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Abstract Background More than half of the people with Tuberculosis (TB) symptoms in India seek care from the private sector. People with TB getting treatment from private sector in India are considered to be at a higher risk for receiving suboptimal quality of care in terms of incorrect diagnosis and treatment, lack of treatment adherence support with a high loss to follow-up rate that could eventually increase their risk of drug resistance. The current study aims at documenting the approach and efforts taken by the Kerala state to partner with the private health care delivery providers for ensuring quality TB care to the people with presumed TB reaching them. Methods A case study approach was adopted with review of all available literature followed by five Key Informant Interviews to understand the case through a primary descriptive exploration. Grounded theory approach was used to generating the single theory of the case itself that explains it. Results Kerala state has taken a variety of interventions to ensure universal access to TB care for citizens reaching the private sector with documented improvement in the quality of TB care. Key learnings from these initiatives were (i) patients need to be at the centre of partnerships, (ii) good governance is essential for ensuring Universal Health Coverage in a mixed health system, (iii) data intelligence is required to guide partnerships, (iv) identification of the correct ‘problems’ is crucial for effective design of partnerships and (v) a platform for meaningful dialogue of key stakeholders is needed. Conclusion Kerala experience demonstrated that if governments take a proactive role in engaging the private sector, in an informed and evidence-based way, they can leverage the advantages of the private sector while protecting the public health interest.

This study explores the understudied role of privately financed ecosystem service provision in biodiversity conservation, focusing on the example of wildflower strips in Germany. Using qualitative methods, it investigates the diversity of private financing schemes, stakeholder involvement, scheme implementation and farmers motivations to engage in private schemes. The results draw on literature-based stakeholder analysis and expert interviews, including ecologists and practitioners, in three German federal states: Baden-Württemberg, Bavaria and Lower Saxony. Findings include a stakeholder map, the identification of four types of private financing schemes, and the formulation of 17 design criteria covering ecological, economic, and social aspects. These criteria aim to guide providers and sponsors and to emphasise the diverse nature of private wildflower strip financing schemes and their role as crucial links among farmers, the private sector, and society. The study highlights private schemes as viable alternatives to public funding but raises concerns about quality control and coordination with public measures. Combining publicly funded agri-environment schemes with private financing is controversial among stakeholders. Government intervention could formalise the private market, improving control and protection, possibly limiting private sector flexibility and attractiveness due to higher levels of bureaucracy. In any case, transparency in management and financial structures is crucial. Policy recommendations overall include incentivising private sector conservation involvement, offering tax credits for private financing, improving government mechanisms, streamlining coordination of public and private conservation at the landscape level and fostering stakeholder networking. Consequently, this study lays a foundational framework for further exploration into the realm of private financing in biodiversity conservation.

Engaging the private sector in extension services and their direct interaction with farmers contributes to conservation agriculture production systems (CAPS) promotion. This study was conducted to assess influencing factors and mechanisms to engage private sector actors and to rank them to perform their engagement with farmers in an agricultural extension model designed to promote CAPS in Cambodia. The sample size for the survey instrument consisted of 481 randomly selected households, including both CAPS and non-CAPS farmers. For focus group discussions, a purposive sample of 28 participants was used. The positive factors influencing CAPS farmers' engagement with the private sector included gender, number of fields, off-farm income, farm experience, familiarity with the private sector in a commune and government subsidies. In contrast, total land size of main crops, and farmers' perceptions of utilization of private services including a distance of service and increase in profit had a negative impact. Subsidy and incentive programs from the government emerged as highly effective mechanisms for encouraging private sector engagement with farmers. Access to financial institutions was a key priority when engaging the private sector with CAPS farmers. Providing subsidies and incentives is a short-term economic benefit for smallholder farmers that could impact the long-term adoption.

Background: More than half of the people with Tuberculosis (TB) symptoms in India seek care from the private sector. People with TB getting treatment from private sector in India are considered to be at a higher risk for receiving suboptimal quality of care in terms of incorrect diagnosis and treatment, lack of treatment adherence support with a high loss to follow-up rate that could eventually increase their risk of drug resistance. The current study aims at documenting the approach and efforts taken by the Kerala state to partner with the private health care delivery providers for ensuring quality TB care to the people with presumed TB reaching them. Methods: A case study approach was adopted with review of all available literature followed by five Key Informant Interviews to understand the case through a primary descriptive exploration. Grounded theory approach was used to generating the single theory of the case itself that explains it. Results: Kerala state has taken a variety of interventions to ensure universal access to TB care for citizens reaching the private sector with documented improvement in the quality of TB care. Key learnings from these initiatives were (i) patients need to be at the centre of partnerships, (ii) good governance is essential for ensuring Universal Health Coverage in a mixed health system, (iii) data intelligence is required to guide partnerships, (iv) identification of the correct 'problems' is crucial for effective design of partnerships and (v) a platform for meaningful dialogue of key stakeholders is needed. Conclusion: Kerala experience demonstrated that if governments take a proactive role in engaging the private sector, in an informed and evidence-based way, they can leverage the advantages of the private sector while protecting the public health interest. [ABSTRACT FROM AUTHOR]

