Public-private dialogue: an essential approach to engage non-state actors in a mixed health system

Evidence shows that low-income and middle-income country (LMIC) governments are still facing challenges to systematically engage the private sector in health. Barriers to greater interactions between public and private health partners include mistrust of the private health sector's motives and misunderstanding of the profit motive, based on deep-rooted philosophical beliefs and personal experiences.This paper examines the implementation of public-private dialogue (PPD) as a means for addressing the aforementioned barriers facing the engagement of the private sector in health in LMICs. The paper responds to a research gap surrounding the process of conducting PPD in health by defining PPD, describing the associated risks and benefits learnt from country examples and providing tactics for leveraging the benefits while addressing the potential risks of PPD. The paper also emphasises the similarities between the process to conduct PPDs in health compared with other social and economic sectors, with the exception of one additional risk, namely 'institutional misalignment'. This additional risk observed in the health sector can be attributed to the limited capacity of Ministries of Health to govern the private sector and the diversity and fragmentation of private health sector entities.