This blog is the third installment in a three-part series designed to engage stakeholders in our new position paper, “Increasing Local Private Sector Engagement in LMIC Public Health Systems”. This in-depth paper identifies the need to integrate private sector Ecosystem Services & Products into public health systems, outlines the major blockers to this integration and offers stakeholders practical actions to address major blockers. Part three of this blog series focuses on immediate actions stakeholders can take to increase private sector provision of Ecosystem Services.
The global health funding landscape has changed. The money promised is gone; organizations working in global health have significantly reduced their operations, and many low- and middle-income countries (LMIC) governments are working on figuring out what’s next.
As the initial shock of this “new normal” fades, LMIC governments are engaged in new thinking on how to improve and strengthen their health systems. Although many LMICs will still need funders to provide essential health services to their citizens, governments are sensitive to the need to avoid having donor-funded organizations build parallel systems that reduce local capacity to manage and operate the public health system. LMIC governments are rethinking the roles funders, technical partners and the private sector play in the delivery of health services and products. Their focus is now on solutions co-developed with governments that utilize all local resources and skills to manage and operate public health systems.
One element we believe governments and their partners should prioritize in this new thinking is how to engage the local private sector to provide Ecosystem Services & Products to make public health systems more efficient and effective.
Private Sector Engagement: Not a New Story
VillageReach has been working to increase collaboration between African governments and the private sector since its inception in 2000. We firmly believe that private sector companies based in Africa (or global companies with Africa in-country operations) can provide public health systems with much-needed expertise in areas such as deploying digital solutions, managing contact centers, conducting data analytics or transporting and storing medicines and other health products.
Our belief is built on 25 years of operational experience in Africa (see Appendix) including outsourcing supply chain logistics, engaging technology and telecommunication companies to increase access to health services, leveraging pharmaceutical distributors for public health supply chains and advising African innovators to adapt products and services for government customers. Through our work, we have encountered major blockers to increase the use of private companies for Ecosystem Services. However, these blockers are not insurmountable.
In fact, there are practical actions that stakeholders should take right now.
Act Now and Later
Today’s Public Health Programs
Governments, technical partners, funders and private companies do not need to wait for new funding or new programs to engage the local private sector for Ecosystem Services. There are actions stakeholders should take immediately to build trust and confidence between government and the local private sector. For example, governments and technical partners should collaborate to (1) identify and increase the visibility of local firms that meet recognized quality standards, (2) leverage existing tools and guidance that facilitate public-private collaboration and (3) establish an independent verification process to validate service provider performance against contractually agreed performance indicators and quality standards. At the same time, governments, funders and private sector companies should establish payment mechanisms that ensure timely payment of private company invoices.
There are also important actions that governments and funders can take for existing programs that will help attract the best private sector firms. For example, governments and funders should:
- Integrate and standardize processes across health programs to increase the volume of contracted services to private firms, in turn increasing their willingness to invest.
- Examine existing contracts with private sector firms to determine whether the duration is sufficient to motivate private sector firms to make the necessary investments in quality, cost-efficient and flexible services.
- Automate payment processes for private firms to ensure contractual payment terms are met.
These are actions that stakeholders should take now, because they will accelerate impact and establish foundational ways of working for future public health programs.
Future Public Health Programs
The best way to increase the uptake of Ecosystem Services is by integrating the local private sector as part of funding agreements for any new program. This will require funders, governments and technical partners to establish formal structures for their private sector engagement (PSE) activities, including country-specific PSE action plans, and full-time PSE personnel. Here are some actions stakeholders can take:
- Governments and funders should only make awards to technical partners with proven experience in engaging with and developing the local private sector.
- Funders should require technical partners and governments to partner with quality local private firms in new funding agreements.
- Technical Partners should include local private firms as an integral part of their work plans and implementation strategies.
By systematically and intentionally including collaboration with local private companies, African governments can leverage private sector expertise while still maintaining oversight and control of public health system operations.
Building Back Local
When there are shocks to a health system, such as epidemics or environmental disasters, stakeholders in global health often talk about “building back better.” This new shock, grounded in a sharp reduction in foreign aid, offers LMIC governments an opportunity to develop more self-reliant health systems based on the “building back local” approach, which integrates all available local resources. Collaboration with local private sector companies can fill public sector operational gaps, reduce a country’s dependency on external partners, and move each country closer to a sustainable, locally managed and responsive primary health care system.
Read other blogs in the series here and here.