Private Sector Engagement for Strong Health Systems and Better Health

Health systems consist of all the people and actions whose primary purpose is to improve health. They may be integrated and centrally directed, but often they are not.

Historically, limited attention has been paid to the range of products and services delivered in the private health sector, or the quality of the outputs delivered (e.g. their safety, appropriateness and efficacy), or their prices (which often are paid by users directly out of pocket).

This situation needs to change. If countries are to reach their health goals, countries need to harness all available resources for achieving and sustaining health goals, and not only that part over which the public sector has formal control. Health policy and strategies need to cover the private provision of health services and private financing, as well as state funding and services. Only in this way can health systems as a whole be oriented towards achieving goals that are in the public interest.

This site shares resources that will help create integrated health systems where all providers public and private, operate in the public interest. It aims to help countries make public policy about the operation of the private health sector, and design and implement tools and strategies that influence the resources, incentives and behaviors of the private sector to help countries to build strong health systems that operate in the public interest.



Read more

In most countries a mix of public and private providers play a significant role in providing health inputs and health care delivery

Many people in low income countries, including the poor, would have no access to health care without privately provided services. In low income countries, the private sector is typically involved in every aspect of health services delivery. Private practitioners are most prominent in delivery of primary and curative care, largely due to relatively low capital requirements, high demand, and patients' willingness and ability to pay. This pattern involves them directly in core "public health" activities such as treating patients with malaria, tuberculosis, and other communicable diseases, as well as treating sick children and pregnant women. Despite widespread concern about clinical quality and cost, patients often bypass public facilities to use private providers - frequently citing reasons of convenience and responsiveness.

Supporting member states' efforts towards the health system objective of UHC is a strategic priority for WHO. It follows that supporting member states on effective engagement of the private health sector is essential to ensure universal access to quality health care without inducing financial hardship.

If properly regulated and strategically leveraged, the private sector can contribute positively to efforts to improve the performance of health systems. The engagement of the private sector through efficiency and innovation can help in the realization of equity in healthcare by better reaching marginalized segments of their populations and expand service coverage. However, failing to properly engage and manage the private sector creates serious threats to efforts towards UHC.

Vision, mission and theory of change

This page provides a space to exchange information and resources to accelerate progress toward:

  • new way of doing governance in mixed health systems.
  • the strengthening of governance behaviors to ensure effective engagement. 
  • well-governed health system in which public and private actors collectively deliver on the realization of UHC.

Governance behaviors

Six governance behaviors have been identified - aiming at effective governance of mixed health systems:

  • Build understanding - Collection and analysis of data to align priorities for action.
  • Deliver strategy - Agreed sense of direction and articulation of roles & responsibilities.
  • Enable stakeholders - Institutional framework that empowers the actors.
  • Foster relations - Working together to achieve shared objectives in a new way of doing business.
  • Align structures - Organizational structures to align with policy objectives.
  • Nurture trust - Mutual trust amongst all actors as accountable participants


Engaging the private sector in response to COVID-19


How can the government successfully engage the private sector in health for equitable distribution of COVID-19 vaccines? An interview series.

Looking to the private sector to accelerate the COVID-19 vaccine rollout: “all hands on deck” for equitable delivery

New blog! A shot in the arm for the COVID-19 vaccine: can the private sector be a critical ally and why strong governance is the key?

Passing the Test: How public and private health services can align to fight COVID-19 - A World Bank blog

New blog! The COVID19 pandemic and the private sector