Role of private sectors in health service and management
The history of private health care system goes back to Rana regime when Jung Bahadur Rana
vaccinated his family members in fee for services schemes
In 1951 UMN came officially to Nepal and started providing health service in organized manner.
The pioneer in development of admitting facilities and private medicine was the Kathmandu
nursing home which was established in 1986 during the period of 8th plan period the current
hospitals beds provide by the private sectors is 41% of the total beds
The mushrooming private organization has contributed in some health care service delivery.
However issues of quality of care, increased dissatisfaction on cost, inclusion in government
reporting system, concentration in the urban areas are the major concerns .currently, the health
care system in Nepal broadly encompasses the following types on the basis of ownership of
service delivery:
1. Public sector :government provides public services ,facilitators and long-term owners
2. Private sectors
private for Non-profit sectors :voluntary organizations, missionaries and trust run
health services
organized private sectors : nursing home ,private hospitals and care provided by
fee for services practitioners
unorganized private sectors : care by traditional faith healers
the private sectors is already playing an active role in many countries ,particularly in the area of
curative care .an effective collaboration with the private sector will reduce the government
burden of expanding curative care and enable to reallocation of public funds towards preventive
and promotive activities
Private sector participation in health care may fall under three general categories
investment in or provision of financial support to privately delivered and managed health
services
provision of financial support to publicly delivered health services and
management or delivery of health services financed by public funds and resources
within each categories several arrangements can be made in regard to the public private
investment mix and relationships between the two sectors
private participation in the delivery of health services is usually in the form of establishment
of hospitals,clinics,laboratories ,pharmacies ,and professional private practice .these facilities
tend to be concentrated in urban areas and are usually profit oriented ,even though a few
private facilities operate as nonprofit organization
Traditional and indigenous private practice continues to be popular in the rural areas. In some
countries traditional birth attendants, working privately, have been integrated into the public
health system by some training and use of delivery kit
The problem associated with private sector health care delivery and financing is the
perception that equity considerations might be compromised .since the private sector is often
motivated by profit. Participants were concerned that the poor and those with limited ability
to pay might be left out. As the private sector would continue to grow in most developing
countries, however, it was stressed that government should direct such growth along lines
complementary to government service.
In order to better understanding of role of private sector in health care delivery, following are
the recommendations for further research
reviewing and identifying options for motivating the private sector to serve in rural
areas
developing mechanisms for effective coordination between public and private health
system
adopting measures to promote cost effectiveness in private health delivery
organizing and synthesizing data to facilitate systematic understanding of private
sector participation in health care, the size of its operation, nature of facilities,
satisfaction of users, paying capacity of users etc
making a more thorough study of the extent of coverage currently provided and
exploring ways of expanding such coverage
