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The private sector has emerged as a crucial source of maternal, newborn, and child health (MNCH) care in many low- and middle-income countries (LMICs). Quality within the MNCH private sector varies and has not been established systematically. This study systematically reviews findings on private-sector delivery of quality MNCH care in LMICs through the six domains of quality care (QoC) (i.e., efficiency, equity, effectiveness, people-centered care, safety, and timeliness). 

The review underscores the need for clearer definitions of “quality” and practical QoC measures, central to the success of Sustainable Development Goals (SDGs) and equitable health outcomes. This research addresses how quality MNCH care has been defined and operationalized to understand how quality is delivered across the private health sector and the larger health system.

Overview

The purpose of this workbook is to assist ministries of health, health managers and practitioners in engaging with the private sector on delivery of quality maternal, newborn and child health (MNCH) services in lower- and middle-income countries. Private health care is one of the fastest growing segments of the health-care system in lower- and middle-income countries, and private providers are an important source of health care. To accelerate progress to reach the Sustainable Development Goals for ending preventable maternal, newborn and child deaths, it is critical that whole health system organizations invest not only in increasing coverage of interventions, but also in quality. The audience for the workbook is those who are involved with organizing and implementing processes for engaging the private sector in delivery of quality MNCH services.

There is a clear need to find ways to effectively harness and steer the public, private and civic sectors to achieve the Sustainable Development Goal (SDG) target 3.8 on universal health coverage (UHC) (1). Effective engagement of the private sector in health can maximize countries’ efforts to secure financial risk protection and ensure access to quality essential health-care services as well as safe, effective, quality and affordable essential medicines and vaccines for all.

This article highlights the growing role of the private healthcare sector in providing maternal and newborn health services in low- and middle-income countries (LMICs), with an increasing number of people seeking care from private providers. The article argues that governments need to engage both the public and private sectors more effectively to improve the quality of care and achieve universal health coverage. While private sector services are often perceived as higher quality, variability in service standards underscores the need for structured government involvement, such as regulatory frameworks, financial incentives, and public-private partnerships.

Examples from countries like Sudan, Mexico, and Bangladesh show the potential of private sector engagement in improving access to essential services, especially during crises like the COVID-19 pandemic. However, challenges remain, such as inconsistent policies and regulatory gaps. The article calls for tailored, context-specific strategies to strengthen collaboration with private providers, ultimately accelerating progress towards universal health coverage and better maternal and newborn health outcomes in LMICs.