Regulating private investment in healthcare: implications for low- and middle-income countries
A/019/020, Alcuin Research Resource Centre, Campus West, University of York (Map)
Event details
Abstract
Background. Private investment in healthcare is diversifying, with financial investors, such as private equity, entering the healthcare market alongside traditional providers, such as public corporations. Evidence, concentrated in high-income countries, varies across settings but tends to associate private equity ownership with poorer health and market outcomes, particularly in the hospital sector. Regulatory frameworks do not distinguish between investor types or their distinct incentives.
Aims. To develop an analytical framework of regulatory instruments and map how low- and middle-income countries (LMICs) regulate private investment in healthcare.
Methods. The framework classifies instruments by domain (structural regulation, entry barriers, market oversight) and stringency (disclosure to prohibition). A comparative case study maps these across 17 lower- and upper-middle-income countries.
Results. National frameworks comprise general competition and healthcare instruments applied irrespective of ownership type; structural regulation targeting financial investors' distinct risks is largely absent. Entry instruments are absent in most countries. Within market oversight, instruments concentrate at the least stringent level, disclosure, and several apply only to listed companies, excluding private equity.
Discussion. Progress towards universal health coverage requires ownership-specific, anticipatory regulation, beginning with ownership and capital transparency extended to large-scale privately held investors.
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Chiara Berardi
Dr Chiara Berardi is an Assistant Professor in Health Systems and Policy at UCL’s Global Business School for Health.
Chiara’s research focuses on the economic and policy analysis of health system financing and provision, and their implications for health system performance. Overall, her work employs evidence-based approaches to support system-level policymaking, engaging with multiple countries operating under different health system models.
Her work has been published in leading journals and has also been featured in media outlets. She has established a track record of competitively awarded research funding as Principal and Co-Investigator. She is member of international research collaborations and multidisciplinary network of academics. She serves as a peer reviewer for leading journals in health systems, policy and health service research.
Previously, Chiara was a Fellow in Health Policy at the London School of Economics and Political Science (2024–2025) and a guest academic at the University of Newcastle, Australia (2020–2024). She also served as a consultant to the Chilean Ministry of Health during a period of healthcare system reform (2019), gaining valuable experience in real-world policymaking.
She is the recipient of the LSE Class Teacher Award (2025) and the Newcastle Business School Higher Degree Researcher Award (2024).
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Contact
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