Private Sector Networks

The health care private sector plays a large role in the delivery of high-quality care services in many healthcare systems around the world. In sub-Saharan Africa, the private sector accounts for over 50% of care provision 1, and in Nigeria, this figure is 60%. As the private sector dominates the sub-Saharan African health provision landscape, the success of the private health care sector will play a significant role in the improvement of overall health outcomes.

Supply of healthcare provision in Nigeria

Private facilities62%
Public facilities38%

Despite the size and expected future growth of the private health sector, there are several challenges that hinder its potential for impact in the overall health system. These include poor and variable quality of care, lack of appropriate data systems for patient information and financial records and heavy fragmentation of the sector that limits the scalability of interventions and activities and creates barriers to accessing much-needed growth capital for the sector.

Physician networks have the potential to play a critical role in the health system by increasing care coordination, expanding access to goods and services, and improving quality of care. Furthermore, by creating a coordinating platform that catalyzes the aggregation of ‘one man shops’ into health facility networks, the private sector will be less fragmented and, better positioned to access critical growth capital. These facility networks will also be well placed to tackle the other resounding issues around data reporting and standardization of the quality of care. In addition, these networks help amplify the voice of the private providers thus enhancing their inclusion in health sector engagement and discourse.

Our Goals

We aim to address certain market failures in service provision through scaling up innovative models for service delivery and quality. Our specific goal in this project is to enhance quality of healthcare, improve data systems and reporting and enhance financial sustainability through establishing and facilitating networks of private healthcare facilities.

hsdf-private-sector-networking-diagram-1To achieve this, we direct our efforts to:

  1. Improve private sector engagement in public health priorities by strengthening data reporting rates and quality of data being reported into the National Health Management Information System.
  2. Improve the quality of care provided by the facilities in the network, and measure this through improvements in clinical care and safety and the development of a capable workforce in which roles and responsibilities are clearly identified.
  3. Improve financial management capabilities of the facilities in the network and ultimately position the facilities to attract impactful investments.

Our Approach

Our approach is divided into two phases. The first phase is focused on reaching and maintaining a baseline standard across all facilities in the network with regards the quality of care provided, data strengthening and financial management.

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Data Strengthening:

We support the facilities to address bottlenecks to effective data reporting and we conduct data quality assessments in line with the national frameworks to ensure data reporting remains consistent and valid. Our target is to reach and maintain good quality DHIS reporting rate from over 90 percent of the network facilities. We are also working to strengthen data and health records through electronic medical record systems.

Quality Improvement:

On a weekly basis, we track the progress of facilities in the network as they implement their quality improvement plans. By doing so, we operationalize an active quality improvement cycle where progress is monitored and corrective actions are implemented where necessary.

Financial Management:

We will support the facilities and the physicians in better understanding financial management approaches with a view to implementing better systems. This phase also tests the feasibility of establishing and maintaining provider networks and understanding the optimal models for networks and the factors that make for successful networks.

The second phase of our engagement focuses on realising the potential of the networks through joint learning, collaborative efforts and resource sharing.

Results

The first phase of the program has been successfully rolled out, with the establishment of six physician networks comprising a total of fifty-five facilities spread across the Lagos mainland. So far, the following have been achieved in the program.

1. To further our objective of improving private sector engagement in public health priorities through data strengthening, all the medical records’ personnel across all 55 network facilities have been trained in data reporting using the National Health Information Management System (NHIMS) tool. Information from the NHMIS tool is fed into the nationally endorsed, district health information system (DHIS) platform and is thereafter publicly accessible and potentially very useful for decision-making at the state and national levels.

2. All 55 network facilities within the 6 networks have been trained in the fundamental healthcare management principles required to achieve basic levels of quality healthcare. These principles include:

  • Risk Management
  • Data Management
  • Patient Rights
  • Infection and Control
  • Leadership and Management

3. Working in collaboration with SafeCare, each facility has been supported to develop a Quality Improvement Plan (QIP) – a stepwise improvement tool to guide implementation of quality activities. Our team continues to support the facilities as they implement these plans through planned training sessions and structured monitoring and evaluation of progress. 4. With our support, each of the facilities has established a fully operational quality improvement team responsible for instituting and tracking quality improvement initiatives.

Ongoing work

Phase 1, which consists of data strengthening and quality improvement efforts across facilities is currently ongoing. Financial management and facility aggregation will follow after these are completed, and then network synergies can be realised.