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Moving towards UHC: engaging non-state providers

Edited by Zubin Cyrus Shroff and Krishna Dipankar Rao
International Journal for Equity in Health

Non-state providers (NSPs) of health services – including actors ranging from informal providers, faith-based groups, non-governmental organizations, as well as the formal private sector – play a major role in the delivery of services in many low- and middle-income countries (LMICs). As universal health coverage (UHC) has become a priority for the global health community, understanding the role of various NSPs and how they contribute to reaching this goal is critical.

This special collection pulls together case studies on engaging NSPs from seven countries including Afghanistan, Bangladesh, Bosnia-Herzegovina, Ghana, South Africa, Tanzania, and Uganda – each shedding light on the unique circumstances that influenced NSP engagement in each setting. Based on the evidence from the country studies, a final cross-cutting study examines what lessons can be drawn for effective contracting of NSPs in LMICs by governments eager to explore ways to move more efficiently and effectively towards UHC.

These eight papers review experiences that reflect significant diversity on various axes: the level of socio-economic development; the type of NSP engaged; the means of engagement; and the methods and tools used, which, overall, provides a unique overview of the sector and rich learning opportunities for engaging NSPs.

Alliance for Health Policy and Systems ResearchPublication charges for select articles in this collection were funded by ​​​​​​​the Alliance for Health Policy and Systems Research. Articles have undergone the journal's standard peer-review process overseen by the Guest Editors, who declare no competing interests. 

Read the associated blog: "Moving towards universal health coverage: engaging non-state providers"

View all collections published in International Journal for Equity in Health

  1. Content type: Editorial

    This editorial provides an overview of the special issue “Moving towards UHC: engaging non-state providers”. It begins by describing the rationale underlying the Alliance’s choice of a research program address...

    Authors: Zubin Cyrus Shroff, Krishna Dipankar Rao, Sara Bennett, Ligia Paina, Marie-Gloriose Ingabire and Abdul Ghaffar

    Citation: International Journal for Equity in Health 2018 17:135

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  2. Content type: Research

    A case study was prepared examining government resource contributions (GRCs) to private-not-for-profit (PNFP) providers in Uganda. It focuses on Primary Health Care (PHC) grants to the largest non-profit provi...

    Authors: Aloysius Ssennyonjo, Justine Namakula, Ronald Kasyaba, Sam Orach, Sara Bennett and Freddie Ssengooba

    Citation: International Journal for Equity in Health 2018 17:130

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  3. Content type: Research

    In 2002 Afghanistan’s Ministry of Public Health (MoPH) and its development partners initiated a new paradigm for the health sector by electing to Contract-Out (CO) the Basic Package of Health Services (BPHS) t...

    Authors: Ahmad Shah Salehi, Abdul Tawab Kawa Saljuqi, Nadia Akseer, Krishna Rao and Kathryn Coe

    Citation: International Journal for Equity in Health 2018 17:128

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  4. Content type: Research

    Formal engagement with non-state providers (NSP) is an important strategy in many low-and-middle-income countries for extending coverage of publicly financed health services. The series of country studies revi...

    Authors: Krishna D. Rao, Ligia Paina, Marie-Gloriose Ingabire and Zubin C. Shroff

    Citation: International Journal for Equity in Health 2018 17:127

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  5. Content type: Research

    Governments increasingly recognize the need to engage non-state providers (NSPs) in health systems in order to move successfully towards Universal Health Coverage (UHC). One common approach to engaging NSPs is...

    Authors: Stephen Maluka, Dereck Chitama, Esther Dungumaro, Crecensia Masawe, Krishna Rao and Zubin Shroff

    Citation: International Journal for Equity in Health 2018 17:118

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  6. Content type: Research

    The general practitioner contracting initiative (GPCI) is a health systems strengthening initiative piloted in the first phase of national health insurance (NHI) implementation in South Africa as it progresses...

    Authors: Linda Mureithi, James Michael Burnett, Adam Bertscher and René English

    Citation: International Journal for Equity in Health 2018 17:107

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  7. Content type: Research

    Faith-based non-profit (FBNP) providers have had a long-standing role as non-state, non-profit providers in the Ghanaian health system. They have historically been considered to be important in addressing the ...

    Authors: Annabel Grieve and Jill Olivier

    Citation: International Journal for Equity in Health 2018 17:97

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  8. Content type: Research

    Contracting-out (CO) to non-state providers is used widely to increase access to health care, but it entails many implementation challenges. Using Bangladesh’s two decades of experience with contracting out Ur...

    Authors: Rubana Islam, Shahed Hossain, Farzana Bashar, Shaan Muberra Khan, Adel A. S. Sikder, Sifat Shahana Yusuf and Alayne M. Adams

    Citation: International Journal for Equity in Health 2018 17:93

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  9. Content type: Research

    Regulation of private health care providers (PHPs) in middle-income countries can be challenging. Mandatory safety and quality standards for PHPs have been in place in the Republic of Srpska since 2012, but no...

    Authors: Severin Rakic, Budimka Novakovic, Sinisa Stevic and Jelena Niskanovic

    Citation: International Journal for Equity in Health 2018 17:92

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