Sexual and Reproductive Health and HIV/AIDS Action Plan for the Independent Private Health Subsector
Sexual and
Reproductive Health and HIV/AIDS Action Plan for the PFP Private Health
Subsector (Independent
Private Hospitals and Clinics)
Executive Summary
The need for an SRH and HIV/AIDs
action plan has been signaled by the role of private health sector in the
general health service delivery which triggers the need for an Action plan for
SRH and HIV/AIDS in the PFP Private Health Subsector.
This Sexual and Reproductive Health Action Plan has
been developed by Uganda National
Association of Private Hospitals (UNAPH) to provide overall guidance for
implementing the Sexual and Reproductive Health Services and HIV/AIDS care and
prevention in the PFP Private Health
Subsector. The plan presents an operational basis for UNAPH to contribute
to achieving the goals of the MDGs and provide a framework through which the
government, Ministry of Health (MOH) and Development partners (HDPs) can
collaborate and partner with the PFP private health subsector in Uganda.
A Ugandan Private-for-Profit HIV/AIDS Care report carried out by USAID and
a Policy Brief on the Role of Private Sector in Sexual and Reproductive Health
services have been used extensively to design this Action Plan. Other
countries’ reports and plans have also been used to support and analyze the
strategies below.
The
Healthcare Environment in Uganda

Public Hospitals
Non-Profit Private Private-for-Profit (PFP)
Health Sector
Health Sector
Why engage the Private Sector
in Reproductive Health
(i) Previous and current systems are falling
short of meeting the Millennium Development Goals, including those related to
improving maternal and child health
and combating HIV/AIDS.
(ii) A significant percentage of people already
receive family planning and reproductive health services from the private
sector. Two-thirds or more of married women receive family planning from the
private sector in Uganda.
(iii) Many consumers value private services because
they perceive the quality of services to be higher. For example, a WHO survey
of 18 sub- Saharan African countries found that patients consistently rank
skills, equipment, and drug availability in for-profit hospitals higher than
similar services in public-sector facilities (IFc 2008).
(iv)
Many PFP private clinics serve
vulnerable people in remote areas that might not otherwise be reached by the public
health system.
(v) Dual
practice, by which salaried public sector providers operate private
practices at the
same time, raises issues with respect to the poor; as such providers
usually provide better
quality
care with shorter waiting times at their private clinics.
Why
have a PFP Health Sub-sector HIV/AIDS and SRH Action Plan?
- Unregulated private sector involvement in health care typically leads to serious quality and equity problems. As the private sector is to a large extent motivated by profit or the pursuit of individual earnings, an inherent feature of unregulated private provision is that providers will ration care to those whose willingness and ability to pay allows providers to make a profit.
- Ensure guidelines for HIV treatment and care providers for the wide provision of, and
access
to, voluntary HIV testing, counseling services and condoms.
- Reducing the proportion of infants infected with HIV and ensure that pregnant women access antenatal care, have information, counseling and other HIV prevention services available to them.
- Develop private health sector strategies to strengthen health care systems and address factors affecting the provision of HIV-related drugs, like affordability and pricing.
- Enact, strengthen or enforce, legislative and other measures to eliminate all forms of discrimination against, and ensuring the full enjoyment of human rights and fundamental freedoms by, people living with, and vulnerable to, HIV/AIDS.
- Sometimes discussion of the public/private mix in health care centers on the question, “How, when, and why should government intervene?” This phrasing presumes that, barring specific reasons to the contrary, the private sector should provide health care services. Policymakers must take this difference in goals into account if government and the private sector are to work together to achieve a common aim.
Priority
Actions for Engaging the Private Sector
The health challenges facing
Uganda are too great for one organization or sector to address on its own.
Increasingly, MOH and development partners (HDPs) recognize the need to engage
the private sector to increase the coverage of health services. In many cases,
national and local governments will need to redefine their roles and broaden
the scope of health planning.
Recommendations
·
Involvement and full integration of Private
Health Care Providers in HCT services provision.
·
Support private health facilities to provide
STI management services.
·
Collaborate with and support private health facilities to provide effective and comprehensive
STI management services using national
treatment protocols.
·
Implement and operationalize the UNAPH
Hospital Accreditation and Survey Guide.
·
Accredit private health facilities offering
syndromic management in line with the national
Protocols
and lobby for the Franchising mechanism / voucher system.
Another set of recommendations
centers on strengthening UNAPH;
1. Support UNAPH to better monitor the
Public-Private Partnership
•
In close collaboration with the
development partners, assist UNAPH with broadening its mandate and enhancing
the diversity of its membership.
• Help UNAPH to become a dependable sustainable
monitoring and evaluation mechanism.
• Assist UNAPH in defining a common vision on
appropriate public-private partnership in
SRH and HIV/AIDS
and in identifying a public-private partnership opportunities to further
encourage cross-sector collaboration.
2. Reposition UNAPH in the marketplace
•
Assess client needs in the area of SRH and HIV/AIDS care services.
•
Strengthen UNAPH institutional capacity to deliver quality sexual and
reproductive health services; train PFP private health providers in clinical
skills, including counseling, etc.
3. Orient UNAPH on the path toward
sustainability
•
Diagnose the organization’s overall
health through a variety of analyses focusing on its
placement in the
market, internal operating capacity, and financial sustainability as a means of
identifying key areas for improvement.
•
Design concise and targeted
positioning strategies based on competitive advantages and
other
diagnostics.
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