In response to growing interest among middle-income countries in the WHO European Region to engage private health-care providers (PHPs) within publicly funded health systems, the WHO Barcelona Office for Health Systems Financing has developed this primer to support informed and effective purchasing decisions. While private sector participation may offer benefits such as increased service capacity, efficiency gains, and greater patient choice, it also introduces risks—especially in contexts where regulatory and accountability mechanisms are underdeveloped.
This report provides practical guidance on how to strategically purchase health care from the private sector in a way that protects equity, financial sustainability, and quality of care. Drawing on country experiences from across the Region, it outlines key considerations for eligibility criteria, contracting, monitoring, and incentive structures that ensure PHPs contribute positively to universal health coverage goals.
Prepared with support from the Universal Health Coverage Partnership and the Government of Catalonia, this document is part of WHO’s ongoing technical assistance to countries navigating the complex balance between public goals and private delivery. It complements resources available through “UHC watch,” WHO/Europe’s digital platform tracking progress toward affordable and equitable health care.