• Models and institutional mechanisms

Models and institutional mechanisms

This report, by the Population Reference Bureau, analyses programmes and interventions aimed at promoting greater access to quality health care services for poor people. It notes that poor people are more likely to suffer from health problems and less likely to use health services than more well off people. Lack of information, lack of empowerment, inaccessible services, unresponsive service providers and prohibitive costs are all barriers to quality health care for the poor. The report highlights some approaches that benefit poor people including: promoting universal coverage of basic health care; creating incentives for health providers and clients and increasing community participation.

Case studies and lessons from the World Bank’s ‘Reaching the Poor’ programmes are presented including examples from Brazil, Cambodia, Tanzania, India and Nepal. The paper concludes that it is possible to achieve better performance in reaching the poor, but there is not any one programme type or model that is more effective than others. There is also no guarantee that an approach that works in one setting will work elsewhere, thus it is necessary to experiment and adapt programmes to best suit each individual context.

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