Community Involvement in Health Care Financing : A Survey of the Literature on the Impact, Strengths, and Weaknesses
2001
Jakab, Melitta | Krishnan, Chitra
The paper reviews 45 published and unpublished reports on community financing completed between 1990 and 2001. The main objective of the study was to explore performance measures reported in the literature regarding community financing. The study concluded that the reviewed literature is rich in describing scheme design and implementation. At the same time, evidence on the performance of community financing schemes is limited. The study focused on reporting measures on three indicators in particular: Resource mobilization capacity. Community financing mechanisms mobilize significant resources for health care. However, there is a large variation in the resource mobilization capacity of various schemes. This review did not find systematic estimates about how much community financing contributes to health revenues at the local and/or national level. Social inclusion. Community financing is effective in reaching a large number of low-income populations who would otherwise have no financial protection against the cost of illness. There is large variation in the size of various schemes. At the same time, there are no estimates about the total population covered through community financing. There are indications that the poorest and socially excluded groups are not automatically reached by community financing initiatives. Financial protection. Community-based health financing schemes are systematically reported to reduce the out-of-pocket spending of their members while increasing their utilization of health care services.
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