Pro-Poor Health Delivery

Helpdesk Query:

Outline a typology/annotated bibliography for ‘pro-poor’ delivery channels for health services. Ideally, the work would set out a broad typology of the approaches that have been developed specifically to increase access to and utilisation of health services by the poor, with 1 – 3 examples/key studies/documents noted under each. This could include systemic approaches (e.g. equitable health financing) or more targeted approaches (e.g. demand side interventions such vouchers and/or conditional cash transfers).

Summary:

Information on pro-poor health policies does not fit neatly into mutually exclusive categories and many of the themes overlap. For example, universal coverage interventions such as abolishing user fees were often discussed as pro-poor targeting. Universal targeting can appear to be targeting the poor but it may be that the less poor are paying for higher quality services. Also the section on health financing approaches refers to community healthcare plans and insurance in this report. Many of the other sections relate to financing, particularly public and private sector financing.

The typology and content featured in the helpdesk report includes the following examples:

  • Targeting – abolition of user fees and benefits for the poor in Uganda and Cambodia; depravation based resource allocation in Zambia; a health card programme in Indonesia, social health insurance in Indonesia
  • Promoting universal healthcare coverage – healthcare in South Africa; strategies in East and Southern Africa; anti-retroviral treatment in South Africa; healthcare in Thailand
  • Public spending – benefit incidence in Asia; public social spending in Africa
  • Increasing availability and access – mobile health units in India; community health workers in Rwanda
  • Private sector involvement – a Rockefeller report outlining different private sector financing and delivery models; assessment of private-sector health utilisation for the poor
  • Incentives for providers and clients – encouraging women to use professional care at childbirth in Nepal; pay-for performance overview
  • Community participation – meeting the needs of the poor in Kenya; participation and accountability for equity
  • Health financing approaches – insurance sector reforms in India; a review in low-income countries

 

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