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Summary

With funding from the World Bank, ThinkWell conducted a study to inform Mozambique’s Ministry of Health’s (MoH) decisions on a potential partnership with the private sector to provide non-clinical health services. We analyzed experiences of outsourcing non-clinical services in hospitals, mapped existing and potential private sector providers, and assessed public sector’s readiness to migrate from the status quo to a new outsourcing model.

Breaking New Ground

The Mozambican government is exploring strategies to leverage partnership opportunities with private healthcare sector actors. In particular, the Ministry of Health (MoH) wants to explore collaboration in the management and delivery of non-clinical services—ancillary services that do not engage directly with the delivery of preventive or curative care—in hospitals.

In response to this interest and to facilitate synergies between the public and the private health sectors, ThinkWell conducted an explorative study to generate insights from examples of outsourcing non-clinical services, to analyze demand and supply, and to evaluate the public sector’s capacity and interest to engage in outsourcing. The study also looked at the financial and human resources implications.

Challenges

The Mozambican health system is severely under-financed, and research suggests that better outcomes could be achieved through more efficient utilization of available resources. So far, non-clinical services have been largely managed and delivered by the public health system across facilities. However, with limited human resources for health available, MoH strategies and programmatic documents prioritize staff directly involved in clinical service provision and restrict recruitment of non-clinical staff. Collaboration with the private sector and outsourcing of non-clinical services could potentially help increase efficiency and reduce the administrative burden of hospital managers.

Approach

Qualitative data were gathered through MoH, hospital manager, and private provider stakeholder interviews. ThinkWell and the World Bank also jointly undertook a cost-benefit analysis of outsourcing non-clinical services across a sample of five public hospitals in Mozambique for hospital cleaning, catering, laundry, waste management, and security services.

Results

Based on the analysis, conclusions, and recommendations of our report, the MoH will further investigate potential costs and benefits of outsourcing non-clinical services in hospitals. ThinkWell and the World Bank are now planning to pilot outsourcing of selected non-clinical services in two central hospitals.

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