This blog post summarizes a presentation that Cauane Blumenberg from the International Center for Equity in Health (ICEH) gave at Countdown’s 2025 annual meeting in Nairobi.
The private sector plays a significant yet often underrepresented role in the provision of reproductive, maternal, newborn and child health (RMNCH) services. Its contribution varies both between and within countries, particularly between urban and rural areas. Despite its importance, the private sector is frequently underreported in routine health facility data and underlisted in national master facility lists. Household surveys like the Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) help fill this gap by capturing information on source of care directly from respondents.
Methods and Indicators
The analysis used DHS and MICS data from 32 countries, focusing on three key RMNCH indicators:
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Care-seeking for child illness
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Caesarean section (C-section)
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Institutional delivery
For each indicator, private sector contribution was estimated at both the national level and by area of residence (urban vs. rural).
Key Findings and Interpretation
Fig 1. National level prevalence
Fig 2. Prevalence by area of residence (rural vs. urban)
Stacked bar charts were used to display the total prevalence of each indicator at the national level (Fig 1) and by area of residence (Fig 2). When interpreting the urban/rural analysis, it is important to note that some rural residents may seek care in urban areas, meaning that the percentage of women/children might be overestimated for rural residents, and no distinction was made between for-profit and non-profit providers, which were both classified as private.
How to Apply This Analysis
Participants were guided through applying this method using the Countdown Shiny app:
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Select the public/private share option in the Health System Performance module.
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Upload the relevant public/private folder.
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Plot and interpret the graphs.
This approach offers a straightforward way for countries to gain insight into private sector engagement in RMNCH—and to better understand patterns of care-seeking that may otherwise go undocumented in routine health system data.
- Download the full presentation here
- Access the Shiny app and Github repository