Equity in public sector health care financing and expenditure

The control of sexually transmitted diseases is a public health priority. It is the association between STDs and the increased transmission of HIV that places STD control high on the public health agenda. The public and private sectors both play an important role in the management of services that impact upon public health. It has been estimated that private general practitioners in South Africa treat approximately 5 million cases of sexually transmitted diseases each year, possibly out-numbering cases seen in the public sector.

The number of cases seen by private general practitioners points to the fact that there is a high number of patients who choose to use the private sector instead of the public sector. Several studies and surveys have confirmed this trend.

This briefing summary explores the following issues:

• the extent to which low income groups utilise private sector care for their primary care needs v the reasons why low income groups pay out of pocket for services of private providers
• how the use of private doctors impacts on sexually transmitted diseases (and generally other preventable diseases)
• how to influence the quality of care of sexually transmitted diseases in the private sector.