Sustainable financing
To achieve universal access, it is essential that SRH services are affordable even for the poorest people in societies. In many instances, this means that services must be free. Reductions in donor funding mean that providing free services is becoming increasingly difficult to sustain, especially in countries with limited resources. In Turkey, the government has dealt with the phase-out of free contraceptives from donors by requesting wealthier clients to make a donation for the commodities they use, and subsidising contraceptives for those most in need.
Non-state providers including commercial firms, not-for-profit organisations and faith-based organisations often provide services when governments are unable to meet people’s SRH needs. Social franchising, or networks of private providers who offer a standard set of services and share training, referral systems, quality standards and brands is one such example. The high volume of patients that these networks can provide for enables them to reduce costs of treatment for poor people. However, as with many commercial providers there is a tension between sustaining services by collecting revenue and providing services for most poor people. Those who cannot afford to pay the fees are excluded. Also, when services exist outside the realms of government regulation and monitoring, it is difficult to ensure that services are of adequate quality, and that people are not financially exploited.
Developing partnerships between government agencies, the private sector and non-governmental organisations through public-private partnerships or contracts can help sustain facilities and improve access for the poor. For instance, in Ghana private providers were given logistical and technical support by the government to operate family planning services in remote areas. In Pakistan, the NGO Marie Stopes International formed a partnership with a district health department to renovate and upgrade obstetric services in rural health centres (see Marie Stopes).
Non-state providers including commercial firms, not-for-profit organisations and faith-based organisations often provide services when governments are unable to meet people’s SRH needs. Social franchising, or networks of private providers who offer a standard set of services and share training, referral systems, quality standards and brands is one such example. The high volume of patients that these networks can provide for enables them to reduce costs of treatment for poor people. However, as with many commercial providers there is a tension between sustaining services by collecting revenue and providing services for most poor people. Those who cannot afford to pay the fees are excluded. Also, when services exist outside the realms of government regulation and monitoring, it is difficult to ensure that services are of adequate quality, and that people are not financially exploited.
Developing partnerships between government agencies, the private sector and non-governmental organisations through public-private partnerships or contracts can help sustain facilities and improve access for the poor. For instance, in Ghana private providers were given logistical and technical support by the government to operate family planning services in remote areas. In Pakistan, the NGO Marie Stopes International formed a partnership with a district health department to renovate and upgrade obstetric services in rural health centres (see Marie Stopes).
Recommended reading
- Public-private interactions: lessons for sexual and reproductive health services
- ( J. Doherty / Initiative for Sexual & Reproductive Rights in Health Reforms [School of Public Health, University of the Witwatersrand] , 2005)
- Recommended reading
- This policy briefing, produced by the Initiative for Sexual & Reproductive Rights in Health Reforms, asks how governments can best draw on private resources to support the achievement of sexual and re...
- The right reforms? Health sector reforms and sexual and reproductive health
- ( T. K. Sundari Ravindran; H. de Pinho / Initiative for Sexual & Reproductive Rights in Health Reforms [School of Public Health, University of the Witwatersrand] , 2005)
- Recommended reading
- This publication, from the Initiative for Sexual and Reproductive Rights in Health Reforms, pulls together available information on how health sector reform has impacted on sexual and reproductive hea...
- Health sector reform: how it affects reproductive health
- ( T. Dmytraczenko; V. Rao; L. Ashford / Population Reference Bureau , 2003)
- Recommended reading
- This brief discusses the steps health managers need to take to ensure that reproductive health objectives are met within the wider aims of health sector reforms. Produced by the Population Reference ...
