The Role of the Private Sector in Addressing the Health Workforce Capacity Shortage
Background
An estimated 2.4 million doctors, nurses, and midwives are needed in fifty-seven countries with critical health worker shortages. The challenge is greatest in sub-Saharan Africa, which has only three percent of the world's health workers yet twenty-four percent of the global burden of disease and the highest burden of HIV infection and AIDS in the world. There is an increasing realization that the private sector can strengthen public health systems by offering resources, knowledge, and skills.
The CCA HIV/AIDS and Health Initiative is participating with the Global Health Institute and the Fuqua School of Business at Duke University, and the Global Healthcare Workforce Alliance (GHWA), a partnership administered by the WHO, to examine the role of the private sector (defined as “non-government”) in addressing the healthcare workforce capacity crisis in the developing world. The Rockefeller Foundation and the GHWA are funding this initiative.
As a result of this partnership, CCA also participated in the First Global Forum on Human Resources for Health in Kampala, Uganda March 1 - 7, 2008.
Design of the Study
In collaboration with a sister project led by the Results for Development Institute and the Brookings Institution, the initiative will compile and review existing research and case studies on innovative private sector responses to the developing world’s human resource crisis in three broad areas: insurance, purchasing/contracting, regulation/accreditation. Initiatives will be evaluated according to their contribution to increasing the supply of health workers, making existing workers more effective and efficient, and/or slowing attrition and misdistribution of workers. Based on its findings, the initiative will make recommendations to the GHWA for policies, practices and funding applicable at the global and country level.
Results
Governments and bi-lateral organizations have recognized the importance of the private sector in the development of a comprehensive response to HIV and the human resource capacity crisis in the health sector. However, there is still a pre-existing bias in many public health systems in poor countries against the private sector. The suspicion of the private sector not only has to do with quality and access, but is also informed by the fear of losing jobs or preferred tasks by public health workers. Some innovative private sector projects may have struggled at inception or to scale due to this bias.
A hospitable “enabling environment” is critical for the development of a viable private health sector and a sustainable response to HIV and AIDS. Access to capital, amenable government policies, supportive stakeholder attitudes, and reliable infrastructure are important factors that affect the ability of private sector initiatives to succeed. Although this study will not focus directly on these issues, these factors will have a critical effect on the environments and contexts in which these projects operate.
Results will be published in late 2008
