Implications of dual practice for universal health coverage

Area of Science:

• Health Policy
• Health Workforce Research
• Public Health

Background:

• Universal health coverage (UHC) necessitates a well-resourced and motivated health workforce.
• Dual practice, defined as concurrent employment in public and private healthcare sectors, is a significant but under-researched aspect of health workforce dynamics.
• Limited attention has been given to the trends and implications of dual practice in shaping health systems.

Purpose of the Study:

• To review existing research on dual practice and its relevance to health workforce policies for achieving UHC.
• To identify gaps in the evidence base concerning the impact of dual practice on health system performance and UHC.
• To advocate for specific research methodologies, such as case studies of policy interventions, to address these knowledge gaps.

Main Methods:

• Systematic review of recent research on dual practice.
• Analysis of studies describing characteristics and correlates of dual practice.
• Identification of policy-relevant evidence and research gaps.

Main Results:

• Existing research primarily describes dual practice characteristics, with limited direct evidence for policymakers.
• No studies were found that evaluated the impact of policies on dual practice or its implications for UHC.
• Significant gaps exist in understanding how dual practice influences health workforce availability, motivation, and performance.

Conclusions:

• There is a critical need for more robust, policy-relevant research on dual practice to support UHC goals.
• Case studies of policy interventions targeting dual practice in diverse settings are essential.
• Investment in data collection and dedicated research efforts are required to study this sensitive health systems topic.