With a special focus on strategic purchasing and contracting of services from nongovernmental providers, this title reviews ways to make public spending on health care more efficient and equitable in developing countries. It is recommended that: experiments and pilot projects for improving public sector hospitals should focus on mission clarity and organizational simplification; programs for improving the composition of utilization should experiment with payments to consumers and with health labor force composition and training; and; initiatives to attract providers to rural areas should use explicit deferred compensation contracts to improve monitoring.