Table 1 Sources of data on private health care providers

Household surveys (eg. Demographic and Health Surveys)

Provides household level data on utilization of private providers

Reliance on consumer recall for data on price, quality of services is problematic.

Private providers registered with MOH

Regulatory databases

Informal providers typically not included.

Only basic data on formal providers collected.

While many LMICs have regulatory frameworks for HMIS, enforcement is often partial leading to incomplete or out-of-date information.

Facility surveys (eg. Service Provision Assessment of DHS)

Survey of health facilities covering aspects such availability of services, staffing and resources, and actual services provided

Can include private providers but does not do so routinely.

No regular roster of facility surveys established despite previous discussions among global actors about the importance of such information.

Demographic surveillance sites (eg. Matlab, Bangladesh; Kintampo, Ghana)

Frequent, regular collection of household health data from surveillance sites, including care seeking behavior

INDEPTH (the society of LMIC surveillance sites) is still working on developing better linkages between such data and facility surveys.

While some surveillance data have explored private sector utilization, there remains considerable scope to expand further.

Data collected by payors such as insurance schemes

Typically encompasses data on patient characteristics, diagnosis, services provided, and price of care received

Partial coverage of health insurance schemes in low and middle income countries means that currently such databases typically cover only a small proportion of the population. Further data collected is designed to meet the needs of payors, rather than informing broader policy decisions.

Financial flows (eg. PETS, NHA)

PETS track the flow of government finance through the health care system. NHA includes components that look at private sector financing and expenditure in the private sector

NHA is relatively well developed with respect to the private sector. PETS typically only cover private sector actors, when public funds flow to them.

Routine Health Management Information systems

Routine data typically including health services data

Private providers typically not included, with the exception of notifiable diseases. Extent of enforcement of regulations on notifiable diseases is unclear.

Financial data

Data on company revenues, capital, profitability. Companies and formal private providers typically report to government for tax reasons

Infrequently used in research or linked with other data sources.