Meeting the health-related needs of the very poor

There is a growing concern within the international development community that policies aimed at reducing the number of people living below the poverty line could leave the most disadvantaged groups behind.

In line with these concerns, this dossier looks at different strategies for reaching the very poor within the health sector, and at the institutional challenges associated with scaling up health-related interventions to cover broader segments of the population. It also highlights the fact that there are ways outside the health sector to improve health or reduce the impoverishing impact of disease, and that in some contexts these may benefit the poor most.

Introduction

This section considers the linkages between health and social protection and reviews different frameworks for analysing health and the very poor. It also looks at social protection in transition economies and the difficulties in operationalising joint health and social protection agendas. More...

Poverty and ill health

This section looks at who are the very poor, how to measure poverty, as well as the impact of ill-health on the very poor. Poor people’s use of health services is constrained by several barriers including lack of information, inadequate services, and their inability to pay. More...

Targeting the very poor

A key area of debate concerns the benefits of non-targeted strategies, such as the provision of universal free health care services, versus specific, targeted strategies for reaching the poor. More...

Strategies for reaching the very poor

There are a number of targeted health-related strategies that aim to meet the needs of the very poor including exemption schemes, insurance and voucher schemes. This section outlines what is known about the strengths and weaknesses of each strategy. More...

Provider behaviour

This section explores the effects of health assistance schemes on providers behaviour, and the ways of improving their performance and accountability. More...

Pro-poor health policies

This section examines issues relating to formulating, designing and implementing pro-poor policies and scaling up interventions. Evidence on the effectiveness and impact of these policies is weak. making it difficult to determine whether successful small-scale or expanded initiatives could be replicated elsewhere. More...