Can working with the private for-profit sector improve utilization of quality health services by the poor? A systematic review of the literature.
Can working with the private for-profit sector improve utilization of quality health services by the poor? A systematic review of the literature.
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DOI：
10.1186/1475-9276-6-17
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发表时间：
2007-11-07
影响因子：
4.8
通讯作者：
Mills, Anne J
中科院分区：
文献类型：
--
作者：
Patouillard, Edith;Goodman, Catherine A;Mills, Anne J
背景技术背景：人们越来越关注私营营利部门在中低收入国家提供保健服务方面的作用。私营部门是所有社会经济群体，包括最贫穷群体的重要护理来源，人们对私营部门提供的护理质量表示了严重关切。已经制定了干预措施，以解决这些技术故障，同时利用私营提供者参与实现公共卫生目标的潜力。关于这些干预措施在多大程度上成功地扩大了穷人和处境不利人口获得优质保健服务的机会，现有资料有限。本文解决了这一知识差距，提出了一个系统的文献综述的结果与私人营利性供应商的工作，以达到穷人。方法：搜索主题的系统文献综述是有效的干预措施与私人营利性部门，以提高穷人利用优质的卫生服务。干预措施包括社会营销、使用凭单、药品预包装、特许经营、培训、监管、认证和外包。已发表文献的检索使用了一系列电子数据库，包括PubMed、Popline、HMIC和CabHealth Global Health。灰色文献和未发表文献的检索使用了万维网上的可用文件。我们专注于研究，评估干预措施的利用和/或服务质量的影响，并提供信息的社会经济地位的受益population.RESULTS：共检索到2483参考文献，其中52个合格的影响评价。5干预措施的受援社区的平均社会经济地位的数据，并在整个社会经济群体的利益分配5 interventions.CONCLUSION：很少有研究提供的证据，私营部门的干预措施的质量和/或利用穷人的护理的影响。然而，很明显，许多干预措施在贫困社区取得了成功，从与主要由穷人使用的供应商合作的干预措施中可以推断出积极的公平影响。为了得出更有力的结论，需要有更好的证据证明与私营部门合作的干预措施对公平的影响。
BACKGROUND: There has been a growing interest in the role of the private for-profit sector in health service provision in low- and middle-income countries. The private sector represents an important source of care for all socioeconomic groups, including the poorest and substantial concerns have been raised about the quality of care it provides. Interventions have been developed to address these technical failures and simultaneously take advantage of the potential for involving private providers to achieve public health goals. Limited information is available on the extent to which these interventions have successfully expanded access to quality health services for poor and disadvantaged populations. This paper addresses this knowledge gap by presenting the results of a systematic literature review on the effectiveness of working with private for-profit providers to reach the poor.METHODS: The search topic of the systematic literature review was the effectiveness of interventions working with the private for-profit sector to improve utilization of quality health services by the poor. Interventions included social marketing, use of vouchers, pre-packaging of drugs, franchising, training, regulation, accreditation and contracting-out. The search for published literature used a series of electronic databases including PubMed, Popline, HMIC and CabHealth Global Health. The search for grey and unpublished literature used documents available on the World Wide Web. We focused on studies which evaluated the impact of interventions on utilization and/or quality of services and which provided information on the socioeconomic status of the beneficiary populations.RESULTS: A total of 2483 references were retrieved, of which 52 qualified as impact evaluations. Data were available on the average socioeconomic status of recipient communities for 5 interventions, and on the distribution of benefits across socioeconomic groups for 5 interventions.CONCLUSION: Few studies provided evidence on the impact of private sector interventions on quality and/or utilization of care by the poor. It was, however, evident that many interventions have worked successfully in poor communities and positive equity impacts can be inferred from interventions that work with types of providers predominantly used by poor people. Better evidence of the equity impact of interventions working with the private sector is needed for more robust conclusions to be drawn.