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Prohibit, constrain, encourage, or purchase: how should we engage with the private health-care sector?
The private for-profit sector's prominence in health-care delivery, and concern about its failures to deliver social benefit, has driven a search for interventions to improve the sector's functioning. We review evidence for the effectiveness and limitations of such private sector interventions in low-income and middle-income countries. Few robust assessments are available, but some conclusions are possible. Prohibiting the private sector is very unlikely to succeed, and regulatory approaches face persistent challenges in many low-income and middle-income countries. Attention is therefore turning to interventions that encourage private providers to improve quality and coverage (while advancing their financial interests) such as social marketing, social franchising, vouchers, and contracting. However, evidence about the effect on clinical quality, coverage, equity, and cost-effectiveness is inadequate. Other challenges concern scalability and scope, indicating the limitations of such interventions as a basis for universal health coverage, though interventions can address focused problems on a restricted scale.
Journal Article
Europe Sees Mixed Results From Public-Private Partnerships For Building And Managing Health Care Facilities And Services
Prompted in part by constrained national budgets, European governments are increasingly partnering with the private sector to underwrite the costs of constructing and operating public hospitals and other health care facilities and delivering services. Through such public-private partnerships, governments hope to avoid up-front capital expenditure and to harness private-sector efficiencies, while private-sector partners aim for a return on investment. Our research indicates that to date, experience with these partnerships has been mixed. Early models of these partnerships-for example, in which a private firm builds a hospital and carries out building maintenance, which we term an \"accommodation-only\" model-arguably have not met expectations for achieving greater efficiencies at lower costs. Newer models described in this article offer greater opportunities for efficiency gains but are administratively harder to set up and manage. Given the shortages in public capital for new infrastructure, it seems likely that the attractiveness of these partnerships to European governments will grow. [PUBLICATION ABSTRACT]
Journal Article
Employee perception of impact of knowledge management processes on public sector performance
Purpose
The application of knowledge management (KM) is critical to public sector firm as it is to private sector firm. However, despite its significance, the academic enquiry of KM in public sector is at its nascent stage. This forms the motivation of the present work; this paper aims to analyze and understand the intricate relationship between KM processes and public sector firm performance in terms of operational, quality and innovation performance.
Design/methodology/approach
A comprehensive KM processes–performance framework consisting of seven constructs (four constructs of KM processes and three constructs of KM performance) and their underlying factors was developed through an extensive literature review. The employee perceptions of these seven constructs were captured on a five-point Likert scale using a country-wide survey in the UAE public sector. The 270 valid responses captured were then used to first validate the KM framework and then test the hypothesized relationships between KM processes and KM performance.
Findings
The findings show that all four KM processes (knowledge creation, knowledge capture and storage, knowledge sharing and knowledge application and use) had a positive and significant impact on operational, quality and innovation performance of public sector in the UAE.
Research limitations/implications
The findings confirm the validity and reliability of all the seven constructs and their underlying factors and the assessment framework. Overall, this study fills a gap in the literature about applying/implementing a KM framework for the public sector and therefore significantly contributes toward the theoretical advancement of the field. However, the study does acknowledge the use of perceptual measures of individual employees as a limitation instead of more objective measures to capture the impact KM processes on KM performance.
Practical implications
The strong and significant impact of KM processes on firm performance is expected to provide the impetus for practitioners and policymakers to implement and leverage from KM processes and improve firm performance in the public sector.
Originality/value
A comprehensive development, validation and assessment of a KM framework for the public sector has not been attempted previously anywhere, let alone UAE, and hence constitutes the novelty of this work.
Journal Article
Public-private partnerships in primary health care: a scoping review
Background
The Astana Declaration on Primary Health Care reiterated that PHC is a cornerstone of a sustainable health system for universal health coverage (UHC) and health-related Sustainable Development Goals. It called for governments to give high priority to PHC in partnership with their public and private sector organisations and other stakeholders. Each country has a unique path towards UHC, and different models for public-private partnerships (PPPs) are possible. The goal of this paper is to examine evidence on the use of PPPs in the provision of PHC services, reported challenges and recommendations.
Methods
We systematically reviewed peer-reviewed studies in six databases (ScienceDirect, Ovid Medline, PubMed, Web of Science, Embase, and Scopus) and supplemented it by the search of grey literature. PRISMA reporting guidelines were followed.
Results
Sixty-one studies were included in the final review. Results showed that most PPPs projects were conducted to increase access and to facilitate the provision of prevention and treatment services (i.e., tuberculosis, education and health promotion, malaria, and HIV/AIDS services) for certain target groups. Most projects reported challenges of providing PHC via PPPs in the starting and implementation phases. The reported challenges and recommendations on how to overcome them related to education, management, human resources, financial resources, information, and technology systems aspects.
Conclusion
Despite various challenges, PPPs in PHC can facilitate access to health care services, especially in remote areas. Governments should consider long-term plans and sustainable policies to start PPPs in PHC and should not ignore local needs and context.
Journal Article
Engaging the Private-Sector Health Care System in Building Capacity to Respond to Threats to the Public's Health and National Security
Disasters tend to cross political, jurisdictional, functional, and geographic boundaries. As a result, disasters often require responses from multiple levels of government and multiple organizations in the public and private sectors. This means that public and private organizations that normally operate independently must work together to mount an effective disaster response. To identify and understand approaches to aligning health care system incentives with the American public's need for a health care system that is prepared to manage acutely ill and injured patients during a disaster, public health emergency, or other mass casualty event, the National Academies of Sciences, Engineering, and Medicine hosted a 2-day public workshop on March 20 and 21, 2018. This publication summarizes the presentations and discussions from the workshop.
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