CLIENT: WORLD HEALTH ORGANIZATION
2020
To help each other learn, Impact for Health is producing examples of how countries engage the private sector in their COVID-19 response.
DISCUSSION NOTE
COVID-19 Testing
The World Health Organization (WHO) called on countries to test, test, test as screening and diagnosis is considered crucial to slowing the COVID-19 pandemic. In low and middle-income countries (LMICs), the private health sector engagement offers strained health systems a strategy to increase testing coverage and reduce bottlenecks. As a first step, governments need to build common objectives, a strategy and a plan that includes the private sector. This plan should address space, staff, stuff, system, and supply-side financing.
The private sector can offer physical space for testing, such as private laboratories, or virtual spaces such as telehealth call centers; in South Africa, a consortium of private sector groups established a call-in center to help screen and refer patients through telehealth. Private health staff should be informed about COVID-19 testing protocols and disseminate this information within their facilities. Supply gaps can be addressed through a pooled procurement mechanism to purchase supplies for all providers participating in COVID-19 response. Governments should review the requirements necessary to integrate the private sector in response systems. Finally, systems also need to consider supply-side financing and contracting mechanisms to reimburse the private sector; in India, testing in private laboratories is promoted with payment covered under ABPM-JAY (national insurance).
This discussion note provides practical advice and illustrates in-country examples of private sector engagement as part of a whole-of-society approach to COVID-19 testing.
COUNTRY EXPERIENCE
Rwanda
Rwanda’s innovative and efficient response to COVID-19 has been deemed successful in suppressing the transmission of the virus. Their experience in leveraging the private sector, effectively engaging them as key players in the response, provides us with valuable lessons learned. Recognizing their importance, the government included representatives of the private sector from the beginning which ensured that the flow of essential information between the government and community was not disrupted. Private practitioners were involved in spreading public awareness, increasing hospital capacity, and enforcing proper hygiene. The private pharmaceutical sector mobilized resources (hand sanitizer, face masks, and gloves) and private banks have donated money and supplies to the national task force.
Innovative technologies developed by private entities also played a large role in the success of Rwanda’s COVID-19 response. Robots deployed in COVID-19 facilities monitored patient vital signs, drones delivered medical supplies and PPE to remote health centers, apps helped with self-diagnosis, and mobile technology facilitated contact tracing. Rwanda has demonstrated the benefits that engagement of the private sector can have on health system strengthening, during COVID-19 and beyond.
DISCUSSION NOTE
COVID-19 Treatment
The battle against COVID-19 presents unprecedented challenges to case management. In low and middle-income countries (LMICs), private health service providers can play an essential role in a whole-of-society approach to the pandemic, including treatment. The private sector can increase treatment of severe COVID-19 cases, reduce disruption to other essential health services, and increase compliance with public health initiatives to limit or control transmission. In order to achieve these goals, the plan should address space, staff, stuff, system, and supply-side financing.
The private sector can increase space for COVID-19 surge capacity, segregated spaces and/or designated facilities for essential services, and ancillary spaces such as isolation and quarantine sites. Private sector staff need to be identified and allocated to support surge requirements, the provision of essential services, and other auxiliary requirements. Supplies for facility and home-based treatment need to be considered for public, private and community-based treatment. Maximal integration of elements of private and government systems will provide flexibility, coverage, equity and reach to COVID-19 treatment. Finally, mechanisms for coordination of payments for COVID-19 services will promote equitable treatment.
This discussion note prov ides practical advice and illustrates in-country examples of private sector engagement as part of a whole-of-society approach to COVID-19 treatment.
COUNTRY EXPERIENCE
Kenya
Kenya’s private health sector was well-established prior to the pandemic. This has positioned them well to support the country’s National Emergency Response Committee which was formed to coordinate Kenya’s COVID-19 response. The private sector, including hospitals and laboratories, have been involved in public awareness campaigns, testing, and treatment and isolation of COVID-19 patients. Private non-health sectors are also participating in the response; one group has played a large role in the first line of defense against COVID-19 by deploying free soap, hand-washing stations, and masks to the public, and disinfecting public spaces. The Kenya Healthcare Federation, a prominent private sector organization, has set up a COVID-19 response team which is responsible for disseminating government directives and updated information to private health facilities.
The coordination of public and private sectors during the pandemic has not come without challenges, however. For example. there is a lack of transparency when it comes to sharing essential data and information (changes in transmission, patient outcomes, etc.) There is potential for an effective whole-of-society approach to COVID-19 in Kenya, but more extensive integration and coordination efforts are required.
DISCUSSION NOTE
COVID-19 Supplies
Ensuring the right supplies are in the right places at the right time is integral to a successful COVID-19 response. The private sector (private manufacturers, distributors, pharmacies, logistics and communications companies) has an important role to play in this aspect of the pandemic response. Supplies should be embedded in a national-level COVID-19 response plan by developing a cohesive supply strategy. To plan for this, representatives from both public and private sectors should be involved. The plan should establish a common set of objectives and strategies, a list of essential supplies and considerations for procurement, warehousing, allocation, and distribution, and should address space, staff, stuff, system, and supply-side financing.
Private sectors spaces can be integrated into the national COVID-19 testing and treatment efforts. Staff need to be identified and deployed to ensure that “stuff”, including supplies and service contracts for renovation and construction of facilities and surveillance, is in the right place at the right time. Arrangements to monitor, move, and pay for supplies should be outlined. Equipment, supplies, and pharmaceutical stockpiles across public and private health systems should be harmonized to provide flexibility to a national COVID-19 response. Finally, a supply-side financing mechanism should be established so that the private sector is confident they will be reimbursed fairly and in a timely fashion.
This discussion note provides practical advice and illustrates in-country examples of private sector engagement as part of a whole-of-society approach to securing COVID-19 supplies.
Impact for Health and the WHO are researching and publishing additional resources on a weekly basis at our Resource House.
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"The landscape of work has changed. UHC cannot be achieved without private sector."
The late Dr. Pete Salama, whose vision and leadership inspire us