Tuesday, April 16, 2024

The Private Healthcare Selection in Low and Middle-Income Countries: A Study on Non-Communicable Diseases

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Non-communicable diseases (NCDs), recognized as a major global cause of mortality and morbidity, particularly in low- and middle-income countries (LMICs), impose a significant burden on individuals, families, and health systems, prompting the need for comprehensive healthcare system policies to address this growing disease burden.

A study was conducted to gather evidence on how people with NCDs select their healthcare providers in LMICs, and the outcomes of these choices, particularly focusing on private sector delivery. The research involved a systematic search for literature following PRISMA guidelines, extraction, and synthesis of data on the determinants and outcomes of private healthcare usage for NCDs in LMICs.

The study included 115 studies. The findings were heterogeneous, often relying on a specific country context, disease, and provider. The most reported determinants for seeking private NCD care were patients with a higher socioeconomic status; greater availability of services, staff, and medicines; convenience including proximity and opening hours; shorter waiting times, and perceived quality. It was also found that transitioning between public and private facilities is common.


Challenges and Needs in Adapting Healthcare for NCDs in LMICs

The costs to patients were usually significantly higher in the private sector, both in inpatient and outpatient settings. The quality of NCD care seemed to vary depending on the disease, facility size, and location, as well as the aspect of quality assessed.

The study concluded that due to the limited, mixed, and context-specific evidence currently available, adapting health service delivery models to respond to NCDs remains a challenge in LMICs. There is a need for more robust research on health-seeking behaviors and outcomes, especially through large multi-country surveys, to inform the effective design of mixed healthcare systems that effectively engage both public and private providers.


Original Article DOI: 10.1186/s12913-023-10464-0

Original title: Health seeking behaviours and private sector delivery of care for non-communicable diseases in low- and middle-income countries: a systematic review

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