Bangladesh should engage the private sector for malaria elimination by 2030

Abstract

ABSTRACTBangladesh reduced malaria by 93% from 2008-2020 through the action of governmental and non-governmental organizations, yet ∼18 million people continue to live at risk of infection. For-profit private healthcare providers, catalytic for malaria elimination in many countries, have not yet been integrated into the national program. By imposing strict definitions on a large and complex literature surrounding private healthcare sector engagement, we distilled eight distinct strategies important in other developing settings: contracting, financing, subsidization, regulation, social franchising, demand-side interventions, infrastructure-building and training. We weighed these in the context of Bangladesh’s flourishing private health care sector—driven by patient demand, self-interest, and aspirations for public good—as well as the heterogeneity in provider capacity and malaria prevalence across districts. We developed a new model dependent on five strategies of subsidization, training, infrastructure building, demand-side intervention, and referral financing, to empower Bangladesh’s phased agenda of eliminating indigenous malaria transmission by 2030.