The role of private and other non-governmental organisations in Primary Health Care : Primary Health Care : systems support

The private sector is playing an increasing role in the provision of Primary Health Care through both the for-profit and not-for-profit portions of the sector. In the post-1994 era, the relevance of this sector for the uninsured population has been markedly increased, due to corporate social investment and employee assistance programmes aimed at this population. A dramatic increase in donor-funded, health-related activities, in the HIV and AIDS and tuberculosis fields, has further expanded this sector's involvement in providing Primary Health Care services to a larger proportion of the population. However, this sector has a relative over concentration of skilled human resources, a situation that appears to be immune to all policy attempts to reverse it. Given this reality, serious consideration should be given to finding mechanisms to leverage these resources, so that they can provide services to the larger community. Government proposals, such as those for a social health insurance system, would help better align the population with health care providers and should therefore be encouraged and fast tracked. A mechanism needs to be developed that would allow the contracting of the private sector, including the not-for-profit component, to address current unmet health service delivery needs among the South African population. Not utilising this resource while the public sector annually shows unspent budget allocations for Primary Health Care services makes little sense.