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encourage the private sector to contribute to health service deliver as part of their UHC scheme. Private
sector engagement is regulated by the government, although there are still shortcomings in the
monitoring of private sector activities. Private healthcare providers currently cover up to 60 per cent
of health care in Indonesia (in particular hospital care) and are also frequented by poor people. In
Turkey too, the private sector is growing under public regulation. In other countries, e.g. Tunisia, the
private sector has grown – with some incentives by the state – not to complement the state’s health
provision, but because of its gaps. Emerging from the experiences is the realization of the role the
private sector can play in filling gaps more efficiently as public institutions usually do, as well as the
potential dangers in relation to affordability, particularly for the poor. Careful monitoring and
regulation seem to be necessary in order to ensure that all segments of the population can access high-
quality health care.
Finally, a common theme across the case study was the importance - or lack thereof- of high-quality
informationmanagement systems which are crucial to informdecision-making, identification of health
priorities, identification of inequalities and areas of exclusion, accountability, transparency,
management, planning and allocation of resources. Even where data information management
systems exist, they are often different across different levels of responsibility and not integrated as
one tool that different stakeholders can use as a source of information and where information can be
shared. Furthermore, there are often different indicators used by different stakeholders and data
collectors, further adding barriers where attempts of harmonisation are made.
Overall, the experiences show that, as access barriers are reduced, for example through the reduction
of out-of-pocket health expenditures and physical infrastructure, demand for health services increases
as many needs are not met (yet). This in turn puts pressure on existing infrastructure and resources
to the point where quality can be compromised. Thus, (further) investments are needed to expand and
improve physical infrastructure, qualified staff, improve andmaintain quality tomeet demand. Besides
health sector specific investments, there is also a need for other sectors’ investments, such as the
transport sector for access for remote/poorly connected populations. Investments in basic
infrastructure such as access to safe drinking water and sanitation will contribute to better health too
and reduce pressure on the health sector by preventing communicable diseases in the first place. So
do investments in the education sector about better sanitation and hygiene practices that improve
health outcomes.