The governance of private sector engagement in health in the African Region: a descriptive case study

Background It is estimated that the private sector plays a significant role in service delivery and training within African health systems. For example, in sub-Saharan Africa, 35% of outpatient care is provided by the private-for-profit sector, and in some countries, an additional 17% is delivered by informal private providers. Given this substantial role, it is crucial for the public sector to engage the private sector and vice versa—referred to as private sector engagement (PSE). As a first step towards PSE, we aimed to understand the current status of PSE in health within the African Region. Methods This study employed a descriptive case study approach, which was based on (i) a survey of stakeholders from the public sector, private sector, and development partners, as well as (ii) presentations and deliberations at a WHO-hosted multi-country consultation in the African Region on PSE to advance progress towards Universal Health Coverage. Results The findings demonstrate that the private sector plays a significant role in health systems in the African Region, with increasing momentum for dialogue on PSE in health in selected countries. For instance, a multi-stakeholder analysis and dialogue was conducted in Nigeria; a strategy to strengthen the health system through the private sector was developed in Senegal; and a PSE Forum was held and a technical working group was established in Sierra Leone. Conclusions Ultimately, the study underscores how increased dialogue on PSE offers an opportunity to adopt more multisectoral, whole-of-society approaches and calls on stakeholders to take action.