The governance behaviours: a proposed approach for the alignment of the public and private sectors for better health outcomes

Health systems are ‘the ensemble of all public and private organisations, institutions and resources mandated to improve, maintain or restore health.’ The private sector forms a major part of healthcare practice in many health systems providing a wide range of health goods and services, with signifi...

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Bibliographic Details
Published in:BMJ global health 2023-12, Vol.8 (Suppl 5), p.e012528
Main Authors: Clarke, David, Appleford, Gabrielle, Cocozza, Anna, Thabet, Aya, Bloom, Gerald
Format: Article
Language:English
Subjects:
Delivery of Health Care
Efficiency
Equity
Government
Health care
Health policy
Health services
Health systems
Humans
Outcome Assessment, Health Care
Practice
Private Sector
Public Health
Public policy
Public Sector
Sustainable development
Telemedicine
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Summary:Health systems are ‘the ensemble of all public and private organisations, institutions and resources mandated to improve, maintain or restore health.’ The private sector forms a major part of healthcare practice in many health systems providing a wide range of health goods and services, with significant growth across low-income and middle-income countries. WHO sees building stronger and more effective health systems through the participation and engagement of all health stakeholders as the pathway to further reducing the burden of disease and meeting health targets and the Sustainable Development Goals. However, there are governance and public policy gaps when it comes to interaction or engagement with the private sector, and therefore, some governments have lost contact with a major area of healthcare practice. As a result, market forces rather than public policy shape private sector activities with follow-on effects for system performance. While the problem is well described, proposed normative solutions are difficult to apply at country level to translate policy intentions into action. In 2020, WHO adopted a strategy report which argued for a major shift in approach to engage the private sector based on the performance of six governance behaviours. These are a practice-based approach to governance and draw on earlier work from Travis et al on health system stewardship subfunctions. This paper elaborates on the governance behaviours and explains their application as a practice approach for strengthening the capacity of governments to work with the private sector to achieve public policy goals.
ISSN:2059-7908
2059-7908
DOI:10.1136/bmjgh-2023-012528