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dc.contributor.authorMolyneux, Catherine
dc.contributor.authorHutchison, Beryl
dc.contributor.authorChuma, Jane
dc.contributor.authorGilson, Lucy
dc.date.accessioned2010-12-02T19:12:35Z
dc.date.available2010-12-02T19:12:35Z
dc.date.issued2007-11-01
dc.identifier.citationHealth Policy Plan 2007;22(6):381-92en
dc.identifier.issn0268-1080
dc.identifier.pmid18006525
dc.identifier.doi10.1093/heapol/czm031
dc.identifier.urihttp://hdl.handle.net/10144/116978
dc.descriptionTo access this article, click on "Additional Links".
dc.description.abstractThere 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.
dc.language.isoenen
dc.relation.urlhttp://heapol.oxfordjournals.org/content/22/6/381.full.pdf+htmlen
dc.rightsPublished by Oxford University Press Archived on this site with kind permission from Oxford University Pressen
dc.subject.meshCommunity Networksen
dc.subject.meshCross-Sectional Studiesen
dc.subject.meshFinancial Supporten
dc.subject.meshFinancing, Personalen
dc.subject.meshFocus Groupsen
dc.subject.meshHealth Status Disparitiesen
dc.subject.meshInterviews as Topicen
dc.subject.meshKenyaen
dc.subject.meshPovertyen
dc.subject.meshRural Populationen
dc.subject.meshUrban Populationen
dc.titleThe role of community-based organizations in household ability to pay for health care in Kilifi District, Kenyaen
dc.typeArticleen
dc.contributor.departmentKenya 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;en
dc.identifier.journalHealth Policy and Planningen
html.description.abstractThere 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.


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