This book provides a framework for developing and analyzing health sector reforms, based on international experience. It offers practical guidance and stresses the need to take account of each country's economic, administrative, and political circumstances. The book explains how to design effective government interventions in five areas—financing, payment, organization, regulation, and behavior—to improve the performance and equity of health systems around the world. There are a number of critical features in the book's approach to health-sector reform. The first is to see the health sector as a means to an end. Reformers should judge their systems by the consequences, to define problems in terms of performance deficiencies, and to assess proposed solutions by whether they promise to remedy those deficiencies. This approach leads to an analytically rigorous method for problem definition, causal diagnosis, and policy development. This kind of method has often been lacking in health reforms efforts, and its lack is partially responsible for the disappointing results. A second major feature of the book's approach is a commitment to combining international experience with deep sensitivity to local circumstances. A third feature of this study is that the book puts forward a multidisciplinary approach to the problems of health-sector reform. Finally, the book argues that health-sector policy inevitably involves ethical choices.