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Non-Government Financing and Provision of Health Services in Africa: A Background Paper

Recent years have seen a growth in interest in what has often been termed the "public/private mix" in health services. Particularly in developing countries this focus has stemmed from a desire to increase and make better use of the total resources available to the health sector. The motivation has also emerged from a recognition of the fact that the private sector is already a significant provider of health services, and that substantial amounts of the resources being spent on health care come from private sources. In addition, changing political ideology questioning prior statistic policies in Western countries has been influential. This paper is organized as follows: Section 1 defines the private sector and considers alternative criteria for measuring the importance of the private sector from a public policy perspective. Section 2 looks at the available information regarding the composition of health expenditures. In Section 3 we review the existing data on health service provision. Section 4 reviews some of the recent experience of policy reform in Africa, particularly looking at policies directed at changing the balance of public and private provision and financing of health services. Section 5 outlines a research agenda for analyzing the private sector in Africa, an agenda which should include both determining the appropriate policy interventions and identifying the conditions under which they are most likely to be successful.