Objective: Private sector engagement is crucial for the success of health programs, as it brings in additional resources, expertise, and innovation. The main objective of this review is to understand private sector engagement in healthcare delivery. Methodology: A descriptive case study design using an analytical framework was used. Literature from well-researched articles was reviewed. Only articles written in English language between 2012-2022 were considered if they talked about private sector engagement in health delivery. The strategy and procedure involved searching for articles using scholarly search engines, namely Google Scholar, Scopus, and Semantic Scholar. Results: Findings demonstrated an in-depth understanding of the challenges faced by healthcare delivery in developing countries, which included 58.2% of private sector involvement by the government, 34.29% inadequate human resources, 30% inadequate budgetary allocation, and 8.45% bordering on meagre leadership and management. Employing various private sector engagement could provide resources required for strengthened health systems. During COVID-19 pandemic, it was established that four contextual factors were very critical in dealing with the pandemic. Individual features, economic crises, a weak health system, and a multi-sectoral response to COVID-19, were the main important factors established. Other contextual factors that impact the success of private sector involvement included human resource management, financial capacity, and multisectoral response to the pandemic. Conclusion: The private sector plays a critical role in supporting provision of healthcare but is mostly recognized only during health disasters like COVID-19 Pandemic. Challenges faced by healthcare can be addressed when steps to involve the private sector are deliberately made to garner support for provision of healthcare through Private Sector Engagement initiatives for the sustainability of health programs.

Abstract Background The private sector is an important yet underregulated component of the TB treatment infrastructure in India. The Joint Effort for Elimination of Tuberculosis (Project JEET) aims to link private sector TB care with the constellation of social support mechanisms available through the Indian National TB Elimination Programme (NTEP), including the provision of free fixed-dose combination (FDCs) drugs to patients. This quasi-experimental study analysed routinely collected data to determine the impact of free drugs on patient follow-ups and treatment outcomes. Methods We used data for private sector patients enrolled with Project JEET who were diagnosed with pulmonary and extrapulmonary TB between 1 January 2019 and 31 March 2020, and completed treatment by 31 December 2021. Propensity score matching was used to create a dataset to compare the number of follow-ups and proportion of successful treatment outcomes for patients on free drugs to a control group who paid out-of-pocket. 11,621 matched pairs were included in the analysis. Logistic regression and ordinary least squares regression models were used to estimate the impact of free drugs on number of follow-ups and treatment success, where latter is defined as treatment completion or cure. Results After controlling for potential confounders, patients on free drugs received on average 2.522 (95% C.I.: 2.325 to 2.719) additional follow-ups compared to patients who paid out of pocket. This equates to a 25% mean and 32% median increase in follow-ups for patients availing free drugs. For treatment success, patients receiving free drugs had 45% higher odds of a successful treatment (Odds Ratio: 1.452, 95% C.I.: 1.288 to 1.637). Conclusions Patients receiving free drugs were found to follow up with their treatment coordinator more frequently, in part likely to enable drug refilling, compared to patients who were paying out of pocket. These additional contacts would have offered opportunities to address concerns regarding side effects, provide additional treatment information, and connect with social support services, all of which subsequently contributed to patients’ continual engagement with their treatment. This potentially represents the unmeasured effect of free drugs on continual social support, which translates into a higher odds of treatment success for patients.

Background: Reported coverage estimates for vaccine have the inherent problem of missing private entity data, to circumvent this, the National Health Mission, Ernakulam, designed and implemented an Immunization Information System (IIS) to collect routine vaccination reports from the private sector. This study attempted to identify the barriers to reporting by the private sector. Methodology: The study was conducted in Kerala's Ernakulam district. The design of the study was cross-sectional. The end–users, who are from the private sector, were the participants of 28 in-depth interviews in the study. Results: The new reporting system has increased private sector involvement in information exchange, all 78 private hospitals (100%) were reporting to NHM Ernakulam. But the completeness of reporting was not uniform. Major barriers identified were the lack of IIS interoperability with the hospital information system (HIS) being used by the private hospitals, variance because of lack of training of staff entering the data, and the unavailability of dedicated staff for reporting data. Conclusion: Addressing these barriers could improve the reporting of routine vaccination data from the private sector.

