There are several alternative delivery models a policy-maker may consider. In many situations, some of the described elements coexist simultaneously in various mixtures, although with different weight and influence over the whole health sector.
Hybrid, ambiguous and transitional situations are very common.
- Public, paid for by tax and custom revenues
- Public, paid for by international aid
- Public / private, paid for through compulsory health insurance
- Private, paid for by voluntary contributions in rich countries, on charity, religious or solidarity grounds.
- Private, paid for by voluntary insurance or out-of-pocket contributions
- Private, channeled through community pre-paid schemes
- Public, through a National Health Service, usually part of the civil service
- Public autonomous providers, often part of local government, sometimes separated from the civil service
- Private not-for-profit providers, funded by donor agencies, through grants
- Private providers contracted by public financiers (usually donor agencies), under the oversight of the recipient government
- Private providers paid for by employers or customers
Level and localization of care
- Hospital, providing mainly high-tech, inpatient, sometimes referral care
- Primary health care (PHC) facility, providing mainly low-tech, outpatient care, of high theoretical effectiveness
- Community / house, provided by professionals (PHC oriented or not)
- Community / house, provided by community health workers
- Mobile (in most cases providing selected services)
Content of care
- Comprehensive package addressing most conditions (up to the affordable technical limits)
- Selective package of priority interventions (disease control, special-group programs etc.)
- Emergency health care, targeting severely distressed populations
- Unplanned, demand-driven, predominantly curative health care
- In most situations, formal preserve of the public sector
- An autonomous body, recognized by all stakeholders, regulates the health sector
- Indirect, through regulatory provisions enforced abroad
See reference for more information.
Adapted from World Health Organization. Health action in crises. Internet, Accessed on October 25, 2018.