Harding-Montagu-Preker Framework: Overview

•Distribution(equity)

•Efficiency

•Quality of Care

Source: Adapted from Harding & Preker, Private Participation in Health Services, 2003.

PHSA•Gather available information

• Identify additional needs

• In-depth studiesActivities•Hospitals•PHC•Diagnostic labs•Producers / Distributors

Ownership•For-profit corporate • For-profit small business• Non-profit charitable

Formal/ Informal

Grow

Harness

Convert

StrategyAssessmentGoal Focus

Private Sector

PublicSector

Restrict

HMP-Framework: Strategies

Source: Adapted from Harding & Preker, Private Participation in Health Services, 2003.

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

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

Priv

ate

Hea

lth S

ecto

r Situ

ation

HMP-Framework: Instruments

Source: Adapted from Harding & Preker, Private Participation in Health Services, 2003.

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

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

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

HMP-Framework: Process

Source: Adapted from Harding & Preker, Private Participation in Health Services, 2003.

Grow Harness Convert

2: MatchGoal to PHS

Situation

3: SelectInstrument

4: Apply Instrument

1: PHSA(evaluate)

HMP-Framework: This Course

Source: Adapted from Harding & Preker, Private Participation in Health Services, 2003.

Grow Harness Convert

2: MatchGoal to PHS

Situation

3: SelectInstrument

4: Apply Instrument

1: PHSA(evaluate)