TY - JOUR
T1 - Private sector, for-profit health providers in low and middle income countries
T2 - Can they reach the poor at scale?
AU - Tung, Elizabeth
AU - Bennett, Sara
N1 - Funding Information:
NH and CARE were the only two companies that extended care to poorer patients in rural areas, and they did this through their charitable arms and often with the use of technology. For example, each of NH’s rural coronary care units is linked to an NH center via videoconferencing and software that enables rural staff to transmit ECG images for consultation with an NH specialist. This service is supported by the Asia Heart Foundation and is free to clients [15]. CARE Foundation actually pre-dates the for-profit hospital chain. Similarly to NH, part of its mandate has been to expand telemedicine, including installing image sharing software, so that rural patients are able to benefit from specialists who are based in urban areas. Additionally, CARE Foundation has forged a partnership with the government of India and other private foundations to pay for about 500 pediatric heart surgeries a year [16].
Funding Information:
ET was a student at the Johns Hopkins School of Public Health at the time of the work. SB’s work on this paper was partly supported by a grant from the Rockefeller Foundation for work on the Future of Health Markets, (grant number 2011 THS 345) and also by support from the UK Department for International Development through the Future Health Systems consortium (grant number PO 5467).
PY - 2014/6/24
Y1 - 2014/6/24
N2 - Background: The bottom of the pyramid concept suggests that profit can be made in providing goods and services to poor people, when high volume is combined with low margins. To-date there has been very limited empirical evidence from the health sector concerning the scope and potential for such bottom of the pyramid models. This paper analyzes private for-profit (PFP) providers currently offering services to the poor on a large scale, and assesses the future prospects of bottom of the pyramid models in health.Methods: We searched published and grey literature and databases to identify PFP companies that provided more than 40,000 outpatient visits per year, or who covered 15% or more of a particular type of service in their country. For each included provider, we searched for additional information on location, target market, business model and performance, including quality of care.Results: Only 10 large scale PFP providers were identified. The majority of these were in South Asia and most provided specialized services such as eye care. The characteristics of the business models of these firms were found to be similar to non-profit providers studied by other analysts (such as Bhattacharya 2010). They pursued social rather than traditional marketing, partnerships with government, low cost/high volume services and cross-subsidization between different market segments. There was a lack of reliable data concerning these providers.Conclusions: There is very limited evidence to support the notion that large scale bottom of the pyramid models in health offer good prospects for extending services to the poor in the future. In order to be successful PFP providers often require partnerships with government or support from social health insurance schemes. Nonetheless, more reliable and independent data on such schemes is needed.
AB - Background: The bottom of the pyramid concept suggests that profit can be made in providing goods and services to poor people, when high volume is combined with low margins. To-date there has been very limited empirical evidence from the health sector concerning the scope and potential for such bottom of the pyramid models. This paper analyzes private for-profit (PFP) providers currently offering services to the poor on a large scale, and assesses the future prospects of bottom of the pyramid models in health.Methods: We searched published and grey literature and databases to identify PFP companies that provided more than 40,000 outpatient visits per year, or who covered 15% or more of a particular type of service in their country. For each included provider, we searched for additional information on location, target market, business model and performance, including quality of care.Results: Only 10 large scale PFP providers were identified. The majority of these were in South Asia and most provided specialized services such as eye care. The characteristics of the business models of these firms were found to be similar to non-profit providers studied by other analysts (such as Bhattacharya 2010). They pursued social rather than traditional marketing, partnerships with government, low cost/high volume services and cross-subsidization between different market segments. There was a lack of reliable data concerning these providers.Conclusions: There is very limited evidence to support the notion that large scale bottom of the pyramid models in health offer good prospects for extending services to the poor in the future. In order to be successful PFP providers often require partnerships with government or support from social health insurance schemes. Nonetheless, more reliable and independent data on such schemes is needed.
KW - Health market
KW - Private for-profit
KW - Quality of care
KW - Scale
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U2 - 10.1186/1744-8603-10-52
DO - 10.1186/1744-8603-10-52
M3 - Article
C2 - 24961496
AN - SCOPUS:84904095847
SN - 1744-8603
VL - 10
JO - Globalization and health
JF - Globalization and health
IS - 1
M1 - 52
ER -