Delphi process: Covid-19 and the collapse of the private health sector in LMICs
Just as pressure is increasing on low- and middle-income countries (LMICs) to increase health system capacity in response to COVID-19, the WHO has received reports that private sector healthcare providers are experiencing significant reductions in their incomes due to the pandemic. There is a risk of this situation leading to large scale insolvency among private health care providers. The stress is particularly acute for Small and Medium Size Enterprises (SMEs) (e.g. primary care practitioners, small community hospitals, individual laboratories and pharmaceutical retailers) - many of which are unlikely to survive the pandemic without additional financial assistance. This problem is likely to have significant implications for health systems – especially in those LMICs (the majority) in which private providers play a major role in delivering essential health products and services to the population, including the poor and vulnerable.
To find consensus on: (1) the methods through which state and donor aid can be made available for the private health care sector; (2) the likely impact and consequences of each option; (3) the relative feasibility and acceptability of options, WHO is organising a Delphi process with key experts and stakeholders.
Five key questions will be discussed:
- Should state and donor aid be made available for the private health care sector?
- What criteria and conditions should be applied to the award of aid?
- What risks may arise from the provision of aid, and how can we manage them?
- Would a bailout provide an opportunity for a new social contract between the public and private health sector and if it would what would such a social contract consist of?
- How could this contribute to countries' long term efforts to achieve UHC, and how could this be implemented?