Public and Private Roles in Providing and Financing Reproductive Health Care

The provision and financing of health care are basic issues that every country must address. In principle, a country's health care can be both provided and financed either entirely publicly, or entirely privately (including by nongovernmental organizations (NGOs)). Indeed, private provision of health care is attractive because it reduces the government's fiscal burden, and because it may encourage better resource utilization, and thus deliver more or better health care services at the same overall cost. However, for a variety of conceptual and practical reasons, a mix of public and private provision and financing generally creates the best possibilities for the efficient provision of accessible, good-quality health care. This mix is not determined blindly by a simplistic formula, but will vary depending on a country’s stage of development. In general, the private share of total health expenditures tends to fall with rising income per capita, both across countries and for individual countries over time. In addition to issues of provision and financing, the public sector may also have an important role to play in establishing a stable system of health insurance.