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Eldis is an online information service providing free access to up-to-date research on international development issues. The resources below are the most recent updates on the Eldis guides to Health Systems and Policy from FHS countries.


Making health markets work for the poor

From 7-9 November 2011, the M4P Hub hosted a conference in Brighton, UK, on making markets work for poor people. It was a key opportunity to discuss and promote the M4P approach, which effectively maps the public, private and non-governmental systems that comprise a sector within a country.

Dr Gerry Bloom from FHS participated in the conference focusing on health markets in developing countries. His presentation gave an overview of work from FHS partners in Bangladesh and Nigeria of the role of informal providers in health markets.

Although he noted the tension in the health sector between working through public systems and engaging health markets, he pointed out that many poor use the private sector as their first point of call when accessing health services. For example, our research in Bangladesh shows that 65% of people who visit a health provider visit private 'village doctors'. In Nigeria, more than half of those studied obtained treatment for malaria through private providers.

Of course, working with these informal providers had risks. Even after training, in Bangladesh village doctors still gave inappropriate and occasionally harmful prescriptions. But while Dr Bloom urged caution, he doesn't think this means we should not engage with the private sector and informal providers. On the contrary, he also pointed out that building capacity of the public sector carried its own set of risks. Rather, he suggested that we need to be aware of these strong incentives and work to improve the business model so that these private providers have the appropriate incentives to provide accurate care.


Reader Comments (1)

Dr. Bloom,
We share your problem analysis, and are interested in finding out if you have any results on improved health outcomes from this initiative? If you have further evidence, maybe we could discuss? We work in Bangladesh on the isolated river islands where only quacks offer health service (no govt or NGO provision). The only significant worthwhile health service is CLP's own short term biweekly clinics. In the longer term, reforming the quacks seems to be the most viable way forward, but as you point out, there is no business model providing incentives that encourage them to behave in ways which improve their service.
By the way, we have the same on animal health systems and have done very well. The ethical issues are lower, but it is one place to look for ideas. Please do come up and visit and would be interested to learn together.
Best wishes,
Ric Goodman,
Chars Livelihoods Programme, clp-bangladesh.org

November 22, 2011 | Unregistered CommenterRic Goodman

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