Most poor people in most poor countries get most of their healthcare from private rather than public sources. This paper reviews current evidence about the way in which the private sector delivers Sexual and Reproductive Health (SRH) and Maternal and Neonatal Health (MNH) services. The paper focuses on three particular issues – equity, quality and cost-effectiveness.

Findings include:

• Few studies find provide evidence on equity
• There is strong evidence that quality of care (QOC) given by private providers can be improved by selected interventions
• It is rare to find a prospectively designed study that has built cost-effectiveness in from the beginning
• For sexual and reproductive health, the strongest evidence for market interventions showed that franchising can expand private sector access to family planning for the poor
• The strongest evidence in support of market interventions in maternal and neonatal health is that conditional cash transfers provide better access to antenatal care for the poor, and better QOC