New approaches to medical care can improve health outcomes (Credit: World Bank, Flickr)
In many poor countries, a large proportion of health services is provided by the private sector, including services to the poor. However, the private sector is highly fragmented and the quality of services varies widely. Private health markets consist of providers with very diverse levels of qualification, ranging from formally trained doctors with medical degrees to informal practitioners without any formal medical training. According to Jishnu Das, in rural Madhya Pradesh— one of the poorest states in India, households can access on average 7.5 private providers, 0.6 public providers and 3.04 public paramedical staff. Of those identified as doctors, 65% had no formal medical training and of every 100 visits to healthcare providers, eight were to the public sector and 70 to untrained private sector providers.
Disasters, whether natural or man-made, destroy and disable healthcare systems just when they’re needed most. But disaster can also create an opportunity to make healthcare better, even in the world’s most troubled places.
I pay through the nose for health insurance for my family, and I’m not happy about it. As a U.S. citizen, I don’t have the luxury of government-backed healthcare. Since I’m technically self-employed, I have to pay the full premium myself. Want some figures? It costs me $830 a month for a family of four, with a high deductible. Besides being expensive, it takes a huge effort to deal with insurance issues, and I find that my provider is expert at finding reasons not to reimburse me for medical expenses. This is chewing a gaping hole in my budget. The only way I’ll ever get value for my money is if I’m hit by a bus.
I could tell something wasn’t quite right with the electrician. He was standing stiffly, poking at the wires in the circuit breaker panel, his face pale, his breathing labored. My wife offered him a cup of tea and asked if he was OK.
“I’m fine,” he said. “I just had a little surgery yesterday.” He kept working until he fixed the wiring; only then did he accept the tea. Then he told us his story.
As we get ready for the launch of the Healthy Partnerships report here in Nairobi, Kenya, there is a strong sense of accomplishment, mixed with nostalgia and hope. This report measures how governments in Sub-Saharan Africa are currently working (or not) with the private health sector in 45 countries we visited a little over a year ago. It has been long in development, but well worth it. We have made a first cut at doing something which some colleagues thought was too difficult. We developed indicators to measure the level of a government’s inclusion of the private health sector in a national health system, allowing cross-country comparison.
Not long ago, I carried a 20-liter bottle of water three blocks to my apartment (there is an artesian well in a nearby park). At first it was easy. I lifted it up onto my shoulders and walked boldly along the street, drawing admiring looks from everyone I passed.
But it didn’t take long for my muscles to feel the burn. Then my back started to ache. By the time I got home, I was wiped out. Never again, I thought.
If mobile phones hold potential for addressing a number of development challenges in existence today then the newest innovations are exciting with cross cutting implications for health. The World Bank recently hosted three top innovators selected from NASA’s LAUNCH Initiative in Health, to provide an overview of new innovations in mHealth and to debate potential bottlenecks in financing and scalability. LAUNCH was formed jointly by NASA, the US Department of State, USAID and NIKE as a global initiative to identify and support innovative work contributing to a sustainable future. All three presenters, Aydogan Ozcan of UCLA, Ramesh Raskar of MIT Media Lab and Josh Nesbit of Medic Mobile, have been widely recognized in the development field as dynamic young innovators.