Background: The private sector is an important yet underregulated component of the TB treatment infrastructure in India. The Joint Effort for Elimination of Tuberculosis (Project JEET) aims to link private sector TB care with the constellation of social support mechanisms available through the Indian National TB Elimination Programme (NTEP), including the provision of free fixed-dose combination (FDCs) drugs to patients. This quasi-experimental study analysed routinely collected data to determine the impact of free drugs on patient follow-ups and treatment outcomes. Methods: We used data for private sector patients enrolled with Project JEET who were diagnosed with pulmonary and extrapulmonary TB between 1 and 2019 and 31 March 2020, and completed treatment by 31 December 2021. Propensity score matching was used to create a dataset to compare the number of follow-ups and proportion of successful treatment outcomes for patients on free drugs to a control group who paid out-of-pocket. 11,621 matched pairs were included in the analysis. Logistic regression and ordinary least squares regression models were used to estimate the impact of free drugs on number of follow-ups and treatment success, where latter is defined as treatment completion or cure. Results: After controlling for potential confounders, patients on free drugs received on average 2.522 (95% C.I.: 2.325 to 2.719) additional follow-ups compared to patients who paid out of pocket. This equates to a 25% mean and 32% median increase in follow-ups for patients availing free drugs. For treatment success, patients receiving free drugs had 45% higher odds of a successful treatment (Odds Ratio: 1.452, 95% C.I.: 1.288 to 1.637). Conclusions: Patients receiving free drugs were found to follow up with their treatment coordinator more frequently, in part likely to enable drug refilling, compared to patients who were paying out of pocket. These additional contacts would have offered opportunities to address concerns regarding side effects, provide additional treatment information, and connect with social support services, all of which subsequently contributed to patients' continual engagement with their treatment. This potentially represents the unmeasured effect of free drugs on continual social support, which translates into a higher odds of treatment success for patients. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has not only affected public health but has also significantly impacted the economy. Bandung, a bustling city in Indonesia serving as a satellite to the capital, has been hit hard due to its high population density, mobility, and reliance on the tourism, trade, and transportation sectors. Using a Computable General Equilibrium (CGE) model developed at the interregional level of Indonesia, this study investigates the microeconomic indicators of several economic activities in Bandung, namely, the transportation, accommodation and food–beverage, water supply, and trade (MSMEs) sectors, to assess the impact of the pandemic. Additionally, the study examines the role of private sector actors in contributing to the sustainable recovery efforts toward achieving the Sustainable Development Goals (SDGs) amidst the pandemic. The findings reveal that Bandung's transportation, accommodation, food and beverage, water supply, and trade sectors experienced a significant decline in economic activity. However, there was a gradual recovery, with increased economic activity between 2019 and 2021. Private sector actors and the health sector were the main drivers of economic recovery, with other sectors also contributing to the effort. [ABSTRACT FROM AUTHOR]

• A global framework for potential private sector investment targets. • Two-thirds of the world's population could benefit from private sector interventions. • Middle-income countries realize greatest benefits from private sector investments. Water security remains a critical global development challenge, compounded by persistent public funding shortfalls. Society urgently needs to identify opportunities for innovative private sector engagement in water security solutions. To identify feasible and impactful solutions, quantitative tools are needed to delineate complex environmental and socioeconomic water challenges and prioritize private sector investment opportunity spaces to address these challenges. We introduce the first global and regional-scale maps showing where threats to water security coincide with private sector opportunities to address them. The successful deployment of water solutions is contingent upon the societal and governance landscape that underpins a nation's capacity to support sustainable water threat interventions and water-related business activities. By delineating areas with substantial pressures on water resources and assessing nations' enabling environments to support private sector investments, we find nearly two-thirds of the world's population could benefit from private sector interventions today, with middle income countries realizing the greatest benefits. In the face of global economic development and climate change, such solutions will become increasingly essential in future decades. [ABSTRACT FROM AUTHOR]

Abstract Background The private sector plays a large role in malaria treatment provision in Nigeria. To improve access to, and affordability of, quality-assured artemisinin-based combination therapy (QA-ACT) within this sector, the Affordable Medicines Facility-Malaria began operations in 2010 and transitioned to a private sector co-payment mechanism (PSCM) until 2017. To assess the impact of the scheme on the ACT market, cross-sectional household and outlet surveys were conducted in 2018 to coincide with the final stockages of ACT medicines procured under the PSCM. Methods An outlet survey was conducted targeting private pharmacies and Proprietary and Patent Medicine Vendors (PPMVs) across different regions of Nigeria to assess supply-side market factors related to availability and cost of anti-malarials, including artemisinin-based combinations subsidised under the PSCM (called green leaf ACT on account of their green leaf logo) and those not subsidised (non-green leaf ACT). A concurrent household survey was conducted to determine demand-side factors related to treatment-seeking practices, ACT brand preference and purchase decision. Data were compared with previous ACTWatch surveys to consider change over time. Results Availability of artemisinin-based combinations increased significantly over the PSCM period and was almost universal by the time of the 2018 market survey. This increase was seen particularly among PPMVs. While the cost of green leaf ACT remained relatively stable over time, the cost of non-green leaf ACT reduced significantly so that by 2018 they had equivalent affordability. Unsubsidised brands were also available in different formulations and dosages, with double-strength artemisinin-based combination reported as the most frequently purchased dosage type, and child artemisinin-based combinations popular in suspension and dispersible forms (forms not subsidised by the PSCM). Conclusions The PSCM had a clear impact on increasing not only the reach of subsidized QA brands, but also of non-subsidised brands. Increased market competition led to innovation from unsubsidised brands and large reductions in costs to make them competitive with subsidised brands. Concerns are drawn from the large market share that non-QA brands have managed to gain as well as the continued market share of oral artemisinin monotherapies. Continued monitoring of the market is recommended, along with improved local capacity for QA-certification and monitoring.

