Sources of care in mixed health systems

The Global Health Observatory

Explore a world of health data

Most health systems are mixed systems, where goods and services are provided both by the public and private sector, and health consumers are requesting these services from both sectors.. Information on where individuals are seeking care are crucial to generate a better understanding of how those mixed health systems operate. Crucial data include, among others: if individuals are seeking care in the public or in the private sector, how is the demand among the various wealth quintiles, and at what level inpatient and outpatient care are provided by the private sector.

These indicators aim at:

Better understanding where populations are seeking care.
Providing comparable and comprehensive information on sources of care.
Showcasing the importance of private provision of inpatient and outpatient care.
Informing policy and program decision-making about private sector engagement.
Facilitating the sharing of lessons across countries with similar public-private distributions.

Private sector landscape in mixed health systems

Summary findings

The private sector provides up to

40%

of all healthcare services in the PAHO, AFRO, and WPRO regions

The private sector provides

57%

of all healthcare services in the SEARO region

The private sector provides

62%

of all healthcare services in the EMRO region

42%

of outpatient care is sought in the formal private sector

27%

of inpatient care is sought in the formal private sector

33%

of the poorest population (by wealth quintile) seek care in the private sector

Sources of care by WHO region

GHO CARE_SOURCE REGIONAL DONUT CHART TEMPLATE Source of care

Loading report

Sources of care by wealth quintile

GHO CARE_SOURCE COUNTRY CLUSTERED BAR TEMPLATE Source of care

Loading report

Sources of care by type of patient, by country

Table

Indicator name: 
 Care-seeking by type of patient and source of care (%) 
Short name: 
 CARE_SOURCE 

                            Topic:
                        
                                Health systems resources
                            
                                Private sector engagement

Rationale:

This indicator aims at supporting countries to better understand where their populations are seeking care in order to govern their health systems accordingly, to advance the understanding of the importance of private-sector policies, and to facilitate the sharing of lessons across countries with similar public-private distributions.

Definition:

Definition This indicator provides information on where patients are seeking care for inpatient and outpatient health services.

Disaggregation:

Inpatient Outpatient Private Public NGO Informal Wealth quintiles Country WHO regions

Method of measurement

Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS)

Method of estimation:

Direct abstraction from public datasets

Method of estimation of global and regional aggregates:

Method of estimation of regional and global estimates For the most recent survey for countries within each WHO region, data were weighted by country population size for the year of the survey. Wealth quintiles were kept as in the original country data, so the regional analyses by wealth represent the behavior of households in the same relative wealth groups.

Preferred data sources:

Household surveys

Unit of Measure:

Percentage

Expected frequency of data dissemination:

National dissemination of DHS and MICS data happens for each country within 2 years of collect. Multi-country analysis of the kind we have conducted occurs sporadically and future analysis and dissemination is not currently planned.

Expected frequency of data collection:

National DHS and MICS data are collected every 5-10 years.

Contact person email:

Dominic.montagu@ucsf.edu

Name:

Dominic Montagu

IMRID:

5655

Limitations:

The data for each country is cross-sectional and so comparisons between countries with surveys at different times will not perfectly reflect current health seeking practices.

Indicator Metadata Registry List

Related publication

Engaging the private health service delivery sector through governance in mixed health systems: strategy report of the WHO Advisory Group on the Governance of the Private Sector for Universal Health Coverage

The 2030 Sustainable Development Goals (SDGs) emphasize partnership to attain health related goals and Universal Health Coverage (UHC). Although World...

Download