Haïti and the health marketplace: the role of the private, informal market in filling the gaps left by the state.

摘要: Abstract Background In most societies the health marketplace is pluralistic in character, with a mix of formal and informal providers. high-income countries, state regulation market helps ensure quality access mitigate failures. present study, using Haiti as case we explore what happens to functioning severely disrupted environments where sector able flourish. Methods The overall research design was qualitative. Research methods included an extensive documentary policy analysis, based on peer-reviewed articles, books “grey” literature--government program reports, unpublished evaluations, reviews from key multilateral bilateral donors, non-government organisations, combined field site visits in-depth informant interviews ( N  = 45). Results findings show that fragility has resulted privatised, commoditised largely unregulated market. While different segments can be identified, reality boundaries between international/domestic, public/private, for profit/not-for-profit, legal/illegal are hazy shifting. Discussion lack capacity provide enabling environment, establish, enforce its regulatory framework highly segmented, heterogeneous result deplorable indices which far below regional averages many other low-income countries. Conclusions Working fragile states limited undertake core function securing population requires new innovative ways working. This needs longer time-frames, combining incremental top-down bottom-up strategies recognize work civil society, public private actors, institutions, progressively facilitate changes functions supply, demand, supporting functions.