Leveraging private sector to improve maternal health, achieve universal coverage

Recent figures indicate that almost half the world’s population lack access to the health services they need and the quality of service received by many with care is poor. Indeed, the world has more people dying from poor-quality care than lack of access to care.

In addition to the lack of progress toward Universal Health Coverage (UHC), the world is not on track to achieve health-related targets of the Sustainable Development Goals. For example, reductions in maternal mortality have stagnated — in 2020, an estimated 287,000 women globally died from a maternal cause.

While improving health outcomes is a global priority, governments have committed to achieving all the Sustainable Development Goals (SDGs) by 2030.

Figures from the United Nations General Assembly (UNGA) indicate that all countries, particularly low- and middle-income ones, are struggling to meet the financing necessary to achieve the SDGs. This is due to: perennially strapped national budgets, with 110 governments expected to spend less, or minutely increase spending on health between now and 2027 in comparison to pre-pandemic periods; cyclical cuts in foreign aid, especially from countries that have historically championed development assistance; slowing increases in donor funding; and funding gaps further exacerbated by the COVID-19 pandemic and new development funding directed toward pandemic response efforts.

According to Devex, amid climate change, Low- and Medium-Income Countries (LMICs) around the globe will continue to experience local threats and crises — pandemics, epidemics, humanitarian emergencies and conflicts, economic crises, natural disasters, mass migration — further threatening the resilience of health systems and progress toward the SDGs, including UHC. In response to this, the World Health Organization calls for an additional $200 billion a year to scale up primary health care across LMICs, despite already strapped national budgets.

Experts are unanimous that local private sector enterprises can act as an additional mechanism to address critical health care system gaps and market health failures and catalyze economic growth for investments.

The recommendation was the major resolution of a session, on Tuesday, at the ongoing 78th UNGA in New York, United States, hosted by Devex and sponsored and convened by MSD for Mothers and WHO’s Country Connector on Private Sector in Health.

The session brought together the perspectives of key stakeholders making strategic decisions about health care investments on the ground in LMICs, including government and development partners. It particularly drew on the experiences of the speakers in health financing and investment for sustainability and resilience to advance equitable access to care. The speakers also highlighted the policies and practices to be strengthened to help bridge the gaps.

Dr. George Uzonwanne, Director, Health and Social Services, Niger Delta Development Commission (NDDC), who represented the Managing Director, Dr. Samuel Ogbuku, said: “We need to look at healthcare as a business. We need to bring in the private sector. The private sector should bring in their services into the villages where there are millions of women that need care. That is big business.

“There are about 40 million people in the Niger Delta Region. We realised that the government does not have the capacity. People expect the government to run health as a social service. But we need to realise that health has to be run as a business for efficiency. This is where the private sector comes in.

“So, we partner with the private sector to see how we can register 12 million women. The women are in the villages but the doctors are not there. We are working with the private sector to register these women, where they live and so on, to use it to plan properly. We are looking at the technical partners and the financial capacity.”

AVP, health equity and lead, MSD for Mothers, Dr. Mary-Ann Etiebet, said: “We are halfway through the SDGs race and we are behind. We have to look at different ways we can optimise the private sector. What about the capacities that already exist? Are we doing everything to integrate these? We need to bring anything we have into the playing field to facilitate and galvanise more inclusive members.”

Health Minister of Malawi, Khumbize Kandondo Chiponda, said: “All of us came from a woman, that is how important a woman is. Since we came in, there is at least a woman that has died somewhere of childbirth related issues. The call is to improve maternal services everywhere. Let us join hands and we can make the difference.”

Carmen Sachiko Villar, vice president of social business innovation, MSD for Mothers, said: “The private sector cannot do everything. The MSD approach is to advance health equity and leverage private sector capacity.

“I want a commitment to action. We need commitments that we will find the resources we need to make this happen.”

Nick Pearson, Co-executive director, Jacaranda Health, said: “Our goal is to ensure all mother’s get favourable outcomes during childbirth. We work with governments to address gaps and to empower women during pregnancy and post-partum.

“We need a digital system to enable the health systems to function better.”

Dr. Jarbas Barbosa, Director, Pan American Health Organisation, said: “We have the challenges of real access and quality of care. We need to partner with the private sector. We really need to think of how to scale up.”

Other speakers at the session include:Dr. Suraya Dalil, Director of WHO Special Programme on Primary Health Care; Jeffrey Smith, Deputy director of implementation research and demonstration for scale on the maternal, newborn & child health team, Bill & Melinda Gates Foundation; Dr. Mories Atoki, chief executive officer, African Business Coalition for HeHealth and Kate Warren, Executive Vice President & Executive Editor, Devex.

Warren said Devex is the media platform for the global development community. “A social enterprise, we connect and inform over one million development, health, humanitarian, and sustainability professionals through news, business intelligence, and funding and career opportunities so you can do better for more people. We invite you to join us,” Warren said.