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Health service delivery

What is needed to provide effective health service delivery? Focusing on contracting, essential drugs management, health services management, human resources, non-state providers, quality improvements.

Poor people - in both developed and developing countries - experience more ill health and shorter life spans than their richer fellow citizens. Although people's health is influenced by a wide range of socio-economic and lifestyle factors, access to high quality and affordable health care and public health services makes a critical contribution to health status.

Health services are failing poor people - with lower rates of child immunisation, skilled attendance at child birth, and TB and malaria treatment. It's also true that richer groups tend to benefit more from public sector subsidies to health care - hospitals in urban centres often receive disproportionate funds compared with primary care in poor rural areas. And in most poor countries which lack formal taxation and insurance systems, out-of-pocket payments are paid to both private and public providers, consume household income and assets, and contribute to impoverishment.

Improving service delivery to the poor involves all the major stakeholders in the health system - the policymakers in ministries of health, finance, and public administration, health service managers and workers, public and private providers and clients and communities themselves. Better access depends on a wide range of factors - on health policies, strategy and plans that prioritise health needs and set out revenue sources and resource requirements (including mechanisms to address inequalities), on motivated and properly trained and remunerated health workers, on infrastructure, drugs and equipment, on good referral links and communication, and – last but not least - on well-informed clients and their representative bodies.

Latest Documents

Social Panorama of Latin America 2013
United Nations [UN] Economic Commission for Latin America and the Caribbean, 2014
This edition of the Social Panorama of Latin America discusses poverty from different angles, and in particular from amultidimensional perspective. This approach enables detailed analysis not only of the magnitude of poverty, but also...
Developing and implementing training materials for integrated community case management in South Sudan
S. George; M. Marasciulo / Malaria Consortium, 2012
In South Sudan, ICCM – or integrated community case management – is carried out by trained community volunteers called community drug distributors (CDDs) or community based distributors. These operate like community based ...
Building capacity for universal coverage: malaria control in Nigeria
S. George / Malaria Consortium, 2012
SunMaP works with the Nigerian National Malaria Control Programme (NMCP) to harmonise donor efforts around agreed national strategies and plans for malaria control.The role of SunMaP is to provide the necessary technical expertise and...
Community dialogues for healthy children: encouraging communities to talk
S. Martin / Malaria Consortium, 2012
Integrated community case management (ICCM) – an approach where community-based health workers are trained to identify, treat and refer children under-five with pneumonia, diarrhoea and malaria – is increasingly being used...
Developing intervention strategies: innovations to improve community health worker motivation and performance
T Frank; K. Källander / Malaria Consortium, 2012
During the last decade child mortality has reduced significantly in a number of African countries, largely due to the scale up of appropriate management of diarrhoea, pneumonia and malaria, three leading causes of death among young ch...
Insecticide treated nets: the role of the commercial sector - case study of three countries in sub-Sahara Africa
A. Kilian / Malaria Consortium, 2012
Studies in the 1980s and after showed the value of Insecticide Treated Nets (ITNs) in the prevention of malaria. This learning paper takes a detailed look at the approaches of direct support to the commercial (ITN) market that were im...
Integrating severe acute malnutrition into the management of childhood diseases at community level in South Sudan
E. Keane / Malaria Consortium, 2013
In an extremely resource-limited setting such as South Sudan, there is a double challenge: a high burden of childhood disease and death, coupled with limited healthcare services to treat these diseases. There is a clear association be...
Moving towards malaria elimination: developing innovative tools for malaria surveillance in Cambodia
Malaria Consortium, 2013
In collaboration with the national malaria control programme in Cambodia (CNM), Malaria Consortium developed a diverse set of tools to improve malaria surveillance and to provide the information needed by national and district staff t...
Implementing integrated community case management: stakeholder experiences and lessons learned in three African countries
A. Wharton-Smith; H. Counihan; C. Strachan / Malaria Consortium, 2014
Integrated community case management (iCCM) of malaria, pneumoniaand diarrhoea at the community level has been a growing focus of community healthcare delivery across sub-Saharan Africa over the last few years, as well as in Malaria C...
Monitoring of health and demographic outcomes in poor urban settlements: evidence from the Nairobi Urban Health and Demographic Surveillance System
African Population and Health Research Center, Nairobi, Kenya, 2011
The Nairobi Urban Health and Demographic Surveillance System (NUHDSS) was set up in Korogocho and Viwandani slum settlements to provide a platform for investigating linkages between urban poverty, health, and demographic and other soc...
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