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Prepaid financing of primary health care in Guinea-Bissau : an assessment of 18 village health posts, Volume 1
Author:Eklund, Per; Stavem, Knut; Collection Title:Policy, Research, and External Affairs working paper ; no. WPS 488
Country:Guinea-Bissau; Date Stored:2001/04/27
Document Date:1990/08/31Document Type:Policy Research Working Paper
SubTopics:Regional Rural Development; Housing & Human Habitats; Health Monitoring & Evaluation; Health Systems Development & Reform; Agricultural Knowledge and Information SystemsLanguage:English
Major Sector:(Historic)Health, Nutrition & PopulationRegion:Africa
Report Number:WPS488Sub Sectors:Primary Health, Including Reproductive Health, Chi
Volume No:1  

Summary: With population growth increasing and budgets declining, the need for cost recovery in health care has grown. This paper discusses a prepayment scheme for drugs and limited primary health care at 18 village health posts in Guinea-Bissau. At these health posts, adverse selection was reduced because enrollment in each village was almost universal. The villager provided construction materials and labor and indicated their willingness to pay more if drugs were available on a timely basis. Villagers' willingness to prepay was often linked to better service, with drugs more readily available and midwidves better trained. Still, the quality of service at village health posts can only be as good as the support they get from the rest of the health care system. Authorities must strengthen health center support services and improve the drug resupply system.

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