Thursday, July 4, 2013

How to provide health services at low cost in poor countries

A 2010 McKinsey study proposes "three innovative delivery models to improve low cost primary care" in Tanzania's health care system: 
  1. Community health workers have only limited training but undertake health promotion activities and serve as liaisons to more highly trained colleagues. Because almost every village can have its own community health worker, the basics of health care delivery are available to all. 
  2. Mobile health care is a way to extend the reach of dispensaries and health centers. Health workers regularly travel to surrounding unserved villages (one day a week, for example), bringing basic medical supplies and communication tools. 
  3. Call centers staffed by nurses (with oversight from doctors) can support both community and mobile health workers, who use mobile phones or other communication technologies to consult with call center staff.
Another suggestion (that Dan will enjoy) is to encourage more private ownership of health facilities: 
Many countries encourage ownership of some forms of care delivery...  One innovation that has been used successfully elsewhere is to encourage nonprofit and private organizations to provide more primary care. In some developing countries, dispensaries and health centers that are owner-operated or managed through a social-franchising model complement public-sector facilities. In Kenya, for example, more than 65 franchised dispensaries provide health care to more than 350,000 patients annually. The cost of these facilities is covered not only by government spending and donor contributions but also by payments from patients—which gives staff an incentive to improve care delivery. 

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