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Browse POLICY Project (1995-2006) Materials

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  • In the effort to develop dynamic national family planning service systems, USAID has supported a sustained set of initiatives to strengthen private sector service delivery. Many of these, like the SOMARC, Enterprise, PROFIT, and Initiatives projects, have focused primarily on the operational side of program expansion (e.g., training private providers, helping clinic managers develop business and financial plans, improving management efficiency, and marketing products and services). This paper looks at how activities in the policy domain often determine the success or failure of efforts to develop private sector services. This paper examines lessons learned in USAID's OPTIONS and POLICY projects, both of which have worked extensively in developing countries to foster private sector involvement in family planning and reproductive health care. It presents lessons learned during implementation of these activities and emphasizes ways to strengthen the policy climate and plan for service expansion. Following a general discussion of lessons learned, the paper includes examples from 11 countries that describe efforts to remove impediments to private sector participation and effective health care financing. The issues range from taxation of imported commodities in the Philippines to divestiture of contraceptive brands in Jamaica to market segmentation in Egypt. In sum, the country examples illustrate the steps governments can take to ensure adequate financing of their programs, use their resources efficiently, and tap the extensive resources of the private sector. Summary of Lessons Learned: • Governments should ensure that sufficient resources are available for services from both public and private sector sources. • Government subsidies should be targeted to appropriate clientele. • Efforts to increase private sector participation in family planning service delivery should begin with the public sector. • Many public sector clients can afford to pay for needed services either in part or in full. • Legal and regulatory barriers can impede the involvement/performance of the private sector. • Governments have a fundamental role in regulating the quality of private sector health services; however, many governments lack experience in regulating the private sector. • The private sector is often able and willing to work with the public sector as a partner. • Donors and cooperating agencies need to communicate and collaborate to ensure synergy of efforts in the field.