Health Financing for Poor People : Resource Mobilization and Risk Sharing

Most community financing schemes have evolved in the context of severe economic constraints, political instability, and lack of good governance. Usually government taxation capacity is weak, formal mechanisms of social protection for vulnerable pop...

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Bibliographic Details
Main Authors:	Preker, Alexander S., Carrin, Guy
Format:	Publication
Language:	English en_US
Published:	Washington, DC: World Bank 2013
Subjects:	HEALTH FINANCING HEALTH CARE ADMINISTRATION COMMUNITY FINANCING COMMUNITY PARTICIPATION RESOURCE MOBILIZATION GOVERNMENT ROLE RISK MANAGEMENT HEALTH OUTREACH SERVICES ACCESS TO HEALTH CARE LOW INCOME POPULATIONS INFORMAL SECTOR HEALTH EXPENDITURES RISK POOLING HEALTH CARE DELIVERY HEALTH CARE FOR POOR CHILDREN ADMINISTRATIVE CAPABILITY HEALTH CARE COST CONTROL HEALTH CARE COVERAGE ABILITY TO PAY BASIC HEALTH CARE BASIC HEALTH SERVICES BASIC SERVICES CASE STUDIES CLINICS COMMUNITY HEALTH COMMUNITY LEADERS COMMUNITY MEMBERS CONCEPTUAL FRAMEWORK COST RECOVERY DATA ANALYSIS DATA SOURCES DEBT RELIEF DEVELOPED COUNTRIES DEVELOPING COUNTRIES DEVELOPMENT GOALS EMPLOYMENT EXPENDITURES FAMILIES FINANCING MECHANISMS HEALTH CARE HEALTH CARE COSTS HEALTH CARE FINANCE HEALTH CARE FINANCING HEALTH CARE PROVIDERS HEALTH CENTER HEALTH EXPENDITURE HEALTH INSURANCE HEALTH OUTCOMES HEALTH SECTOR HEALTH SERVICE HEALTH SERVICES HEALTH SYSTEM HEALTH SYSTEM GOALS HEALTH WORKERS HOSPITAL SERVICES HOSPITAL UTILIZATION HOSPITALIZATION HOSPITALS HOUSEHOLD CHARACTERISTICS HOUSEHOLD DATA HOUSEHOLD LEVEL HOUSEHOLD SURVEY HOUSEHOLD SURVEYS IMPROVED ACCESS INCOME INCOME POPULATIONS INDIVIDUAL LEVEL INPATIENT CARE INTERNATIONAL LABOUR ISOLATION LABOR MARKET LIFE INSURANCE LOCAL LEVEL LOW- INCOME COUNTRIES LOW-INCOME COUNTRIES MANAGEMENT CAPACITY MEDICAL CARE MEDICAL ECONOMICS MEDICAL INSURANCE MORTALITY PATIENTS POLICY MEASURES POLICY OPTIONS POOR COMMUNITIES POOR HOUSEHOLDS POOR LIVING POOR PEOPLE POPULATION SIZE POVERTY ALLEVIATION PRIMARY CARE PRIVATE SECTOR PROBABILITY PUBLIC EXPENDITURE PUBLIC FUNDS PUBLIC HEALTH PUBLIC HOSPITALS PUBLIC POLICY PUBLIC SECTOR PUBLIC SERVICES RESEARCH DESIGN RESOURCE ALLOCATION RESOURCE CONSTRAINTS RISK SHARING RURAL AREAS RURAL COMMUNITIES RURAL POOR RURAL RESIDENTS SECTOR PROVIDERS SERVICE DELIVERY SOCIAL CAPITAL SOCIAL EXCLUSION SOCIAL INCLUSION SOCIAL PROTECTION STATISTICAL DATA SUSTAINABILITY TAX COLLECTION TECHNICAL ASSISTANCE TECHNICAL SUPPORT URBAN CENTERS URBAN HOUSEHOLDS URBAN POOR WORKERS
Online Access:	http://documents.worldbank.org/curated/en/2004/05/3522037/health-financing-poor-people-resource-mobilization-risk-sharing http://hdl.handle.net/10986/15019

Description
Summary:	Most community financing schemes have evolved in the context of severe economic constraints, political instability, and lack of good governance. Usually government taxation capacity is weak, formal mechanisms of social protection for vulnerable populations absent, and government oversight of the informal health sector lacking. In this context of extreme public sector failure, community involvement in the financing of health care provides a critical albeit insufficient first step in the long march towards improved access to health care by the poor and social protection against the cost of illness. Health Financing for Poor People stresses that community financing schemes are no panacea for the problems that low-income countries face in resource mobilization. They should be regarded as a complement to - not as a substitute for - strong government involvement in health care financing and risk management related to the cost of illness. Based on an extensive survey of the literature, the main strengths of community financing schemes are the extent of outreach penetration achieved through community participation, their contribution to financial protection against illness, and increase in access to health care by low-income rural and informal sector workers. Their main weaknesses are the low volume of revenues that can be mobilized from poor communities, the frequent exclusion of the very poorest from participation in such schemes without some form of subsidy, the small size of the risk pool, the limited management capacity that exists in rural and low-income contexts, and their isolation from the more comprehensive benefits that are often available through more formal health financing mechanisms and provider networks. The authors conclude by proposing concrete public policy measures that governments can introduce to strengthen and improve the effectiveness of community involvement in health care financing.

Health Financing for Poor People : Resource Mobilization and Risk Sharing

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