Private sector engagement (PSE) is increasingly acknowledged in both literature and practice as a necessary mechanism to sustainably address development challenges. Despite increased practitioner and academic interest in these partnerships, there have been negligible attempts to systematically investigate cross‐sector partnerships to distill best practices from the multiple environments in which they are employed. This manuscript presents a robust review of the social science and business literatures on cross‐sector partnerships, yielding an interdisciplinary, evidence‐based framework detailing archetypes of three prominent partnership characteristics of purpose, context, and relationship enablers. This work integrates a wide range of best practices and values pertinent to businesses and society, enabling researchers, practitioners, and partnership managers to characterize and evaluate partnerships systematically. The introduced framework also enables partners to situate and evaluate their partnership activities to optimize outcomes for each partner and impact on the challenge at hand. [ABSTRACT FROM AUTHOR]

Background: To avoid misuse of anti-malarials, correct diagnosis of fever prior to drug prescription is essential. Presumptive treatment in the private healthcare sector is a concern in Nigeria, where availability of affordable artemisinin-based combination therapy (ACT) is high following the implementation of subsidy schemes from 2010 to 2017. Similar subsidies have not, however, been implemented for malaria rapid diagnostic tests (RDTs). A market survey in 2018 predominantly designed to assess the ACT market in the private sector also collected data related to RDTs, results of which are presented herein. Methods: A 2018 market survey consisted of (i) an outlet survey targeting private pharmacies and Proprietary and Patent Medicine Vendors (PPMVs) across different regions of Nigeria to assess supply-side market factors related to availability of RDTs (defined as having stock available for purchase at the time of the survey) and (ii) a household survey to determine demand-side factors related to knowledge of RDTs, healthcare-seeking practices and affordability. Results: Availability of RDTs at the time of the survey was low in both outlet types and significantly lower in PPMVs (22.1%, 95% CI) among pharmacies versus (13.6%, 95% CI) among PPMVs (p < 0.01). Reasons for not restocking RDTs included low demand and no supply. The majority of households diagnose malaria based on experience, while one-third would visit a PPMV or pharmacy. Half of households had heard of RDTs (48.4%) and 38.6% thought they were affordable. Conclusions: Low availability of RDTs among PPMVs and pharmacies may be attributed to lack of demand, supply-side issues and cost. Increasing household knowledge of RDTs may aid increasing demand, while subsidized RDTs may address supply and price issues. Addressing the deficit in RDT provision is important for targeting of ACT medicines. [ABSTRACT FROM AUTHOR]

More than half of the people with TB in India seek care from the private sector, where suboptimal quality of care is a concern. Significant progress has been made over the last five years to expand the coverage and to involve more private sector providers in TB care under the National TB Elimination Program (NTEP) in India. The objective of this review is to describe the major efforts and the progress made with regard to the engagement of the ‘for-profit’ private health service delivery sector for TB care in India, to critically discuss this, and to suggest the way forward. We described the recent efforts by the NTEP for private sector engagement based on the literature, including strategy documents, guidelines, annual reports, evaluation studies, and critically looked at the strategies against the vision of partnership. The NTEP has taken a variety of approaches, including education, regulation, provision of cost-free TB services, incentives, and partnership schemes to engage the private sector. As a result of all these interventions, private sector contribution has increased substantially, including TB notification, follow-up, and treatment success. However, these still fall short of achieving the set targets. Strategies were focused more towards the purchase of services rather than creating sustainable partnerships. There are no major strategies to engage the diverse set of providers, including informal health care providers and chemists, who are the first point of contact for a significant number of people with TB. India needs an integrated private sector engagement policy focusing on ensuring standards of TB care for every citizen. The NTEP should adopt an approach specifically tailored to the various categories of providers. For meaningful inclusion of the private sector, it is also essential to build understanding and generate data intelligence for better decision making, strengthen the platforms for engagement, and expand the social insurance coverage.

Background: The private sector plays a large role in malaria treatment provision in Nigeria. To improve access to, and affordability of, quality-assured artemisinin-based combination therapy (QA-ACT) within this sector, the Affordable Medicines Facility-Malaria began operations in 2010 and transitioned to a private sector co-payment mechanism (PSCM) until 2017. To assess the impact of the scheme on the ACT market, cross-sectional household and outlet surveys were conducted in 2018 to coincide with the final stockages of ACT medicines procured under the PSCM. Methods: An outlet survey was conducted targeting private pharmacies and Proprietary and Patent Medicine Vendors (PPMVs) across different regions of Nigeria to assess supply-side market factors related to availability and cost of anti-malarials, including artemisinin-based combinations subsidised under the PSCM (called green leaf ACT on account of their green leaf logo) and those not subsidised (non-green leaf ACT). A concurrent household survey was conducted to determine demand-side factors related to treatment-seeking practices, ACT brand preference and purchase decision. Data were compared with previous ACTWatch surveys to consider change over time. Results: Availability of artemisinin-based combinations increased significantly over the PSCM period and was almost universal by the time of the 2018 market survey. This increase was seen particularly among PPMVs. While the cost of green leaf ACT remained relatively stable over time, the cost of non-green leaf ACT reduced significantly so that by 2018 they had equivalent affordability. Unsubsidised brands were also available in different formulations and dosages, with double-strength artemisinin-based combination reported as the most frequently purchased dosage type, and child artemisinin-based combinations popular in suspension and dispersible forms (forms not subsidised by the PSCM). Conclusions: The PSCM had a clear impact on increasing not only the reach of subsidized QA brands, but also of non-subsidised brands. Increased market competition led to innovation from unsubsidised brands and large reductions in costs to make them competitive with subsidised brands. Concerns are drawn from the large market share that non-QA brands have managed to gain as well as the continued market share of oral artemisinin monotherapies. Continued monitoring of the market is recommended, along with improved local capacity for QA-certification and monitoring. [ABSTRACT FROM AUTHOR]

