Approaches, enablers and barriers to govern the private sector in health in low- and middle-income countries: a scoping review

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The private sector plays a substantial role in delivering and financing healthcare in low- and middle-income countries (LMICs). Supporting governments to govern the private sector effectively, and so improve outcomes across the health system, requires an understanding of the evidence base on private health sector governance. This paper reports on a scoping review, which synthesised evidence on the approaches used to govern private sector delivery and financing of healthcare in LMICs, the effectiveness of these approaches and the key enablers and barriers to strengthening governance.

The authors conclude that governance choices shape not just the current health system, but also its future development. Common barriers to effective governance must be addressed in policy design, stakeholder engagement, public and private sector accountability, monitoring and capacity. Achieving this will require in-depth explorations of governance mechanisms and more rigorous documentation of implementation and outcomes in diverse contexts.

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Citation

Goodman C, Witter S, Hellowell M, et al. Approaches, enablers and barriers to govern the private sector in health in low- and middle-income countries: a scoping review. BMJ Global Health 2024;8:e015771.