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 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.
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dig-okr-1098615019 |
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koha |
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Banco Mundial |
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DSpace |
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Estados Unidos |
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US |
| component |
Bibliográfico |
| access |
En linea |
| databasecode |
dig-okr |
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biblioteca |
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America del Norte |
| libraryname |
Biblioteca del Banco Mundial |
| language |
English en_US |
| topic |
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 COMMUNITY FINANCING 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 COMMUNITY PARTICIPATION 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 EXPENDITURES HEALTH FINANCING 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 INFORMAL SECTOR 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 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 COMMUNITY FINANCING 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 COMMUNITY PARTICIPATION 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 EXPENDITURES HEALTH FINANCING 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 INFORMAL SECTOR 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 |
| spellingShingle |
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 COMMUNITY FINANCING 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 COMMUNITY PARTICIPATION 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 EXPENDITURES HEALTH FINANCING 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 INFORMAL SECTOR 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 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 COMMUNITY FINANCING 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 COMMUNITY PARTICIPATION 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 EXPENDITURES HEALTH FINANCING 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 INFORMAL SECTOR 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 Preker, Alexander S. Carrin, Guy Health Financing for Poor People : Resource Mobilization and Risk Sharing |
| description |
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. |
| author2 |
Preker, Alexander S. |
| author_facet |
Preker, Alexander S. Preker, Alexander S. Carrin, Guy |
| topic_facet |
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 COMMUNITY FINANCING 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 COMMUNITY PARTICIPATION 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 EXPENDITURES HEALTH FINANCING 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 INFORMAL SECTOR 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 |
| author |
Preker, Alexander S. Carrin, Guy |
| author_sort |
Preker, Alexander S. |
| title |
Health Financing for Poor People : Resource Mobilization and Risk Sharing |
| title_short |
Health Financing for Poor People : Resource Mobilization and Risk Sharing |
| title_full |
Health Financing for Poor People : Resource Mobilization and Risk Sharing |
| title_fullStr |
Health Financing for Poor People : Resource Mobilization and Risk Sharing |
| title_full_unstemmed |
Health Financing for Poor People : Resource Mobilization and Risk Sharing |
| title_sort |
health financing for poor people : resource mobilization and risk sharing |
| publisher |
Washington, DC: World Bank |
| publishDate |
2004 |
| url |
http://documents.worldbank.org/curated/en/2004/05/3522037/health-financing-poor-people-resource-mobilization-risk-sharing https://hdl.handle.net/10986/15019 |
| work_keys_str_mv |
AT prekeralexanders healthfinancingforpoorpeopleresourcemobilizationandrisksharing AT carringuy healthfinancingforpoorpeopleresourcemobilizationandrisksharing |
| _version_ |
1807154755897655296 |
| spelling |
dig-okr-10986150192024-08-08T17:35:56Z Health Financing for Poor People : Resource Mobilization and Risk Sharing Preker, Alexander S. Carrin, Guy Preker, Alexander S. Carrin, Guy 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 COMMUNITY FINANCING 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 COMMUNITY PARTICIPATION 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 EXPENDITURES HEALTH FINANCING 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 INFORMAL SECTOR 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 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. 2013-08-12T18:52:26Z 2013-08-12T18:52:26Z 2004 http://documents.worldbank.org/curated/en/2004/05/3522037/health-financing-poor-people-resource-mobilization-risk-sharing 0-8213-5525-2 https://hdl.handle.net/10986/15019 English en_US CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank application/pdf text/plain Washington, DC: World Bank |