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Keystone Module Background Paper: Private Participation in Health Services Handbook

Attitudes toward private health care providers in developing countries are changing. Growing numbers of policymakers are considering or attempting to incorporate private facilities and practitioners into overall sector policy, using methods such as contracting, training of private practitioners, integration into public referral networks, etc. Unfortunately, these efforts are infrequently recorded, making it difficult for policymakers to learn from the experience of others. Rigorous evaluation of these efforts is rarer still, making it difficult, even perilous, to establish guidelines about such policies. It is possible, however, to review options for enhancing health sector policies related to private service provision, and this paper will do so. The purpose of the review is to familiarize policymakers and sector experts with the full range of policies for enhancing the contributions of private health care providers, both for-profit and non-profit, to sector objectives. Since the objective of this Handbook is to support analysis that feeds into operational policy, attention is focused on this level, avoiding lengthy discussions of theoretical or other more academic issues. This Introductory paper is intended to be comprehensive in nature. Users seeking more detailed information about specific strategies and instruments are referred to subsequent papers in the Handbook.