Summary
MOMENTUM Private Healthcare Delivery (MPHD) is a five-year (2020-2025) global award that seeks to strengthen private provider contributions to maternal, newborn and child health services, voluntary family planning, and reproductive health care (MNCH/FP/RH). The project supports private providers and expands public and private partnerships to strengthen MNCH/FP/RH care.
MPHD is one of a suite of USAID projects that accelerates reductions in maternal, newborn, and child mortality and morbidity in high-burden countries. To do this, the project increases host country commitment and capacity to provide high-quality, integrated health care. MPHD is at heart a “service delivery” program with an emphasis on supply through the mechanism of private providers. At the same time, MPHD recognizes that demand and enabling environment are critically important elements to expanded and sustained health coverage.
ThinkWell is a partner of a global consortium led by Population Services International (PSI), with partners Jhpiego, Avenir Health, and FHI 360. ThinkWell serves as the technical lead on health financing for sustainability of private sector service delivery.
Challenges
Over recent decades, incredible progress has been made to improve outcomes for maternal, newborn, and child health. From 1990 to 2015, the global maternal mortality ratio declined by 44%, with some of the most significant gains coming from RMNCH priority countries. In 2017, global coverage rates for diphtheria-tetanus-pertussis (DTP3) reached 85%, up from 21% in 1980.Globally, use of modern contraception has risen slightly, from 54% in 1990 to 57.4% in 2015.In 2018, there were 48 million additional FP users compared to 2012.
Despite these gains, more remains to be done to ensure that quality MNCH/FP/RH services are provided at scale and sustainably. To advance health systems strengthening across low- and middle-income countries (LMICs), donors make large investments to increase the capacity and knowledge of providers. Donors also make large investments to improve the regulatory and policy environment and alignment of incentives across stakeholders. Yet these efforts focus primarily on public-sector facilities and providers. There are few documented large-scale attempts for comprehensive market systems strengthening across the private sector, including supply chain, provider capacity and motivation, and the creation of a favorable financing context for private providers. In some limited cases, governments have used strategic financing mechanisms to address the challenges of capacity, quality, and motivation seen in the private health care sector. Governments have not systematically leveraged financing mechanisms to improve private-sector MNCH/FP/RH service delivery. Private MNCH/FP/RH providers face unique challenges which undermine their ability to achieve quality at scale and sustainably to meet population health needs.
Approach
ThinkWell strengthens private provider engagement with governments through 1) facilitating private provider engagement with purchasing and 2) improving the coherence of quality schemes.
MPHD has four overarching technical priorities to increase availability of and demand for quality MNCH/FP/RH information, services, and supplies offered by private providers and expanded public and private partnerships. This will help to ensure a total market approach (TMA) for improved health coverage. These technical priorities encompass how MPHD delivers the overarching MOMENTUM suite of improved MNCH/FP/RH care. MPHD’s specific priorities reflect important contributions to market-based solutions that support countries’ Journey to Self-Reliance.
Figure 1. MPHD Key Technical Approaches
