There is significant variability in the quality and scope of non-state services. There is no reason why non-constituent civil society organizations (i.e. those without a membership base), or NGOS, should be any more accountable to the population than private sector organizations. They may in fact be more accountable to the international funding agencies that resource them.

Gilson et al. (1994), quoted in Robinson & White (1997), conclude that some NGOs have a long-term and sustained comparative advantage in providing health services in the areas where they are able to:

• perform better
• access resources not available to government
• meet a need not currently met (such as in improving coverage or tapping community potentials).