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    Feb 24, 2021
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    The role of community-based organizations in household ability to pay for health care in Kilifi District, Kenya

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    Authors
    Molyneux, Catherine
    Hutchison, Beryl
    Chuma, Jane
    Gilson, Lucy
    Affiliation
    Kenya Medical Research Institute (KEMRI)/Wellcome Trust Collaborative Research Programme, Centre for Geographic Medicine Research, Kilifi, Kenya; Medecins Sans Frontieres, Amsterdam, The Netherlands; Centre for Health Policy, University of Witwatersrand, Johannesburg, South Africa; London School of Hygiene and Tropical Medicine, London, UK;
    Issue Date
    2007-11-01
    
    Metadata
    Show full item record
    Journal
    Health Policy and Planning
    Abstract
    There is growing concern that health policies and programmes may be contributing to disparities in health and wealth between and within households in low-income settings. However, there is disagreement concerning which combination of health and non-health sector interventions might best protect the poor. Potentially promising interventions include those that build on the social resources that have been found to be particularly critical for the poor in preventing and coping with illness costs. In this paper we present data on the role of one form of social resource--community-based organizations (CBOs)--in household ability to pay for health care on the Kenyan coast. Data were gathered from a rural and an urban setting using individual interviews (n = 24), focus group discussions (n = 18 in each setting) and cross-sectional surveys (n = 294 rural and n = 576 urban households). We describe the complex hierarchy of CBOs operating at the strategic, intermediate and local level in both settings, and comment on the potential of working through these organizations to reach and protect the poor. We highlight the challenges around several interventions that are of particular international interest at present: community-based health insurance schemes; micro-finance initiatives; and the removal of primary care user fees. We argue the importance of identifying and building upon organizations with a strong trust base in efforts to assist households to meet treatment costs, and emphasize the necessity of reducing the costs of services themselves for the poorest households.
    URI
    http://hdl.handle.net/10144/116978
    DOI
    10.1093/heapol/czm031
    PubMed ID
    18006525
    Additional Links
    http://heapol.oxfordjournals.org/content/22/6/381.full.pdf+html
    Type
    Article
    Language
    en
    Description
    To access this article, click on "Additional Links".
    ISSN
    0268-1080
    ae974a485f413a2113503eed53cd6c53
    10.1093/heapol/czm031
    Scopus Count
    Collections
    Health Politics

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