ABSTRACT
This chapter highlights the fact that the long lasting compartmentalization of health systems into private and public sectors no longer reflects the reality; the diversification of actors and functions in health systems inevitably leads to interactions. It focuses on the fact that the actors are becoming increasingly aware of the evolutions in management methods. A situation in which the public sector, represented solely by the Ministry of Health, and the private sector, whether for profit or denominational, ignore or clash with one another to provide health services is increasingly remote from reality. The gradual transformations of roles and statuses of the traditional actors and the rise of new ones, of which some are external to the health sector, have made it more complex to organize a health system. The evolution of health systems has been characterized by a diversification of actors and a contestation of the organizational principles.
