Involving private voluntary health care providers in 'Better Health for Africa'.

In Sub-Saharan Africa private voluntary health care providers are mostly Church-related or social not for profit organizations. They provide between 40% and 60% of health care services. In the context of Health Care Reforms, the World Bank and others have (re)discovered these non governmental providers. The World Bank document 'Better Health for Africa', promotes prominent roles for them in the execution of basic package of services and public health tasks. Unfortunately, the World Bank does not outline clearly how these roles should be achieved. The danger exists that governments, under pressure to economize, will only take the privatization angle which is in contradiction with the aims and objectives of the not for profit private providers. Thus their potential to contribute to Public Health care will be left unused and the reforms harder to achieve. My argument is that the collaboration between government and NGOs should be approached in the perspective of delegation of public duties and partnership. Thus the autonomy of NGO providers can be respected while their technical capabilities can be used optimally.