Harding-Montagu-Preker Framework: Overview Distribution (equity) Efficiency Quality of Care Source: Adapted from Harding & Preker, Private Participation in Health Services, PHSA Gather available information Identify additional needs In-depth studies PHSA Gather available information Identify additional needs In-depth studies Activities Hospitals PHC Diagnostic labs Producers / Distributors Ownership For-profit corporate For-profit small business Non-profit charitable Formal/ Informal Activities Hospitals PHC Diagnostic labs Producers / Distributors Ownership For-profit corporate For-profit small business Non-profit charitable Formal/ Informal Grow Harness Convert Strategy Assessment Goal Focus Private Sector Public Sector Restrict

HMP-Framework: Strategies Source: Adapted from Harding & Preker, Private Participation in Health Services, Grow Harness Convert Government shifting from funding to purchasing From “NHS” to social health insurance system  could leverage private resources to expand / improve services currently provide by goverment Public-Private- Partnerships in investment, delivery, or management Government shifting from funding to purchasing From “NHS” to social health insurance system  could leverage private resources to expand / improve services currently provide by goverment Public-Private- Partnerships in investment, delivery, or management A well-functioning part of the private sector  could contribute more by expansion, e.g.: NGOs? ORS producers? Corporate hospitals? Diagnostic labs Pharmacies Midwives A well-functioning part of the private sector  could contribute more by expansion, e.g.: NGOs? ORS producers? Corporate hospitals? Diagnostic labs Pharmacies Midwives A large existing private sector with problems Not participating in disease surveillance Quality failings Monopolistic behavior  could be leveraged to Serve targeted population Provide critical services  could be improved by active management Assure geographic distribution & coverage A large existing private sector with problems Not participating in disease surveillance Quality failings Monopolistic behavior  could be leveraged to Serve targeted population Provide critical services  could be improved by active management Assure geographic distribution & coverage Private Health Sector Situation

HMP-Framework: Instruments Source: Adapted from Harding & Preker, Private Participation in Health Services, Grow Harness Convert Regulation Contracting Training/Information Social marketing Social franchising Info. to patients Demand-side (incl. Vouchers) EQA / Accreditation PPP transactions Enable environment improvement Regulation Contracting Training/Information Social marketing Social franchising Info. to patients Demand-side (incl. Vouchers) EQA / Accreditation PPP transactions Enable environment improvement Policy and Programmatic Instruments Government shifting from funding to purchasing From “NHS” to social health insurance system  could leverage private resources to expand / improve services currently provide by goverment Public-Private- Partnerships in investment, delivery, or management Government shifting from funding to purchasing From “NHS” to social health insurance system  could leverage private resources to expand / improve services currently provide by goverment Public-Private- Partnerships in investment, delivery, or management A well-functioning part of the private sector  could contribute more by expansion, e.g.: NGOs? ORS producers? Corporate hospitals? Diagnostic labs Pharmacies Midwives A well-functioning part of the private sector  could contribute more by expansion, e.g.: NGOs? ORS producers? Corporate hospitals? Diagnostic labs Pharmacies Midwives A large existing private sector with problems Not participating in disease surveillance Quality failings Monopolistic behavior  could be leveraged to Serve targeted population Provide critical services  could be improved by active management Assure geographic distribution & coverage A large existing private sector with problems Not participating in disease surveillance Quality failings Monopolistic behavior  could be leveraged to Serve targeted population Provide critical services  could be improved by active management Assure geographic distribution & coverage

HMP-Framework: Process Source: Adapted from Harding & Preker, Private Participation in Health Services, Grow Harness Convert 2: Match Goal to PHS Situation 3: Select Instrument 4: Apply Instrument 1: PHSA (evaluate)

HMP-Framework: This Course Source: Adapted from Harding & Preker, Private Participation in Health Services, Grow Harness Convert 2: Match Goal to PHS Situation 3: Select Instrument 4: Apply Instrument 1: PHSA (evaluate)