Poverty and Access to Health Care in Developing Countries

Bibliographic Data

ID23324186
AuthorsDavid H Peters (0000-0001-8377-3444, Johns Hopkins University, corresponding author), Anu Garg (Johns Hopkins University), Gerry Bloom (Institute of Development Studies), Damian Walker (0000-0003-4568-0970, Johns Hopkins University), Damian G Walker, William R Brieger (0000-0001-9863-8296, Johns Hopkins University), M Hafizur Rahman (0000-0003-2292-9163, Johns Hopkins University)
Year2008
Volume1136
Issue1
Pages161-171
Publication date2008-06-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueAnnals of the New York Academy of Sciences (JOURNAL)
Journal identifiersISSN: 0077-8923 • E-ISSN: 1749-6632
PublisherWiley (PUBLISHER • GB)
DOI10.1196/annals.1425.011
PMID17954679
OpenAlexW2076489890
LanguageEN
Citations received256
References cited88

People in poor countries tend to have less access to health services than those in better‐off countries, and within countries, the poor have less access to health services. This article documents disparities in access to health services in low‐ and middle‐income countries (LMICs), using a framework incorporating quality, geographic accessibility, availability, financial accessibility, and acceptability of services. Whereas the poor in LMICs are consistently at a disadvantage in each of the dimensions of access and their determinants, this need not be the case. Many different approaches are shown to improve access to the poor, using targeted or universal approaches, engaging government, nongovernmental, or commercial organizations, and pursuing a wide variety of strategies to finance and organize services. Key ingredients of success include concerted efforts to reach the poor, engaging communities and disadvantaged people, encouraging local adaptation, and careful monitoring of effects on the poor. Yet governments in LMICs rarely focus on the poor in their policies or the implementation or monitoring of health service strategies. There are also new innovations in financing, delivery, and regulation of health services that hold promise for improving access to the poor, such as the use of health equity funds, conditional cash transfers, and coproduction and regulation of health services. The challenge remains to find ways to ensure that vulnerable populations have a say in how strategies are developed, implemented, and accounted for in ways that demonstrate improvements in access by the poor.

Business · Developing country · Disadvantage · Disadvantaged · Economic growth · Economics · Equity (law) · Health care · Health equity · Political science · Poverty · Public economics · Global Health Care Issues · Global Maternal and Child Health · Healthcare Systems and Reforms