This paper seeks to learn lessons about the role of the private sector in subnational governance by analysing the UK's Local Enterprise Partnerships (LEPs). The paper outlines the public justifications for LEPs using documentary analysis, and then considers these against findings from interviews and network analysis, concluding that the justifications are problematic. LEPs were established on the assumption that civic and business leaders needed to be brought together in business-led institutions. However, network analysis shows most civic leaders also hold private sector roles, undermining the assumed need for a 'bringing together'. Three further justifications of the LEP model are also challenged. Firstly, business leaders were supposed to enable knowledge flows, but analysis shows that this knowledge is skewed by unrepresentative LEP boards. Secondly, it was assumed that LEPs would catalyse networks, but the networks have been built around individual interests, without transparency. Finally, LEPs were meant to mirror business structures, but this has undermined democratic accountability. Taken together, these findings suggest that the creation of LEPs has attempted to solve the wrong problem in the wrong way. The paper concludes by proposing guiding principles for the role of the private sector in the Levelling Up agenda: representation, transparency and accountability. [ABSTRACT FROM AUTHOR]

Abstract Background Haiti and the Dominican Republic (DR) are targeting malaria elimination by 2022. The private health sector has been relatively unengaged in these efforts, even though most primary health care in Haiti is provided by non-state actors, and many people use traditional medicine. Data on private health sector participation in malaria elimination efforts are lacking, as are data on care-seeking behaviour of patients in the private health sector. This study sought to describe the role of private health sector providers, care-seeking behaviour of individuals at high risk of malaria, and possible means of engaging the private health sector in Hispaniola’s malaria elimination efforts. Methods In-depth interviews with 26 key informants (e.g. government officials), 62 private providers, and 63 patients of private providers, as well as 12 focus group discussions (FGDs) with community members, were conducted within seven study sites in Haiti and the DR. FGDs focused on local definitions of the private health sector and identified private providers for interview recruitment, while interviews focused on private health sector participation in malaria elimination activities and treatment-seeking behaviour of febrile individuals. Results Interviews revealed that self-medication is the most common first step in the trajectory of care for fevers in both Haiti and the DR. Traditional medicine is more commonly used in Haiti than in the DR, with many patients seeking care from traditional healers before, during, and/or after care in the formal health sector. Private providers were interested in participating in malaria elimination efforts but emphasized the need for ongoing support and training. Key informants agreed that the private health sector needs to be engaged, especially traditional healers in Haiti. The Haitian migrant population was reported to be one of the most at-risk groups by participants from both countries. Conclusion Malaria elimination efforts across Hispaniola could be enhanced by engaging traditional healers in Haiti and other private providers with ongoing support and trainings; directing educational messaging to encourage proper treatment-seeking behaviour; and refining cross-border strategies for surveillance of the high-risk migrant population. Increasing distribution of rapid diagnostic tests (RDTs) and bi-therapy to select private health sector facilities, accompanied by adopting regulatory policies, could help increase numbers of reported and correctly treated malaria cases.

Objective: To understand if, and how, Australian ultra-processed food industry actors use Twitter to influence food and health policy debates and produce a conceptual framework to describe such influence.Design: Twitter data of prominent industry actors were defined through purposive sampling and inductively coded to investigate possible influence on food and health policy debates. These are described using descriptive statistics and coded extracts.Setting: Australia.Participants: Twitter accounts of nine prominent ultra-processed food industry actors, including major trade associations.Results: Ultra-processed food industry actors actively used Twitter to influence food and health policy debates. Seven overarching strategies were identified: co-opting public health narratives; opposing regulation; supporting voluntary, co- or self-regulation; engaging policy processes and decision-makers; linking regulatory environments to the need for ongoing profitability; affecting public perceptions and value judgements; and using ignorance claims to distort policy narratives. Each lobbying strategy is underpinned with tactics described throughout and captured in a framework.Conclusions: The current study creates a framework to monitor how food industry actors can use social media to influence food and health policy debates. As such, social media appears to be not only an important commercial determinant of health for brand marketing, but also an extension of lobbying practices to reshape public perceptions of corporate conduct and policy-making. [ABSTRACT FROM AUTHOR]

