Improving Health Markets for the Poor—A Goal Worth Pursuing

We are building the Center for Health Market Innovations (CHMI) because we believe that the poor in developing countries deserve high quality health care without having to pay so much that they go deeper into poverty. Improving the performance of vast, unorganized health marketplaces—with lots of private health care providers, lots of consumer direct spending, and little regulation--will be no easy task. But we think it’s a goal worth pursuing, given the dominance of health markets in many countries.

Over the past few years, we have been collecting and reviewing evidence about the role of private health care providers in developing countries. What we have found complements and underscores years of work by others in the field. Despite the efforts of many governments to provide free care in public facilities, private sector providers are a primary source of care for many people--including the poor. And direct payments from households make up the majority of national health expenditures in many countries. But many of these countries have little or no enforced regulation of private providers, who may or may not have much formal training.

Through our research, we found some reasons to be optimistic. We identified a number of programs around the world that have the potential to improve health markets. Programs that better organize fragmented health care providers—such as franchises and professional associations—make it easier to create standards and provide training. Programs that educate patients can help them become more savvy consumers of care. And a number of new business models developed by social entrepreneurs—many using innovative information technologies—can reduce costs of care or improve access for people in remote areas. Many promising programs are being implemented by NGOs and social entrepreneurs, often with donor support. See the diagram below to learn more about Health Market Innovations.

How Health Market Innovations Work

But we are convinced that governments must play a crucial role if markets are to deliver better results—especially for the poor. Well-functioning health markets require broad stewardship of the entire health system. Governments must see their role as more than just building public hospitals, hiring doctors, and planning public health campaigns.

These will continue to be important functions, of course. But governments must also improve their ability to set quality standards for all care providers and then make sure those standards are enforced. They must develop financing mechanisms that spread health risks and costs across the entire population and ensure that the poor have “purchasing power”. The good news is that a number of countries are starting to realize this. At the May 2010 World Health Assembly, member countries passed a resolution to strengthen the capacity of governments to engage the private sector.

Our goal at CHMI is to work with our many partners to better understand what can be done to improve health markets. We will identify and track promising programs around the world. We will analyze this information and evaluate programs to try to figure out what is working…and what is not working. And we will create better linkages among program implementers, funders, researchers, and policymakers—whose efforts will be crucial to facilitating improvements in health markets. We hope this new CHMI website will support your efforts by furthering your ability to identify a number of different types of promising Health Market Innovations in different countries and make connections with others in the field.

CHMI remains a work in progress. In the coming months, the database of programs will grow significantly as we add more in-country partners to our network and as more users like you suggest programs and contribute information to keep program profiles up-to-date. New in-depth CHMI analyses, which are currently in progress, will be published early next year. We also expect to add new interactive online functions.

In the meantime, please check out the CHMI website and let us know what you think. Watch the How-To Video below to get started!

Learn about the innovative technology Development Seed used to build the CHMI web-platform.

For more background on our health market perspective, read our report on Stewardship of Private Providers in Mixed Health Systems.