Sustainable financing
Public-private interactions: lessons for sexual and reproductive health services
Involving the private sector in sexual and reproductive health services: the need for caution
Authors:
J. Doherty; Initiative for Sexual & Reproductive Rights in Health Reforms
Publisher:
Initiative for Sexual & Reproductive Rights in Health Reforms [School of Public Health, University of the Witwatersrand], 2005
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 reproductive health (SRH) service objectives. It reports that, while interactions between the public and private sectors may expand coverage and improve services for some, there is evidence that they can also worsen inequity, provide poor quality care, create inefficiencies and undermine the coherence and sustainability of the health system, especially in the realm of SRH. It argues that public and donor subsidies to public-private interactions (PPIs) risk diverting funds away from the poorest and hardest to reach populations, towards urban centres and higher income groups.
The briefing argues that public-private interaction (PPI) should be approached in a cautious and planned manner. Governments should be guided by clear principles for engagement, and supported by strong regulatory frameworks and contractual arrangements. They also need the capacity to implement and monitor PPIs appropriately. The briefing emphasises that responsibility for meeting international targets such as the Millennium Development Goals, still lies in the hands of the public sector. The strengthening of the public sector must not be compromised by parallel efforts to extend private sector involvement.
