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The Progression Pathway for Governance of Mixed Health Systems

Effective governance of the private health sector is critical for achieving national health goals, yet it remains underprioritized in many contexts. Recent reviews underscore the need for a clear vision, strengthened institutional capacity, and the strategic use of synergistic tools—such as aligning regulation with contracting—to improve system performance. Transparent and inclusive policy processes, alongside greater public sector accountability, are essential to prevent corruption and ensure legitimacy. The governance choices made today will shape tomorrow’s health systems—either paving the way to universal health coverage (UHC) or reinforcing barriers to it.

To support countries in navigating this complex landscape, WHO has developed the Progression Pathway for Governance of Mixed Health Systems. This tool is designed to help governments more effectively govern mixed systems and harness the private sector's contributions toward achieving UHC.

Analytical Tool

A multi-country consultation in the African Region

In the African Region, 17 countries1 requested technical support for private sector engagement (PSE) in health and outlined PSE as a priority in their 2022/2023 work plans. This request for technical support included support to host in-country workshops and/or dialogue sessions to improve awareness, generate evidence for how to better engage the private sector, develop frameworks for engagement and associated evaluation plans, and disseminate country-led studies on the private sector.

It is with this background that the health strategies and governance (HSG) unit in the Universal Health Coverage & Life Course cluster at the WHO Regional Office for Africa, in collaboration with WHO headquarters and EMRO region, organised a multi-country consultation on PSE for UHC to build awareness and foster leadership.

This multi-country consultative and sensitization workshop convened country teams from the 17 countries that included PSE in their 2022/2023 work plans, inviting country teams to participate. Country teams include senior staff from ministries of health working with the private sector, private sector representatives, WHO Country Office, and other relevant country partners. The meeting spanned two days, averaging an estimated 60 participants in attendance per day.

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