This report looks at the characteristics and extent of private sector involvement in health financing and provision in East and Southern African countries. For the purpose of the report, a broad definition of private health sector is adopted and is taken to include the (formal and informal) for-profit hospitals, private health insurance, private medical officers, private pharmacies/ drug sellers, not-for profit/ faith-based organizations. As external financial resources play a key role in the funding of private sector initiatives (both for-profit and not-for-profit), the extent of external funding is also considered. Thereafter, an overview is provided of the presence (or not) of private health insurance, and different types of private providers. A trend observed in this review is the expansion of South African private health care organizations into other African countries. The review showed that while private health insurance plays a small yet growing role in some of the countries reviewed, very few have any form of mandatory health insurance. There is a considerable burden of out-of-pocket (OOP) payments at point of service by households. Private for-profit hospitals are quite limited in most countries, but some countries are developing these hospitals specifically targeting medical tourism. At present, not-for-profit health services and informal private providers are very prevalent in most African countries.