Discerning the role of the private sector in creating health system resilience: A case study in Zambia

The COVID-19 pandemic has threatened the ability of many health systems to function and continue delivering healthcare. Resilient health systems can adapt their health services in response to shocks like COVID-19. Resilience is closely linked to community trust and the interactions between actors in the system. However, very little is known about the ways in which the private, for-profit health services sectors contributes to the health system’s ability to manage resilience. By studying the Zambian health system during COVID, the project aims to better understand how the private, for-profit health services sector contributes to the health system’s capacity to manage resilience during shocks. During COVID, changes in service delivery in public and private health facilities will be identified and explored using facility data and semi-structured interviews. A social network analysis and stakeholder interviews will assess interactions between private and public health service actors. Focus group discussions and interviews with community members will be used to understand trust in the private compared to public health services. Exploring the private sector’s role in resilience will help to improve interdependence among health system sectors and strengthen the community’s trust and ownership in the system, ultimately building resilience for future shocks. Lund University, the University of Zambia, and the University of Geneva will run the project between Jan 2022 and Dec 2024.