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Unformatted text preview: 4 ) The Business of Health in Africa …the private health sector in Sub-Saharan Africa is surprisingly large and constitutes an important, diverse component of the region’s health care systems. Of total health expenditure of $16.7 billion in 2005, around 60 percent (predominantly out-of-pocket payments by individuals), was financed by private parties. Private providers captured about half of that total expenditure. The Business of Health in Africa ( 5 T he vibrancy and positive contribution of the private sector to health care in Sub-Saharan Africa is very encouraging. Examples of pri- vate sector participation—complementing and supplementing the public sector and improving quality, accessibility, and efficiency in health care—can be found throughout the region. Reactions to the private sector among donors, ministries of health, and other public policy offi- cials vary. Some know little about the sector, and some are ideologically opposed to its participation in health care, believing that the financing and provision of health care should be strictly within the public sector’s domain. Many others recognize its potential, but are suspicious of the profit mo- tive and have legitimate concerns about consis- tency of quality and the difficulty of regulating a diverse group of entities. The private sector already plays a major role in the financing and delivery of health care through- out Sub-Saharan Africa. It is also clear that all fu- ture scenarios for health care in the region will include a major role for the private sector. Signifi- cant increases in demand for health care services are expected in many countries and, if the right environment is created, the private sector, work- ing within a plural system, can significantly help to improve the scope, scale, quality, and efficiency of access to those services. This section of the report examines the role that the private sector plays in health care in the region today as well as its potential for growth. The Private Sector Already Plays an Important Role in Health Care in Sub-Saharan Africa Its size varies by country but the private health sec- tor in Sub-Saharan Africa is surprisingly large and constitutes an important, diverse component of the region’s health care systems. It covers all of the elements along the health value chain, including provision, financing, manufacturing, distribution, and retail. Of total health expenditure of $16.7 bil- lion in 2005, 25 around 60 percent 26 (predominant- ly out-of-pocket payments by individuals), was fi- nanced by private parties. Private providers captured about half of that total expenditure. 27 The share of the health care market held by the private sector varies widely across countries and regions based on a variety of political, historical, and economic factors. In some countries, includ- ing Uganda and Ghana, private sector usage is over 60 percent, while in others, such as Namibia, it is less than ten percent. Figure 1.1 summarizes it is less than ten percent....
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- Fall '11