Abstract Background Inadequate access to quality health care services due to weak health systems and recurrent public health emergencies are impediments to the attainment of Universal Health Coverage and health security in Africa. To discuss these challenges and deliberate on plausible solutions, the World Health Organization Regional Office for Africa, in collaboration with the Government of Cabo Verde, convened the second Africa Health Forum in Praia, Cabo Verde on 26–28 March 2019, under the theme Achieving Universal Health Coverage and Health Security: The Africa We Want to See. Methods The Forum was conducted through technical sessions consisting of high-level, moderated panel discussions on specific themes, some of them preceded by keynote addresses. There were booth exhibitions by Member States, World Health Organization and other organizations to facilitate information exchanges. A Communiqué highlighting the recommendations of the Forum was issued during the closing ceremony. More than 750 participants attended. Relevant information from the report of the Forum and notes by the authors were extracted and synthesized into these proceedings. Conclusions The Forum participants agreed that the role of community engagement and participation in the attainment of Universal Health Coverage, health security and ultimately the Sustainable Development Goals cannot be overemphasized. The public sector of Africa alone cannot achieve these three interrelated goals; other partners, such as the private sector, must be engaged. Technological innovations will be a key driver of the attainment of these goals; hence, there is need to harness the comparative advantages that they offer. Attainment of the three goals is also intertwined – achieving one paves the way for achieving the others. Thus, there is need for integrated public health approaches in the planning and implementation of interventions aimed at achieving them. Recommendations To ensure that the recommendations of this Forum are translated into concrete actions in a sustainable manner, we call on African Ministers of Health to ensure their integration into national health sector policies and strategic documents and to provide the necessary leadership required for their implementation. We also call on partners to mainstream these recommendations into their ongoing support to World Health Organization African Member States.

Introduction: Engaging the private sector effectively has been considered as the single most important intervention required for Revised National TB Control Program (RNTCP) to achieve the overall goal of universal access and early detection. This study attempts to identify the barriers and facilitators in the involvement of private practioners in signed schemes of RNTCP. Materials and Methods: Six focus group discussions - four among private sector doctors and two among RNTCP TB key workers and 10 key informant interviews were conducted. Themes were divided into private sector involvement in RNTCP, barriers for private sector involvement, facilitators for private sector involvement and suggestions for better PPP. Results: General feel was that private sector involvement in RNTCP was increasing. Public sector at ground level has not really understood the need to engage the private sector. Lack of capacity for public sector staff to understand and deal with private sector, power relations and not taking hospital managements to trust emerged as important barriers for engagement while private sector doctors expressed concerns over patient confidentiality and patient choices, apprehension of losing patients, inability of program to keep commitments and timely payments, poor recognition to private sector, bureaucratic hurdles and cumbersome formalities. Building locally customised partnership schemes, behaviour change for PPP, building managerial capacity of Public sector to deal with private sector, presence of an interphase agency and quality control through a participatory body were important suggestions for improvement of PPP. Conclusion: Strategies have to be formulated to customise partnership for private sector doctors using the flexibilities of the program. Strengthening PPP will be possible in presence of strong administrative will and the understanding that personal relationships are the best key to Public Private Partnerships.

Health systems across the world have been baffled by the COVID19 pandemic. Tuberculosis (TB) care and prevention especially in high burden countries has faced disruption to their routine services. Though these setbacks were predicted by many modelling studies, reports and surveys from the field convey the hard reality faced by the TB services. However, health systems have not given up and have become resilient by adapting interesting strategies to overcome these obstacles. The private health sector has also stepped up to the occasion by supporting national TB programs through innovative approaches. The scientific community has laid down several evidence-based recommendations to help TB programs get back on track. Its time to unite these forces to not just overcome the challenge posed by the pandemic but also to build a more resilient health system.

Abstract Background The global travel and tourism industry has been rapidly expanding in the past decades. The traditional focus on border screening, and by airline and cruise industries may be inadequate due to the incubation period of an infectious disease. This case study highlights the potential role of the hotel industry in epidemic preparedness and response. Methods This case study focuses on the epidemic outbreaks of SARS in 2003 and H1N1 swine flu in 2009 in Hong Kong, and the subsequent guidelines published by the health authority in relation to the hotel industry in Hong Kong which provide the backbone for discussion. Results The Metropole Hotel hastened the international spread of the 2003 SARS outbreak by the index case infecting visitors from Singapore, Vietnam, Canada as well as local people via close contact with the index case and the environmental contamination. The one-week quarantine of more than 300 guests and staff at the Metropark Hotel during the 2009 H1N1 swine flu exposed gaps in the partnership with the hotel industry. The subsequent guidelines for the hotel industry from the Centre of Health Protection focused largely on the maintenance of hygiene within the hotel premises. Conclusion Positive collaborations may bring about effective preparedness across the health and the tourism sectors for future epidemics. Regular hygiene surveillance at hotel facilities, and developing coordination mechanism for impending epidemics on the use of screening, swift reporting and isolation of infected persons may help mitigate the impact of future events. Preparedness and contingency plans for infectious disease control for the hotel industry requires continuous engagement and dialogue.

