Delivering maternal and child health interventions through the private sector in LMIC: a scoping review of strategies and effective approaches.

Despite growing evidence on the role of private health providers, the global public health response to date has primarily focused on the provision of public sector health services for women and children in low and middle-income countries (LMIC). Limitations of this approach are well documented and include shortage of human resources, inefficient institutional frameworks and inadequate quality especially in rural areas. In order to achieve universal health coverage, it is important to strengthen both the public and private sectors. The objective was to determine effective strategies for engagement with private health providers for maternal and child health in LMIC. A scoping review of both published and grey literature from 2000 to 2023 was undertaken, including papers reporting on either population-level data on the extent of utilisation of the private sector for maternal and child health services in more than one country; or interventions for service provision in the private sector using population-level results in one or more country; or both of the above. PubMed, Embase and Web of Science databases were searched, 362 full-text articles were reviewed and 43 studies were included in the synthesis. Aggregate results were extracted, and content analysis was used to identify engagement strategies/themes. The results confirm that the private sector is the dominant provider of outpatient care for women and children in LMIC, and a significant provider of reproductive and maternal health services including for inpatient care. Effective strategies and recommendations for engagement with private health providers are presented across challenges of private health provider engagement.