Healthcare clinic and pharmacy chains in Kenya and Nigeria: A qualitative exploration of the opportunities and risks they present for healthcare regulatory systems.

Autor: Wafula F; Open Phences Hub, Strathmore University Business School, Nairobi, Kenya., Onoka C; Health Policy Research Group, University of Nigeria, Enugu, Nigeria., Musiega A; Open Phences Hub, Strathmore University Business School, Nairobi, Kenya., Okpani A; National Primary Health Care Development Agency, Abuja, Nigeria., Ogira D; Open Phences Hub, Strathmore University Business School, Nairobi, Kenya., Ejughemre U; Delta State Contributory Health Commission, Asaba, Delta, Nigeria., Miller R; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK., Goodman C; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK., Hanson K; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
Jazyk: angličtina
Zdroj: The International journal of health planning and management [Int J Health Plann Manage] 2022 Nov; Vol. 37 (6), pp. 3329-3343. Date of Electronic Publication: 2022 Aug 18.
DOI: 10.1002/hpm.3560
Abstrakt: Background: Regulating fragmented healthcare markets is a major challenge in low- and middle-income countries. Although a recent transformation towards consolidation could improve regulatory efficiency, there are concerns over risks to client safety and market functioning. We investigated market consolidation through the emergence of clinic and pharmacy chains in Kenya and Nigeria and explored resultant regulatory opportunities and risks.
Methods: The study was conducted in Nairobi Kenya and Abuja Nigeria. Data were collected through document reviews and 26 interviews with chain operators, professional associations and regulators between September and December 2018. A thematic analysis was conducted.
Results: We characterised two broad types of chains: organic chains that started as single business locations and expanded gradually, and investor-driven chains that expanded rapidly following external capital injection. In both countries, chains and independents were regulated similarly, with regulators failing to both capitalize on opportunities and guard against risks. For instance, chains' brand visibility and centralised management systems made them easier to regulate and more suitable for self-regulation. On the other hand, chains were perceived to pose the risks of market dominance, commercialisation of healthcare, and regulatory capture.
Conclusion: As healthcare chains expand, regulators should build on opportunities presented and guard against emerging risks.
(© 2022 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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