There appears to be very little literature on the effectiveness of non-state providers (NSPs) of health services in fragile states. There is some useful case study material, particularly from Afghanistan and Cambodia although this tends to focus on the effectiveness of service provision rather than the extent to which NSPs align services with government systems and policies. Furthermore, there is no consensus on what actually constitutes ‘effectiveness’. Antuono et al (2006) evaluate the involvement of NGOs in service delivery in Bangladesh and Nepal in terms of effectiveness, cost, accountability and transparency, sustainability and transferability.
In most cases however, the literature offers no such clarification. Notwithstanding these limitations, this helpdesk report: presents literature on non-state provision of health services1 in fragile, conflictaffected, and post conflict states, including a number of country case studies; and explores the issue of effectiveness of non-state providers in low income countries in general.