As the majority of the poor rely on the public sector for their health needs, it will be crucial to ensure that public services, especially when decentralized, are of a comparable standard to private services to avoid inefficiencies of creeping market segmentation. More efforts should be directed at expanding the outreach of activities to rural areas and other less-served areas, addressing supply and demand side barriers to reduce socio-economic disparities in contraceptive security. Payment systems, especially in the public sector, also require reform.