Towards developing new private sector obstetric care and contracting models in South Africa: Insights from public hospitals using private general practitioners to provide caesarean deliveries

Authors

  • G C Solanki Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; NMG Consultants and Actuaries, Cape Town, South Africa
  • T Doherty Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, South Africa
  • V Brijlal Clinton Health Access Initiative, Pretoria, South Africa
  • E Daviaud Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
  • S Fawcus Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Cape Town, South Africa

DOI:

https://doi.org/10.7196/SAMJ.2024.v114i4.1531

Keywords:

Obstetric care, public-private partnership, national health insurance, universal health coverage

Abstract

Maternal healthcare in South Africa faces huge private and public health systems challenges. A key challenge for policy makers is how to address the inappropriate patterns of obstetric care in the private sector and how to mobilise private sector resources to serve the broader population dependent on the public sector, without replicating those patterns of inappropriate care. Developing and implementing new obstetric care models that address these challenges and lend themselves to public private engagements could play a vital role in efforts to improve obstetric care in the country. Drawing on insights from research we carried out on the care and contracting models used by five rural district hospitals in the Western Cape Province to contract private general practitioners to provide caesarean delivery services, this article outlines a potential alternative private sector obstetric care model with the aim of stimulating discussion by all relevant stakeholders on the development of new obstetric models for improving obstetric care in the country.

Author Biographies

  • T Doherty, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, South Africa

    T Doherty (MPH, PhD). Chief Specialist Scientist, Health Economics, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.   Honorary Professor, Department of Paediatric and Child Health, Faculty of Health Sciences, University of Cape Town, South Africa.

  • V Brijlal, Clinton Health Access Initiative, Pretoria, South Africa

     V Brijlal (BCom (Law, Economics), MSc (Economics)),Senior Director, Clinton Health Access Initiative, Pretoria, South Africa. 

  • E Daviaud, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa

    E Daviaud, MSc (Economics, Health Economics),Ex Senior Specialist Scientist (now retired), Health Economics, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa

  • S Fawcus, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Cape Town, South Africa

    S Fawcus,  MA, MB BCh, FRCOG, Senior Scholar and Professor Emeritus, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Cape Town, South Africa

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Published

2024-04-18

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Section

Research

How to Cite

1.
Solanki GC, Doherty T, Brijlal V, Daviaud E, Fawcus S. Towards developing new private sector obstetric care and contracting models in South Africa: Insights from public hospitals using private general practitioners to provide caesarean deliveries. S Afr Med J [Internet]. 2024 Apr. 18 [cited 2024 Apr. 21];114(4):e1531. Available from: https://samajournals.co.za/index.php/samj/article/view/1531

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