The behaviour of private sector health care providers will depend crit
ically on the environment within which they operate. A bewildering arr
ay of possible regulatory and incentive setting structures exist. Most
developing countries have the basic legislation for regulation, but t
here are frequently difficulties in enforcing such controls. While pro
cess aspects of quality of care regulation are often the responsibilit
y of professional organizations, these organizations may have limited
incentives to be active in ensuring high quality medical care. There h
as been less experience with the use of incentives to encourage approp
riate behaviour amongst private providers: this appears a promising ar
ea for further work. Above all, adequate information is essential both
for the enforcement of regulations and the application of incentive m
echanisms.