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Abstract Background In malaria elimination settings, all malaria cases must be identified, documented and investigated. To facilitate complete and timely reporting of all malaria cases and effective case management and follow-up, engagement with private providers is essential, particularly in settings where the private sector is a major source of healthcare. However, research on the role and performance of the private sector in malaria diagnosis, case management and reporting in malaria elimination settings is limited. Moreover, the most effective strategies for private sector engagement in malaria elimination settings remain unclear. Methods Twenty-five experts in malaria elimination, disease surveillance and private sector engagement were purposively sampled and interviewed. An extensive review of grey and peer-reviewed literature on private sector testing, treatment, and reporting for malaria was performed. Additional in-depth literature review was conducted for six case studies on eliminating and neighbouring countries in Southeast Asia and Southern Africa. Results The private health sector can be categorized based on their commercial orientation or business model (for-profit versus nonprofit) and their regulation status within a country (formal vs informal). A number of potentially effective strategies exist for engaging 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. Facilitating reporting, referral and training linkages between the public and private sectors and making malaria a notifiable disease are important strategies to improve private sector involvement in malaria surveillance. Financial incentives for uptake of rapid diagnostic tests and artemisinin-based combination therapy should be combined with training and community awareness campaigns for improving uptake. Private sector providers can also be organized and better engaged through social franchising, effective regulation, professional organizations and government outreach. Conclusion This review highlights the importance of engaging private sector stakeholders early and often in the development of malaria elimination strategies.

Introduction: Engaging the private sector effectively has been considered as the single most important intervention required for Revised National TB Control Program (RNTCP) to achieve the overall goal of universal access and early detection. This study attempts to identify the barriers and facilitators in the involvement of private practioners in signed schemes of RNTCP. Materials and Methods: Six focus group discussions - four among private sector doctors and two among RNTCP TB key workers and 10 key informant interviews were conducted. Themes were divided into private sector involvement in RNTCP, barriers for private sector involvement, facilitators for private sector involvement and suggestions for better PPP. Results: General feel was that private sector involvement in RNTCP was increasing. Public sector at ground level has not really understood the need to engage the private sector. Lack of capacity for public sector staff to understand and deal with private sector, power relations and not taking hospital managements to trust emerged as important barriers for engagement while private sector doctors expressed concerns over patient confidentiality and patient choices, apprehension of losing patients, inability of program to keep commitments and timely payments, poor recognition to private sector, bureaucratic hurdles and cumbersome formalities. Building locally customised partnership schemes, behaviour change for PPP, building managerial capacity of Public sector to deal with private sector, presence of an interphase agency and quality control through a participatory body were important suggestions for improvement of PPP. Conclusion: Strategies have to be formulated to customise partnership for private sector doctors using the flexibilities of the program. Strengthening PPP will be possible in presence of strong administrative will and the understanding that personal relationships are the best key to Public Private Partnerships. [ABSTRACT FROM AUTHOR]

Background: In malaria elimination settings, all malaria cases must be identified, documented and investigated. To facilitate complete and timely reporting of all malaria cases and effective case management and follow-up, engagement with private providers is essential, particularly in settings where the private sector is a major source of healthcare. However, research on the role and performance of the private sector in malaria diagnosis, case management and reporting in malaria elimination settings is limited. Moreover, the most effective strategies for private sector engagement in malaria elimination settings remain unclear. Methods: Twenty-five experts in malaria elimination, disease surveillance and private sector engagement were purposively sampled and interviewed. An extensive review of grey and peer-reviewed literature on private sector testing, treatment, and reporting for malaria was performed. Additional in-depth literature review was conducted for six case studies on eliminating and neighbouring countries in Southeast Asia and Southern Africa. Results: The private health sector can be categorized based on their commercial orientation or business model (forprofit versus nonprofit) and their regulation status within a country (formal vs informal). A number of potentially effective strategies exist for engaging 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. Facilitating reporting, referral and training linkages between the public and private sectors and making malaria a notifiable disease are important strategies to improve private sector involvement in malaria surveillance. Financial incentives for uptake of rapid diagnostic tests and artemisinin-based combination therapy should be combined with training and community awareness campaigns for improving uptake. Private sector providers can also be organized and better engaged through social franchising, effective regulation, professional organizations and government outreach. Conclusion: This review highlights the importance of engaging private sector stakeholders early and often in the development of malaria elimination strategies. [ABSTRACT FROM AUTHOR]

Reducing emissions from deforestation and forest degradation (REDD+) has emerged as a potentially important component of the global policy mix to mitigate climate change. Against a background of increasing engagement between private sector entities and conservation organizations, private sector investment has emerged in REDD+. Despite slow developments at the international scale, there continues to be private sector interest in REDD+ and continued voluntary investments in REDD+ projects and initiatives. In order to better understand possible models for private sector engagement in REDD+, this study analysed the motivation of private sector stakeholders to engage in REDD+, the perception of the potential of REDD+, the critical obstacles to making REDD+ functional and how actors perceive themselves as part of future REDD+ scenarios. Based on interviews and a workshop with private sector actors, this study found that few expect a regulatory market for REDD+ to emerge and that credits from the voluntary market have to be tailored to specific needs. As a carbon offset, REDD+ provides insufficient motivation for investment, particularly if cheaper alternatives exist. Co-benefits such as biodiversity conservation and community development are more important when traditional corporate social responsibility motivations play a role. Project scale remains important not only for the fact that smaller projects are viewed as offering more visible benefits to stakeholders but also as a means of having more control over risks on the ground, posing a challenge for the design of jurisdictional REDD+. Moving towards supply chains that are free from deforestation offers an opportunity to tackle commodity-driven deforestation. While questions remain about how such an approach might be integrated into REDD+, it could help address a perceived gap between private sector understanding of the values of REDD+ and the risks associated with these values not arising – termed here as a ‘missing middle’. [ABSTRACT FROM AUTHOR]

