Levers of Control of Private Service Delivery

“Chaos results when the world changes faster than people”

The heterogenous nature of the private sector makes it difficult to measure, difficult to control, and difficult to direct. This is both the hallmark of entrepreneurial potential, and the bane of donors and governments. Does heterogeneity have to result in anarchy? What are the opportunities, the points of influence, that might cause the private health sector to operate so as to benefit public health: by providing services not offered by government, by competing on quality and price rather than colluding, by delivery goods and services that are beneficial to the broader public good? This section summarizes the governmental options - for legislative interventions that can facilitate, allow, or restrict the private sector generally or aspects of the private sector specifically and for regulatory opportunities to enforce directly or through collaboration the legislations put in place by national or local governing bodies. We then look at non-government, or quasi-governmental opportunities for assuring the cost, quality, services, or location of the private sector. Specifically we address accreditation (often confused with certification, which is in fact a form of regulation and quite different) and the obligations and metrics inherent in contracting for services.