Sara Bennett's presentation from the Private Sector in Health's webinar - Shaping future health markets: Reflections from Bellagio.

1. Shaping future health markets:
Reflections from Bellagio
What future for health markets?
www.futurehealthsystems.org
Dr. Sara Bennett
7 March 2013

2. Why health markets?
• Health markets are pervasive
o Health related goods and services
o Sub-national, national and global
o Public and private sector actors
• Understanding how markets work will
enable us to intervene in them better,
particularly to protect the poor.
2

3. Health markets - The past 20 years
• Have learnt much: heterogeneity of private
providers, “informal” markets, contracting for
services, social marketing
• But much still to learn: scaling up effective
market interventions, improving quality of
services, especially for poor
• Increased importance of health markets: due to
economic growth, new technologies e.g. ICTs,
economic liberalization
3

4. Health markets – The next 20 years?
Supplier-side
• Consolidation to
stronger players
• Vertical integration
Consumer-side Governance-side
• New technologies • Push for UHC
• Consumer education • Public finance for
• Non-communicable private providers?
diseases • Oversight
Evolving
market
dynamics
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5. Process
Landscaping Identification Preparation of Bellagio Research
analysis of key topics background meeting uptake
• Document • Regulation of papers (December activities
review health markets • Scoping papers 2012) • Bellagio
• Interviews with • Networking and literature statement
• Consultation
range of providers reviews • Webinar
with diverse
stakeholders • Learning in stakeholders • Journal special
health markets issue
• Meeting with
HANSHEP
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6. The Bellagio Statement
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7. Strengthen data
• Lack of data on health markets continues to
plague decision making
• Identify key data that health market actors
should provide
o Require data provision as part of participation in
government financing schemes
• Pilot a market data platform – that draws
together different types of data from diverse
sources (eg. DHS, NHA, market research)
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8. Experiment with regulatory approaches
• Effective regulation requires bundles of
regulatory approaches
• Dynamic regulatory approaches are required to
respond to dynamic market situations
• “Learn and do”
o Regulatory experimentation
o Real time, rigorous, assessment of effects
o Adaptation of strategy
o Lessons learned?
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9. Strengthen government stewardship
capacity
• Governments frequently lack appropriate capacities to
manage health markets
• Develop individual skills and organizational capacity for:
Leadership Technical Collaborative Analytical
skills – capacity – capacity – skills –
to balance to develop to work with to anticipate
powerful market civil society, future
interests information private developments
systems, providers, in health
contract out business markets
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10. Sustain investments
• Donor funding has supported private sector
experimentation e.g. social franchising
• Such initiatives – often small scale, but some
provide critical services to poor
• How will these be sustained going forward?
• While initiative seek to develop sustainable
models, government financing is key to enabling
access for the poor
• Needs to be proactive engagement with
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government on future sustainability

11. Link market and health worker policies
• Connections between health workers
and health markets insufficiently
acknowledged:
o Moonlighting
o Migration
• Future for community health workers,
if governments do not funding their
11 salaries?

12. Learn about and manage networks
• Business models are evolving – greater
networking and integration of previously
disorganized private providers?
• Networks can help to correct failures typical of
health markets:
o Informational asymmetries
o Facilitate distribution of subsidies
• But, networks can also create monopolies and
exert political influence
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13. Promote learning in health markets
• Better coordination and more consolidated
research on health markets needed
• Priorities?
Effects of
New Mobile and
information
regulatory informational
on consumer
approaches technologies
behavior
• Real time learning – need for alternative
13 evaluation approaches

14. Next steps
• HANSHEP – knowledge priorities group
• Collaborate with developing countries to
pilot data collection systems for health
markets
• Create a challenge fund to support
experimentation and learning on health
markets
• Broaden the debate, in particular including
14 more market actors

15. Future Health Systems is a research sbennett@jhsph.edu
consortium working to improve access,
affordability and quality of health services
for the poor. We are a partnership of leading www.futurehealthsystems.org
research institutes from across the globe
working in a variety of contexts: in low-
income countries (Bangladesh, Uganda),
middle-income countries (China, India)
and fragile states (Afghanistan) to build
resilient health systems for the future.
The Africa Power and Politics Programme is
a consortium research programme funded
by the UK Department for International
Development (DFID) and Irish Aid for the
benefit of developing countries.
www.institutions-africa.org