chapter  1
8 Pages

Making Health Systems More Equitable

Information about the private component of country health systems is sparse, and such information that does exist deals mainly with specific services rather than with the record of the private component as a whole. This

in private than in government services. Figure 1 shows data for four basic maternal and child health services in around 50 developing and transitional countries, separated by type of service provider. For each of the four services, private facilities or providers treat far fewer cases in the poorest segment of the population than do public facilities (figure 1 A). The most extreme example is facility-based deliveries: the few women in the poorest 20% of the population who deliver in medical establishments are about ten-fold more likely to use government than private facilities. Also, the distribution of people using private facilities or providers is heavily skewed toward the well-off (figure 1 B). For all four services, the ratio between the highest and lowest 20% of the population is over twice as high for private than for public providers.