Private sector includes both medical and non-medical groups. The medical group consists of mobile drug sellers, drug outlets, cabinets, clinics, hospitals, pharmaceutical companies, etc. The non-medical includes agricultural farm/companies, construction companies located in the forested areas as well as phone/internet companies. Private sector engagement, as part of multi-sectorial collaboration, is crucial for successful malaria control and surveillance programs. In areas with limited public-sector services and access, the private sector can be a resource for creating stronger malaria elimination programs. In many countries, the health private sector is often the first source for seeking health care services. However, there are critical gaps between public and private sector resources such as in the affordability, quality and availability of malaria RDTs and antimalarial between the public and private sector. Malaria elimination strategies should include policies on engaging the private sector to complement services identified as a gap in the public sector. In addition, the non-medical private sector can also contribute to malaria elimination through proper management of their workers, supporting communication services for malaria surveillance in real time alerting and reporting of malaria cases. It is essential to understand the challenges of private sector engagement and possible methods and engagement initiatives.
Challenges to private sector integration into NMCPs:
- Difficulty in comprehending the role and reach of the formal and informal private sector,
- The lack of understanding by NMCPs of the market size and structure of the private sector can make it difficult to formulate appropriate engagement and intervention policies,
- Misunderstanding within the private sector of the importance of reporting and counting all fever cases creates issues of inaccurate data accumulation by malaria surveillance systems,
- Miscommunication issues between the private and public sector on updated national policy, strategy, regulations and protocols along with their compliance and implementation,
- Different levels of diagnostic training, treatment and resources within private sector businesses create issues in providing a standard level of quality in services,
- Limited participation of private providers due to low motivation.
Methods and engagement initiatives for the private sector:
- Conducting a baseline assessment of the private sector is critical to understanding its composition, size, geographical distribution and quality of services provided and their readiness to participation in malaria elimination programmes,
- The use of social marketing or commercialization of health products to expand the delivery of key interventions to target populations (from Malaria Journal),
- Making malaria a notifiable disease (from WHO),
- Financial incentives for uptake of mRDT + artemisinin-based combination therapy combined with training and community awareness campaigns for improving uptake (from Malaria Journal),
- Improving and promoting training, referral, and reporting linkages between the private and public sector by developing better communication and training policies,
- Ensuring private sectors are well informed about updated national policy, new strategy, regulations and protocols along with their compliance and implementation,
- Increasing effective regulations for the private sectors coupled with continuous monitoring systems to enforce a standard level of quality in delivery of health services and reporting requirement,
- Contracting private sector services to meet specific objectives and enforcing regular supervision and monitoring of their performance,
- Issuing acknowledgement and appreciation to the best practices of private providers but also warning and terminating those who do not comply with rules and regulation e.g. unlicensed service, fake/substandard medical products or other harmful action to patients and malaria program,
- Engaging the non-medical private sector in regular forum of the malaria elimination working group updating on malaria situation, seeking contribution and intervention with constant follow up on every forums’ recommendation or action.