Health Programs in Developing Countries
While advances in health care in the developed world often emphasize new technologies, in developing lower- and middle-income countries simply expanding the reach of basic primary care services is crucial to improving health. By providing ready access to basic health services and coordinating care with more specialized services as needed, primary care can reduce hospitalizations and mortality, increase life expectancy, and deliver better overall health. In 2003 a report was published that 63% of child deaths in the 42 countries that account for 90% of global child mortality could be prevented each year through more effective primary care. That is 6 million lives – 100 football stadiums of children – that could be saved each year.
In developing countries, primary care tends to be delivered by a mix of public and private sector providers. Increasingly, private for-profit and non-profit ventures are becoming central to high-quality primary-care services, and scaling these is essential to maximize their impact. While scaling these services is challenging, our research shows that having the right business skills is critical to success.
As we define it, scaling is the process of expanding primary care services to serve more people, with the aim of increasing health impact. There are considerable hurdles to scaling any health service in resource-constrained settings. Primary care delivery faces additional challenges for scaling because it operates on thin margins, often is not highly valued by patients, and has difficulty attracting trained providers. However, some primary care programs are overcoming these barriers and creating successful care models with substantial scale.