While healthcare access remains stagnant, private health enterprises thrive.

 While healthcare access remains stagnant, private health enterprises thrive.

In contrast to those in need of healthcare, private health corporations benefit from investments made by development financing institutions from the Global North, according to a new Oxfam research.

According to a recent analysis by Oxfam, development funding from high-income nations and the World Bank that is supposed to improve access to healthcare actually ends up in the pockets of private health businesses. According to the report "Sick Development," even though development finance institutions allocate funds for healthcare in the Global South with the intention of achieving the Sustainable Development Goals (SDGs), the money primarily benefits the private sector with little improvement in healthcare access. These organisations include national ones like the European Investment Bank (EIB) and the World Bank's International Finance Corporation (IFC), as well as regional ones like France's Proparco and the British International Investment.

A total of 358 direct and indirect investments totaling more than USD 5.5 billion were made in different health firms by development financing institutions between 2010 and 2022. The fact that 206 of these investments—amounting to USD 3.2 billion—were made through multi-sector intermediaries makes it more difficult to pinpoint which businesses ended up benefiting. It is more difficult to maintain transparency and accountability in the use of funds because development financing institutions frequently channel their investments through other entities, like the notorious Abraaj Group, which operate through tax havens.

According to a recent Oxfam research, development assistance intended to provide access to healthcare from high-income countries and the World Bank actually finds its way into the pockets of private health companies. Even though development finance organisations fund healthcare in the Global South with the goal of achieving the Sustainable Development Goals (SDGs), according to the report "Sick Development," there has been little progress in improving access to healthcare. These entities range from regional ones like France's Proparco and the British International Investment to national ones like the European Investment Bank (EIB) and the International Finance Corporation (IFC) of the World Bank.

Despite evidence suggesting social protection models provide higher long-term health benefits, investments provided by organisations like Proparco focus on obtaining Universal Health Coverage (UHC), with a preference for health insurance models over others. The private sector is further favoured by prioritising health insurance options, and it is yet unclear how much these models genuinely increase access to healthcare. Many people still find the costs excessively high in nations like Kenya, who have a national health insurance policy, and are forced to pay additional expenses out of pocket, frequently at prohibitively high rates.

Patients are imprisoned in private hospitals.

The examples given in the paper are all too familiar to local campaigners. People frequently sell their possessions to pay for the medical care they require, according to Peninah Khisa, the People's Health Movement (PHM) East and Southern Africa region coordinator. In Kenya, the first thing that springs to mind when private hospitals are mentioned is out-of-pocket expenses, according to Khisa.

She continues by pointing out that some private hospitals in Kenya make a big effort to detain patients as long as possible in order to raise their costs, particularly in situations where the patient has health insurance. Additionally, private hospitals may use what might be referred to as an internal two-tier model, wherein more expensive, higher-quality care is offered by qualified staff. Even yet, according to her, "the higher costs are much exaggerated compared to the services received."

Even though the co-payments may be cheap by Global North standards, people in the Global South may not be able to afford them. The paper claims that even small user fees of $1 or $2 exclude, impoverish, and kill.

Particularly when coercive tactics are used by private healthcare providers to assure payment, this is true. According to a research by Oxfam, the Nairobi Women's Hospital chain in Kenya engaged in the unsettling practise of holding patients hostage until they made full payment on their bills or until their cases attracted public attention. This practise continued at least through the end of 2019 in the report. Schoolchildren, refugees, and postpartum women were among the detained individuals.

According to Peninah Khisa, "Women and girls are the biggest victims of the situation." "Women who are in labour emergencies frequently seek care at local medical institutions to ensure a safe delivery. They then receive hospital bills, which they occasionally fail to pay because of financial difficulties. This results in hospital detention while the bill is being paid, which is against fundamental rights and the right to health, she said in her conclusion. 

Birthing a Child is Expensive.

With expensive costs of birthing at private hospitals—recipients of investments from high-income countries—the prevailing model of development investment also disproportionately affects women and girls outside of Kenya. For instance, the cost of a vaginal delivery in Nigeria's Lagoon hospitals is equivalent to the income of the poorest 50% of the population for nine months. Even more costly private hospitals exist. Given that 91% of Nigeria's poorest women currently give birth without the assistance of a trained midwife or attendant, this is very troubling.

With expensive costs of birthing at private hospitals—recipients of investments from high-income countries—the prevailing model of development investment also disproportionately affects women and girls outside of Kenya. For instance, the cost of a vaginal delivery in Nigeria's Lagoon hospitals is equivalent to the income of the poorest 50% of the population for nine months. Even more costly private hospitals exist. Given that 91% of Nigeria's poorest women currently give birth without the assistance of a trained midwife or attendant, this is very troubling.

The People's Health Movement and Peoples Dispatch jointly publish the fortnightly publication known as People's Health Dispatch. Visit People's Health Dispatch's website for more articles and to sign up.