Tuesday, November 07, 2006

Health and Poverty

Health and Poverty " Let’s start with a brief discussion about what we routinely observe about the relationship between the health system and the poor. First, we generally see
that the poor suffer from poor health, often attributable to diseases that can be easily prevented and/or treated at an early stage by appropriate interventions. Clearly, there is some mismatch in volume or type between the services being supplied and what is “needed” or demanded. Second, looking at poor households, we usually find that families recognize the importance of good health, both for their general welfare and for its effect on earnings. But we see that households generally use less of services that appear to be “available” (that is, nearby and even affordable, counting direct prices) than public health
professionals would see as desirable to achieve a positive health outcome. We see that even the poor, who are typically seen as the target of governmentfinanced
actions in health, often opt for privately provided services--and that these services may not be seen by the public health community as the ones that are essential to good health. Third, looking at the health services themselves, we often see that government health services are not close to the people, or they do not function well, or they are unresponsive to the demands of the population--or all of the above! Finally, peering into the black box of public policy, we see that rhetoric about universal coverage, free services, priority dedicated to primary care and other worthy objectives are not matched by the patterns of spending."

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