The role of the market in health systems responsiveness

We critically interrogate the current conceptualisation of health systems responsiveness in light of ongoing political, economic, and health system transitions occurring in many low- and middle-income countries (LMICs), and call for a nuanced, contemporaneous, and expanded understanding of the conce...

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Main Authors: Kimberly Lakin, Sumit Kane
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Critical Public Health
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/09581596.2025.2519770
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author Kimberly Lakin
Sumit Kane
author_facet Kimberly Lakin
Sumit Kane
author_sort Kimberly Lakin
collection DOAJ
description We critically interrogate the current conceptualisation of health systems responsiveness in light of ongoing political, economic, and health system transitions occurring in many low- and middle-income countries (LMICs), and call for a nuanced, contemporaneous, and expanded understanding of the concept. Drawing on key work on health economics and healthcare markets, we unpack the economic and health systems transitions that LMICs have experienced in the last two decades, specifically the shift towards neoliberalism. We discuss the impact of these transitions, particularly, the rapid growth in for-profit care and the covert or outright privatisation of public health services, on health care provision. We critically review the literature on health systems responsiveness to then demonstrate how current analytical frameworks do not yet sufficiently reflect the role of the market in responsive care provision. In light of this, we make a case for explicitly recognising the role of the market logic in both shaping peoples’ expectations of their health systems and the health system’s response to these expectations.
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spelling doaj-art-2b035bec434b45fdab0f6dcb30fe3f4a2025-08-20T03:31:24ZengTaylor & Francis GroupCritical Public Health0958-15961469-36822025-12-0135110.1080/09581596.2025.2519770The role of the market in health systems responsivenessKimberly Lakin0Sumit Kane1Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, AustraliaNossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, AustraliaWe critically interrogate the current conceptualisation of health systems responsiveness in light of ongoing political, economic, and health system transitions occurring in many low- and middle-income countries (LMICs), and call for a nuanced, contemporaneous, and expanded understanding of the concept. Drawing on key work on health economics and healthcare markets, we unpack the economic and health systems transitions that LMICs have experienced in the last two decades, specifically the shift towards neoliberalism. We discuss the impact of these transitions, particularly, the rapid growth in for-profit care and the covert or outright privatisation of public health services, on health care provision. We critically review the literature on health systems responsiveness to then demonstrate how current analytical frameworks do not yet sufficiently reflect the role of the market in responsive care provision. In light of this, we make a case for explicitly recognising the role of the market logic in both shaping peoples’ expectations of their health systems and the health system’s response to these expectations.https://www.tandfonline.com/doi/10.1080/09581596.2025.2519770Health system responsivenesshealth inequalitieshealth systemslow- and middle-income countries
spellingShingle Kimberly Lakin
Sumit Kane
The role of the market in health systems responsiveness
Critical Public Health
Health system responsiveness
health inequalities
health systems
low- and middle-income countries
title The role of the market in health systems responsiveness
title_full The role of the market in health systems responsiveness
title_fullStr The role of the market in health systems responsiveness
title_full_unstemmed The role of the market in health systems responsiveness
title_short The role of the market in health systems responsiveness
title_sort role of the market in health systems responsiveness
topic Health system responsiveness
health inequalities
health systems
low- and middle-income countries
url https://www.tandfonline.com/doi/10.1080/09581596.2025.2519770
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