Global health centre
20 June 2018

People, purpose and provision - The role of the private sector in UHC

It is estimated that about half of the global population lacks access to adequate health services without financial hardship. Such access is promised under the Universal Health Coverage (UHC), to which the current leadership of the World Health Organization is publicly committed. The Global Health Centre and Rabin Martin gathered diverse experts to discuss the progress towards UHC and the role of the private sector under the title “the new health economy”.  This discussion was held during the 71st World Health Assembly and explored questions including: What is a health economy? How is it composed? Who contributes to it?

The health economy is a significant source of economic growth and a target of large portion of household consumption: it encompasses areas such as elderly care, sports and well-being, and manufacturing of healthcare products. Furthermore, the health workforce is an important component of the health economy and constitutes typically also a significant portion of the overall labour force of a country. Globally, the health sector is the fastest growing employment sector. Despite this, the health workforce is often seen as a cost to be contained, rather than an investment to the economy itself.

Partially due to its size, the health economy has a great potential to increase and stabilise the economy of countries in various stages of development. Demand for health sector employment and health service provision does not reduce during periods of instability in a similar manner as other sectors, making it a reliable source of employment, stability and economic output for countries, in particular in low and middle income settings.

It is impossible to discuss the health economy without discussing the role of women: 70% of the global health workforce are women, who are concentrated particularly at the low-paid and unpaid end of the scale. At the same time, women’s paid labour force participation is a motor for economic growth, and the increasing demand for the health workforce globally provides more employment opportunities for women, as well as an added asset towards creating economic prosperity. However, currently the unpaid care and health work provided by women is in effect a very significant hidden subsidy to the economy. The private sector can play a pivotal role in investing to decent employment for women in the health sector. In addition to the investment into health workforce and in particular women working in the sector, good governance and stewardship from the governments are needed.

Finally, the private sector has a role in the provision of health for all because many countries are struggling to provide universal health coverage on public sector provision alone. Therefore, the involvement of both non-profit and for-profit health providers outside the government is both complimentary and necessary.  Nevertheless, multiple political, economic, regulatory and legal barriers still hinder the participation of private sector in primary health provision. In many cases, it is very difficult for governments to engage with scattered for-profit providers and to oversee the quality and standards of health-services they provide. Many countries have begun benefiting from a network of specialised private sector health providers rather than a single provider responsible for all health services. Engaging in the health economy provides multiple avenues and can be advantageous for the both the private and the public sector.

Economies with better health systems are known to have higher human capital due to healthier population, making them more successful in the long term. Therefore, the intended outcome of a new health economy is a healthier population who can access appropriate health services without the prospect of financial hardship.