Private Health Providers in Developing Countries

Serving the Public Interest

Edited by Sara Bennett, Barbara McPake, and Anne Mills


This work presents the results from a co-ordinated programme of research on the private health care sector including studies carried out by Asian, African and Latin American researchers. It draws upon both industrialized and developing country literature.
New ideas on the role of the state in developing countries have considerable implications for the social sectors, especially health. Certain international organizations have advocated a larger role for private sector health care providers and many developing country governments have adopted this approach. Yet, until now, very little evidence has existed about how shifting the balance between public and private roles might affect equity, and the quality and efficiency of health care.

This book presents the results from a coordinated programme of research on the private health care sector including studies carried out by Asian, African and Latin American researchers. The conceptual chapters draw upon both industrialized and developing country literature to describe the intellectual terrain, analyse the key issues and summarize experience to date.

This book will help increase understanding of the private sector, as well as illustrating the contentious issues involved in privatization. It will be useful to students and academics involved in international public health courses, and to health policy makers in developing countries.

Author Bio

Barbara McPake is a professor in the Institute for Global Health and Development at Queen Margaret University.

Sara Bennett is an associate professor at the Center for Global Health, Johns Hopkins University.

Anne Mills is a professor of health economics and policy at the London School of Hygiene and Tropical Medicine

Table of Contents

  • List of Tables
  • List of Figures
  • About the Authors
  • Preface
  • 1. The Public/Private Mix Debate in Health Care - Sara Bennett, Barbara McPake and Anne Mills
  • Part I: The Behaviour and Performance of Private Health Providers
    • 2. The Role of the Private Sector in Health Service Provision - Barbara McPake
    • 3. Public and Private Practitioners in a Rural District of Malaysia: Complements or Substitutes? - Syed Alijunid and Anthony Zwi
    • 4. Characteristics of Public and Private Health-Care Providers in a Thai Urban Setting - Supasit Pannarunothai and Anne Mills
    • 5. Private Practitioners in the Slums of Karachi: Professional Development and Innovative Approaches for Improving Practice - Inayat H. Thaver and Trudy Harpham
  • Part II: The Nature and Characteristics of Health-Care Markets
    • 6. Health-Care Markets: Defining Characteristics - Sara Bennett
    • 7. The Nature of Competition Among Private Hospitals in Bangkok - Sara Bennett
    • 8. Monitoring Product Movement: An Ethnographic Study of Pharmaceutical Sales Representatives in Bombay, India - Vinay R. Kamat and Mark Nichter
    • 9. The Private-Sector Activities of Public-Sector Health Workers in Uganda - Delius Asiimwe, Barbara McPake, Frances Mwesigye, Matthias Ofoumbi, Lisbeth Ørtenblad, Pieter Steefland and Asaph Turinde
    • 10. Regulating the Funding of Private Health Care: The South African Experience - Alex van den Heever
    • 11. The Role of an NGO in the Market for Maternal and Child Health-Care Services in Mexico City - Teresita Ramirez, Beatriz Zurita, Carlos Cruz, Manuel Recio and Carlos Vargas
  • Part III: Contractual Relationships Between the Public and Private Sectors
    • 12. Contractual Relationships Between Government and the Commercial Private-Sector in Developing Countries - Anne Mills
    • 13. To Purchase or to Provide? The Relative Efficiency of Contracting Out Versus Direct Public Provision of Hospital Services in South Africa - Jonathan Broomberg, Patrick Masobe and Anne Mills
    • 14. Private-Sector Involvement in Public Hospitals: Case-Studies in Bangkok - Viroj Tangcharoensathien, Sanguan Nitayarumphong and Sukalaya Khongsawatt
    • 15. Contracting Out of Dietary Services by Public Hospitals in Bombay - Mrigesh Bhatia and Anne Mills
    • 16. Contracting Out of Non-Clinical Services: The Experience of Papua New Guinea - Elvira Beracochea
    • 17. Should African Governments Contract Out Clinical Health Services to Church Providers? - Lucy Gilson, Joseph Adusei, Dyna Arhin, Charles Hongoro, Phare Mujinja and Ken Sagoe
  • 18. Future Research Directions - Anne Mills, Sara Bennett and Barbara McPake
  • Index


'A major step forward in thinking about private provision of health services and the public interest.'
Andrew Cresse, World Health Organization

'I Strongly recommend this book for policy makers.'
Asamoa Baah, Ministry of Health, Ghana

'Sure to be a key reference point. It significantly broadens our vision of real conditions in pluralistic health care systems.'
Peter Berman, Harvard School of Public Health


Publication Date: 1 June 1997
336 pages

Product ISBNs: Paperback: 9781856494960
Library Edition: 9781856494953

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