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Sources of revenue

Principal sources of health financing are: out-of-pocket-payment, social and private insurance, and taxation. In the poorest countries foreign grants and borrowing are also important sources of funding. Out-of-pocket payments were, and still are in most developing countries, the principal source of revenue for health services. Health services are costly and their use is unpredictable, generating a demand for insurance.

Moral hazard, adverse selection and other sources of market failure create challenges in establishing an efficient insurance market with universal coverage. For these reasons, and to improve accessibility of services, the governments will tend either to finance health services directly from taxation, or to regulate insurers closely.

Indian community health insurance schemes provide partial protection against catastrophic health expenditure

This article in BMC health services research examines two Indian community health insurance (CHI) schemes, ACCORD and SEWA, to determine whether insured households are protected from catastrophic health expenditure (annual hospital expenditure greater than 10 per cent of annual income).

Recommended readings

An overview of community-based health financing
( Partners for Health Reformplus , 2004)
This PHRplus document aims to answer basic questions about community-based health financing (CBHF) that might be posed by policymakers and technical assistance providers. The report outlines how sche...
National Health Accounts: what are they and how can we use them?
( M. Pearson / Department for International Development Health Systems Resource Centre , 2000)
What are National Health Accounts (NHAs) and what advantages can they bring to developing countries? This briefing paper produced on behalf of the Department for International Development (DFID) by th...
Reaching universal coverage via social health insurance: key design features in the transition period
( G. Carrin; C. James / World Health Organization , 2004)
This paper, produced by the World Health Organisation, discusses the process of extending specific social health insurance (SHI) programmes in low and middle-income countries to cover entire populatio...

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Developing countries need evidence-based approaches to health policy, with equity as a key focus.
( Regional Office for the Western Pacific, World Health Organisation , 2009)
This book, published by the Western Pacific Regional Office of the World Health Organization, notes that health equity and the barriers to achieving it in developing countries have been a major s...
Does socioeconomic status determine access to health care in Peru?

( C. Kristiansson (ed);E. Gotuzzo;H. Rodriguez / International Journal for Equity in Health , 2009)
Good health is recognised by many as being central to individual and national development. However, there is often a disconnect between the access and utilisation of health services by the poor. In co...
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