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Private Providers (private + provider)

Distribution by Scientific Domains

Humanities and Social Sciences	57%

Selected Abstracts

The role of private providers in treating child diarrhoea in Latin America

HEALTH ECONOMICS, Issue 1 2008
Hugh R. Waters
Abstract Diarrhoeal disease, a leading cause of child mortality, disproportionately affects children in low-income countries , where private and non-governmental providers are often an important source of health care. We use 10 Living Standards Measurement Surveys from Latin America to model the choice of care for child diarrhoea in the private sector compared to the public sector. A total of 36.8% of children in the combined data set saw a private provider rather than a public one when taken for treatment. Each additional quintile of household economic status is associated with an increase of 6.5 percentage points in the probability that a child with diarrhoea is taken to a private provider (p<0.001). However, treatments provided in the private sector are manifestly of worse quality than in the public sector. A total of 33.0% of children visiting a public provider received Oral Rehydration Solution, compared to 13.7% of those visiting a private provider. Conversely, children treated by a private provider are more likely to receive drugs, most commonly unnecessary antibiotics. Ironically, when it comes to treatment for child diarrhoea, wealthier and better educated households in Latin America are paying for treatment in the private sector that is ineffective in comparison with treatments that are commonly and inexpensively available. Copyright © 2007 John Wiley & Sons, Ltd. [source]

The ,New Minimalist Approach' to Private-Sector Development: A Critical Assessment

DEVELOPMENT POLICY REVIEW, Issue 4 2006
Tilman Altenburg
Recent literature on private-sector development emphasises the need to establish a ,level playing field' and tends to disregard selective supportive interventions. The most commonly highlighted elements are administrative simplification and effective property rights policies, with business services largely left to private providers - what we call the ,new minimalist approach' (NMA). However, the NMA is based on certain unrealistic assumptions and is barely backed by empirical evidence. A range of complementary public policies is needed to create competitive sectors and overcome internal constraints, especially in small-scale economies. [source]

The role of private providers in treating child diarrhoea in Latin America

Catastrophic payments for health care among households in urban Tamil Nadu, India

JOURNAL OF INTERNATIONAL DEVELOPMENT, Issue 2 2009
Salem Deenadayalan Vaishnavi
Abstract Urban residents in India face important health problems due to unhygienic conditions, excessive crowding and lack of proper sanitation. The private sector has started occupying the centre stage of the health system and households are burdened with increasing levels of health expenditure. This paper aims to study out-of-pocket expenditure (OOPE) and the extent of catastrophic payments for health care among households in a highly urbanised state, Tamil Nadu. The study used data on morbidity and health care for the year 2004 collected by the National Sample Survey Organization, India. Care was sought for 84 per cent of illness episodes in urban areas, and the majority used private sector providers (67 per cent for inpatients and 78 per cent for outpatients). Mean OOPE for inpatients and outpatients was higher for households with higher income. The average cost burden per visit was higher among those who sought care from private providers for inpatient services (29 per cent of household consumption expenditure) and outpatient services (20% of household consumption expenditure) compared with the burden associated with public health service use (3,4 per cent of consumption expenditure). About 60 per cent of households which used private health services faced catastrophic payments at the 10 per cent threshold level. To avoid catastrophic expenditure, greater use of the public sector which is providing services at an affordable cost is needed. Improving access to public health services, better gate-keeping systems, stronger controls on drug prices and increasing the quality of services are required to reduce the incidence of catastrophic expenditure both on inpatients and outpatients. Greater use of risk pooling mechanisms would encourage the poor to seek health care and also to protect households from all socio-economic groups from catastrophic expenditure. Copyright © 2009 John Wiley & Sons, Ltd. [source]

WHAT WORKS BEST WHEN CONTRACTING FOR SERVICES?

PUBLIC ADMINISTRATION, Issue 4 2007
AN ANALYSIS OF CONTRACTING PERFORMANCE AT THE LOCAL LEVEL IN THE US
During the last decade the field of public administration has undergone a period of renewed interest in the topic of performance and effectiveness. Key contributions to the growing stream of research on public sector performance include work focusing on the adoption and implementation of performance measurement in the public sector (see, for example, Julnes and Holzer 2001; Behn 2003); theoretical and empirical research on management's effect on organizational performance (see, for example, O'Toole and Meier 1999; Meier and O'Toole 2002); and efforts to identify the determinants of organizational effectiveness (see, for example, Rainey and Steinbauer 1999; Brewer and Selden 2004). Surprisingly, this literature includes very few studies that explicitly address the issue of performance in contracting for services (exceptions include Domberger and Hensher 1993; Romzek and Johnstone 2002). In the United States alone, hundreds of billions of dollars are contracted out every year, and innumerable policies and programmes are implemented, at least in part, through contractual arrangements between public agencies and private providers (Savas 2000; DeHoog and Salamon 2002; Kelman 2002; Cooper 2003). Moreover, contracting for services appears to be a growing trend in Western Europe and other regions (Kettl 2000; Savas 2000). With the stakes so high, there is a pressing need for research that identifies factors and practices that contribute to success in contracting for services. This paper takes on the challenge by developing a model of contracting performance and testing it using Substantively Weighted Analytic Techniques (SWAT), a new methodology that allows researchers to isolate high performance among a large number of observations in order to identify variables practitioners can manipulate to improve practice (Meier and Gill 2000). [source]

Government engagement with non-state providers of water and sanitation services

PUBLIC ADMINISTRATION & DEVELOPMENT, Issue 3 2006
Kevin SansomArticle first published online: 24 JUL 200
Abstract Increasingly, governments in developing countries recognise that the public sector alone cannot provide adequate water and sanitation services to all. Non-state providers (NSPs) including both formal and informal private providers, as well as civil society institutions, also have important roles to play. There are clear challenges for governments intending to work with NSPs, not least of which is the institutional compatibility between bureaucratic agencies and informal water and sanitation NSPs. However, positive examples of government agencies working effectively with NSPs are emerging in many countries. Government engagement with water and sanitation NSPs can be split into five main types: recognition, dialogue, facilitation/collaboration, contracting and regulation. In many situations, a lack of formal recognition of water or sanitation NSPs is an impediment to more productive forms of engagement. There are a number of potential intervention options within each of the five types of engagement that government agencies should carefully consider when supporting the development of NSP water and sanitation services. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Filling hollowed out spaces with localised meanings, practices and hope: Progressive neoliberal spaces in Te Rarawa

ASIA PACIFIC VIEWPOINT, Issue 2 2009
Nick Lewis
Abstract The contracting out to private providers of services previously delivered within the state has been framed critically as ,hollowing out' and read for its erosion of social democracy, social justice and welfare, as well as its inefficiencies in practice. It is commonly dismissed as neoliberalism. In this paper, we highlight the gains made through this new contractualism by Te Oranga, the Family, Health and Education division of Te Runanga o Te Rarawa located in the Far North of New Zealand. Our aim is not to narrate the exceptional, but to point to the inherent resistances to totalising projects residing in agency and place. Placed at the service of a deep sense of community being and community good rather than self-interest, delivery contracts have enabled Te Oranga to pursue an alternative form of local development and craft a set of progressive spaces. Although highly contingent upon powerful Maori political projects, we argue that the case suggests that gains may be sought in other settings, albeit partial, temporary, and politically contingent. We thus offer a more nuanced account of neoliberalism by highlighting its agency, fractures, politics, and contradictions, and by demonstrating that actualised neoliberalisms are co-constituted with other political projects. [source]