PSPH - Private Sector Partnerships in Health - phase II

Somalia, a low income country in the Horn of Africa, has been ravaged by war and famine that has exerted a significant human and economic cost to the Somali population. This is evidenced by low socio-economic indicators. A lack of social safety nets, a weakened public health infrastrucure and reliance on private health services has resulted in high out-of-pocket spending on health that limits access to health services for the majority of the Somali population.

Swiss TPH has partnered with DT Global who have a strong history in working in emerging markets such as Somalia where the private health sector providers serve a wide spectrum of the population. Somalia has some of the world’s poorest health indicators. Overall, the healthcare system in Somalia remains weak, poorly resourced, and inequitably distributed. Health expenditure remains extremely low with especially severe risk of financial burden on the poor. Somalia’s healthcare market is heavily distorted; for decades, healthcare has primarily been financed through direct funding from external donors, completed with out-of-pocket expenditures by the populace. Nearly half of total health expenditure in Somalia comes from donors, and most public health services provided in country have been provided free of charge by donors through implementing NGOs and UN agencies. This system based on external dependency is fragile and unsustainable.

Meanwhile, Somalia’s private healthcare sector is thriving, with a 60% share of total health expenditure, although it is fragmented, underregulated, and concentrated in urban areas. PSPH seeks to harness the power of the private sector to strengthen the overall healthcare system and improve access to quality and affordable healthcare for all Somalis, including disadvantaged groups.

To address these challenges, PSPH follows a Market Systems Development (MSD) approach, an adaptive, facilitative approach that emphasizes sustainability, system building, and scale. It focuses on two healthcare sub-systems, healthcare finance and healthcare service delivery. PSPH is the only program in Somalia’s health sector that works with the private sector out of 85 donor-funded health programs reported to the UN FTS in 2023. It is recognized as the only dedicated MSD project in the healthcare sector anywhere in the world. PSPH offers only technical assistance and does not provide direct funding to partners.

Swiss TPH leads the technical assistance provided to the PSPH team and identified partners (private sector organizations) in Somalia and Somaliland for the healthcare finance component of the project. The aim is to work with private sector actors to identify, conceptualize, test, pilot and subsequently roll out innovative healthcare financing interventions that improve financial protection and access to care for the mass market in Somalia. This phase follows the first phase of the PSPH project where the first health insurance products (low cost products) were launched by two different private health insurers in Somalia and Somaliland, targetting specifically the mass market.

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