Private sector engagement for advancing universal health coverage

9 September 2017

64thSession of

the Regional Committee

for the Eastern Mediterranean

Islamabad, Pakistan9–12 October 2017

Private Sector Engagement in EMR for Advancing Universal Health Coverage

2

Share of Out-of-Pocket Payment (OOP) in Total Health

Expenditure (THE) by Country Group, 2014

Group 1: Bahrain, Kuwait, Qatar, Saudi Arabia, Oman and United Arab EmirateGroup 2: Egypt, Iran, Iraq, Jordan, Lebanon, Libya, Morocco, Palestine, Syria and TunisiaGroup 3: Afghanistan, Djibouti, Pakistan, Somalia, Sudan and Yemen 3

Duality of practice between public and private sectors

Concentration of private workforce in urban areas

Limited data on workforce distribution, salary structure and multiple job holding

Private Health Workforce – Issues and Challenges

0

10

20

30

40

50

60

70

80

90

100

Saudi Arabia Oman Kuwait UAE Jordan Iran

Pe

rcen

tage

Public

Private

Percentage of physicians working in public and private sectors in selected EMR countries

5

Utilization of Private and Public Sectors Outpatient Clinics in Selected Countries

Assessment of private health sector in 12 countries. Cairo: WHO Regional Office for the Eastern. Mediterranean; 2013 (unpublished).

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

private sectorPublic sector

Perc

ent

Source: Demographic and Health Surveys

85.1

62.8 63.6

0

10

20

30

40

50

60

70

80

90

100

Public Private Public Private Public Private Public Private

Pakistan Egypt Morocco Jordan

Poorest Middle Richest

Use of outpatient clinics (private and public providers)

6

7

• Absence of MoH vision• Weak political will • Lack of comprehensive

strategy toward PHS

• Lack of the capacity in formulating policies

• No official recognition of poor quality in public sector

• Public services is MOH priority

• It is considered a “blind spot” in most countries• Reporting is sporadic and incomplete• Inadequate information on human resources or outcomes

• Limited MoH enforcement capacity of PHS regulations (PHS taking advantage of such situation)

• Outdated regulations governing PHS

MoH vision toward PPP

Enforcement of PHS regulations

MoH capacity for engagement with

PHS

Information

8

Reliable information gathering; effective engagement; strategy development and capacity building.

We seek Member States’ guidance for developing this area further to advance UHC in the region.

Way Forward

9

10

Hassan Salah 9 September 2017

64thSession of

the Regional Committee

for the Eastern Mediterranean

Islamabad, Pakistan9–12 October 2017

Private Sector Engagement in EMR for Advancing Universal Health Coverage