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Beyond Public and Private? Unorganised Markets in Health Care Delivery

This paper puts forward three arguments. First our understanding of the health sector is handicapped by trying to fit it into language and concepts which do not adequately capture its changing realities and the political economies within which health sectors are embedded. Second, this has disposed to putting forward decontextualised, and thus largely normative solutions, such as "regulation," to the problem of improving service delivery in poorly performing environments. Third, approaches need to move beyond the dualism of public versus private and work creatively with messy and sometimes contradictory realities. It concludes with a discussion of how this analysis can be applied to a major international intervention set up to benefit the poor – the Global Fund for HIV/AIDS, TB and Malaria.