PT  - JOURNAL ARTICLE
AU  - Gahimbare, Lydia
AU  - Shalita, Nina
AU  - Dumas, Erin Files
AU  - Rodríguez, Mariela
AU  - Moon, Pierre
TI  - Early Lessons From Working With Local Partners to Expand Private-Sector Health Care Networks in Burundi and Mali
AID  - 10.9745/GHSP-D-24-00109
DP  - 2024 Oct 29
TA  - Global Health: Science and Practice
PG  - e2400109
VI  - 12
IP  - 5
4099  - http://www.ghspjournal.org/content/12/5/e2400109.short
4100  - http://www.ghspjournal.org/content/12/5/e2400109.full
SO  - GLOB HEALTH SCI PRACT2024 Oct 29; 12
AB  - Key FindingsWorking with local partners supports the expansion of private health care networks in a form that differs from traditional social franchises and that enables support to and stewardship of a larger number of private health care facilities.Expanded private health care networks include a diverse array of providers and facilities and require flexibility in defining criteria for inclusion, supporting quality of care, and collecting and reporting monitoring data.Some local partners are well positioned to support private health care facilities and represent the private health care sector in national and subnational fora. However, they require support and capacity-strengthening to realize and sustain these roles.Key ImplicationsOne approach to organize the private health care sector and reduce fragmentation is through expanding networks of health facilities, which may be particularly important in low-income and fragile contexts where there is limited stewardship of the private health care sector.Donors and international nongovernmental organizations should continue to invest in and support the capacity-strengthening of local partners if they are to play meaningful roles in improving private health care delivery.The private health care sector is an important source of service delivery in low- and middle-income countries (LMICs). Yet, the private sector remains fragmented, making it difficult for health system actors to support and ensure the availability of quality health care services. In global health programs, social franchising is one model used to engage and organize the private health care sector. Two social franchise networks, ProFam in West Africa and Tunza in East and Central Africa, provide health care through branded networks of facilities. However, these social franchise networks include a limited number of private health care facilities, and in fragile contexts, like Burundi and Mali, they have faced challenges in integrating with national health systems. The MOMENTUM Private Healthcare Delivery (MPHD) project in Burundi and Mali sought to expand the number of health facilities it engaged beyond the existing ProFam and Tunza networks. The expansion aimed to help improve service quality in more private facilities while advancing localization and reducing fragmentation for improved stewardship by health system actors. MPHD achieved this expansion by removing barriers for private health facilities to join inclusive, nonbranded networks and engaging local partners to build and maintain these networks. We share lessons learned regarding the growing role of local organizations as actors within mixed health systems and provide insights on strengthening stewardship of the increasingly heterogeneous private health care delivery sector in LMICs, particularly in fragile settings.