Achievement of the health-related Millennium Development Goals is dependent on increasing take-up of preventive public health services (PHSs) in developing countries. Poor country governments often lack the resources to provide optimal access to preventive services and a great deal of attention is being directed towards the private sector to fill this void. In many developing countries, the private sector already plays a large role in health care. However, the for-profit private sector has little incentive to provide PHSs. The lack of provision of services by the for-profit sector may create a barrier to take-up of these services. In this study, we use data from a census of health facilities combined with data from community and provider surveys from Kenya to analyse whether the private for-profit sector has lower provision rates of child immunization services, and subsequently whether this creates a barrier that results in lower immunization take-up. We show that only 34% of for-profit facilities provide immunizations and that in areas with a larger share of for-profit providers, children are more likely to have no immunization coverage. Our model predicts that the odds of a child receiving no immunization coverage are 4.8 times higher in areas where all health facilities are for-profit compared to areas with no for-profit facilities. This indicates that a policy of engagement with the private for-profit sector aimed at increasing provision of immunization services may be an effective strategy for increasing take-up. [ABSTRACT FROM PUBLISHER]

Background: While consensus on malaria vector control policy and strategy has stimulated unprecedented political-will, backed by international funding organizations and donors, vector control interventions are expansively being implemented based on assumptions with unequaled successes. This manuscript reports on the strategies, achievements and challenges of the past and contemporary malaria vector control efforts in Zambia. Case description: All available information and accessible archived documentary records on malaria vector control in Zambia were reviewed. Retrospective analysis of routine surveillance data from the Health Management Information System (HMIS), data from population-based household surveys and various operations research reports was conducted to assess the status in implementing policies and strategies. Discussion and evaluation: Empirical evidence is critical for informing policy decisions and tailoring interventions to local settings. Thus, the World Health Organization (WHO) encourages the adoption of the integrated vector management (IVM) strategy which is a rational decision making process for optimal use of available resources. One of the key features of IVM is capacity building at the operational level to plan, implement, monitor and evaluate vector control and its epidemiological and entomological impact. In Zambia, great progress has been made in implementing WHO-recommended vector control policies and strategies within the context of the IVM Global Strategic framework with strong adherence to its five key attributes. Conclusions: The country has solid, consistent and coordinated policies, strategies and guidelines for malaria vector control. The Zambian experience demonstrates the significance of a coordinated multi-pronged IVM approach effectively operationalized within the context of a national health system [ABSTRACT FROM AUTHOR]

One consequence of the economic downturn and pressure for public sector reform is a renewed focus upon private sector engagement (PSE) within subnational economic governance. Yet past attempts to promote PSE within urban and regional development policy and governance have been routinely characterised by the partial and uneven involvement of business interests. Adopting a strategic-relational approach, and building upon insights from the developing literature on business-society relations, this paper critically examines how PSE unfolded in a specifi c spatial and temporal context, through empirical investigation of the evolution of the City Growth Strategy as realised within two areas in London. This analysis explores the diff erence between policy script and business performance and identifi es key dimensions of material self-interest, nonmarketbased rationales, and divergent private/public discourses as critical to the selective nature of emergent PSE strategies and tactics. Critically, these issues remain largely unaddressed within current moves to put in place a private sector led subnational agenda, with clear consequences for understanding its likely impact across diff erentially constituted urban and regional contexts. [ABSTRACT FROM AUTHOR]

Greenhouse gas emission reduction and decarbonization goals drive citizens' interests in alternative fuel vehicles and have created fast-growing demands on alternative fuels. While governments are promoting the transition to alternative fuel vehicles, the lack of refueling and recharging infrastructure for the vehicles is a key barrier to the adoption. At the same time, the public sector cannot solely provide needed alternative fueling infrastructure due to limited financial resources. Consequently, governments in the U.S. have been working on facilitating the private sector's investment in alternative fueling infrastructure. The most common approach was financial incentive programs and policies, but the U.S. also promotes self-organized collaborative governance of alternative fuels across sectors at the local level. This paper asks whether these two approaches stimulate the private sector's engagement in providing alternative fueling infrastructure. This study uses the case of the Clean Cities program that targets the reduction in petroleum usage, adoption of alternative fuels and creation of self-governance at the local level. Local private businesses, local government agencies and non-profit organizations voluntarily participate in the local transition to alternative fuels. Therefore, this governance aims at facilitating more sustainable actions and business choices in the private sector. This paper tests the hypotheses of whether the local self-governance of Clean Cities increases privately-owned alternative fueling infrastructure using panel fixed-effects Poisson regression models. Based on the data of counties in 12 states from 2004 to 2015, the results of empirical analysis suggest that both self-governance and financial incentive programs are effective in increasing the engagement of private actors in providing alternative fueling infrastructure. [ABSTRACT FROM AUTHOR]