Profit in maternal and child health: A four-letter word?

The word “profit” has six letters, but when it comes to delivering healthcare in the developing world, it may as well be a four-letter word. Surely there’s no room for business to make money by providing health services to the more than 3 billion people living on less than $2.50 a day, right?

Wrong – at least according to several important side sessions held at the Women Deliver conference in Kuala Lumpur. However, while the content of these discussions was certainly compelling, the fact that they were merely side sessions was even more notable. How can a conference that focuses on women’s health, power and economic status relegate conversations about the local private sector to the periphery?  

As the world approaches 2015, when the Millennium Development Goals are set to expire, the global development community will transition to Sustainable Development Goals with a new and sharpened focus on economic empowerment. Health, of course, will be a significant component of this agenda, and groups like the WHO have already indicated that universal healthcare will be their priority. But how can development be sustainable – and healthcare be universal – without a clear and central role for health businesses, which are critical components of health systems across the developing world?

Despite certain preconceived notions, the private sector provides an unexpectedly high percentage of care in Africa and South Asia, which bear 85% of the world’s burden of maternal deaths. In Africa, roughly half the population seeks health services from the private sector. This rate exceeds three-quarters of the population in South Asia. And, importantly, private healthcare isn’t just confined to the highest income levels: in places like Nigeria, Uganda and India, the poor use private services almost as much as the wealthy.

The aforementioned side sessions at Women Deliver 2013 harnessed this notion provocatively. In one session entitled “Health Systems Strengthening: The Role of the Private Sector,” Population Services International, USAID, Marie Stopes International and Abt Associates discussed different strategies they’re using to support the private provision of health services, including social franchising, community distribution networks and contracting. Likewise, Merck for Mothers’ “Getting Down to Business” panel showcased other innovative private-sector tactics such as cross subsidies, voucher schemes and networks of maternity clinics.

Unfortunately, these discussions were whispers in a cacophony of efforts to improve the future for our world’s women. But that doesn’t have to be the case.

The conference touched on many important post-2015 themes that better private-sector engagement would not only support, but accelerate. Like improved access to care: the local private sector can get critical products and services to women in hard-to-reach areas at a price they can afford. Like economic empowerment: so much of the private health workforce is comprised of women, offering promising routes towards financial independence and even prosperity. Like sexual and reproductive health rights: health businesses are often rooted in the communities they serve and attuned to their needs, giving women more voice and choice when it comes to seeking care. Like sustainability: the local business community has demonstrated an ability to stay financially solvent while meeting the health needs of their customers.

Alongside governments and civil society, the private sector is only one leg of the health and development tripod. But without it, our efforts to better the lives of women and girls will, naturally, fall flat. Finding ways of supporting health businesses has the potential yield promising opportunities for women in a post-2015 world.

Women Deliver 2013 offered an unprecedented platform for improving the health, power and economic status of women. But if its underlying focus is on sustainable development and universal healthcare, we need the global community to prioritize strategies that engage – and challenge – the private sector to help deliver on these ambitious goals.

Where’s the plenary session on that?