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Shaping future health markets: Reflections from Bellagio - What future for health markets?
Shaping future health markets: Reflections from Bellagio What future for health markets? www.futurehealthsystems.org Dr. Sara Bennett 7 March 2013
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
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 liberalization3
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 dynamics4
ProcessLandscaping Identification Preparation of Bellagio Researchanalysis 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 HANSHEP5
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)7
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?8
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 markets9
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 with10 government on future sustainability
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 their11 salaries?
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 influence12
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 alternative13 evaluation approaches
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 including14 more market actors
Future Health Systems is a research firstname.lastname@example.org 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 isa consortium research programme fundedby the UK Department for InternationalDevelopment (DFID) and Irish Aid for thebenefit of developing countries.www.institutions-africa.org