improving quality, and ensuring that prices are not exploitative. Community education could help people recognise, demand, and obtain higher quality care, and to know what they might expect to pay for it – although it may not be enough to improve the quality of services in relation to drugs, diagnostic tests, and complex clinical services. Accreditation schemes could monitor the services offered by providers against agreed quality standards. Finally, free services for target groups also deserve consideration. [adapted from authors]