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Health

Financial incentives in health: supply- vs. demand-side. Your help is needed!

Adam Wagstaff's picture

A blogpost on financial incentives in health by one of us in September 2015 generated considerable interest. The post raised several issues, one being whether demand-side financial incentives (like maternal vouchers) are more or less effective at increasing the uptake of key maternal and child health (MCH) interventions than supply-side financial incentives (variously called pay-for-performance (P4P) or performance-based financing (PBF)).

The four of us are now hard at work investigating this question — and related ones — in a much more systematic fashion. And we'd very much welcome your help.

Of quacks and crooks: The conundrum of informal health care in India

Jishnu Das's picture

I usually don’t wake up to hate mail in my inbox. What prompted this deluge is a recent paper that evaluates the impact of a training program for informal health care providers (providers without any formal medical training) in the state of West Bengal, India (paper summary). Training improved the ability of informal providers to correctly manage the kind of conditions they may see in their clinics, but it did not decrease their overuse of unnecessary medicines or antibiotics.

When does pollution policy work? The water quality and infant mortality impacts of Mehta vs. Union of India

Quy-Toan Do's picture
India’s rivers are heavily polluted. According to official estimates, 302 of 445 river stretches fail to meet even bathing criteria (Central Pollution Control Board [CPCB], 2014). This is known to have a heavy disease burden: each year, 37.7 million Indians are affected by waterborne diseases, 73 million working days are lost, and 1.5 million children are estimated to die of diarrhea alone (Water Aid, 2008). 
Yavuz SariyildizShutterstock.com

Biting back at malaria: On treatment guidelines and measurement of health service quality

Arndt Reichert's picture

Growing up in a tropical country, one of us (Alfredo) was acutely aware of mosquito-borne diseases such as dengue and malaria. For many years now, vector-control strategies were—and still are—promoted by government- and school-led campaigns to limit the spread of these diseases. Consequently, it is somewhat alarming to know that diseases spread by mosquitoes remain an enormous challenge facing large parts of the developing and even developed world, particularly sub-Saharan Africa. It is perhaps less surprising that our shared interest in the health sector has resulted in a joint paper on assessing the overall quality of the health care system via compliance with established treatment guidelines.

India’s informal doctors are assets not crooks

Jishnu Das's picture

This article was originally published on SciDev.Net. Read the original article.

Most of us would agree that when it comes to healthcare providers, some training is better than none. Yet even this seemingly innocuous statement is highly contentious in India, where training primary care providers who lack formal medical qualifications is anathema to the professional medical classes.
 
But the professionals are wrong. Training informal providers (IPs) could vastly improve the quality of care for millions of rural Indians and there is no evidence that it would make matters worse.
 
It is time to implement such training and critically evaluate its impact, to guide Indian states in deciding whether to treat these providers as an obstacle or an opportunity.

What to expect when you’re expecting, in Nigeria: Lessons from a series of health impact evaluations

Anushka Thewarapperuma's picture
The life of a Nigerian midwife


Childbirth is a time for expectant mothers to revel in the wonders and joy surrounding the arrival of a new human being; one breathing crisp new air, bawling with resonance in finding their voice and opening their eyes in awe to see the world around them. It’s the last conceivable moment where a mother wants to worry about the cleanliness of the birth facility, the baby’s life and, least of all, her own life. But in many developing countries including Nigeria, this is the reality.  

What can societies do to age with growth and prosperity?

Hans Lofgren's picture
Identifying and making policies that effectively counter the drag of aging on global growth is imperative for the long haul. During the last 15 years, close to 80 percent of global growth took place in middle- and high-income countries that, during the next few decades, will undergo rapid aging, with shrinking population shares in working age and growing shares of elderly.

Saturday, December 12 was UHC Day. What have we learned in the last 12 months about Universal Health Coverage?

Adam Wagstaff's picture
It turns out lots of interesting things happened on December 12. Beethoven had his first lesson in music composition with Franz Joseph Haydn (1792), Washington, D.C. became the capital of the US (1800), Guglielmo Marconi sent the first transatlantic radio signal (1901), Kenya declared independence from the UK (1963), The Beatles played their last UK concert (1965), and  Ed Sheeran announced he was “taking a break” from social media (2015). Oh yes, and the UN endorsed a resolution calling for countries to “provide affordable, quality health care to every person, everywhere” (2012).

Poverty is falling faster among Africa’s female headed households

Dominique Van De Walle's picture
A sizeable number of households in Africa today have female heads.  Based on the latest Demographic and Health Surveys (DHS), 26% of all households Africa-wide are headed by women. Although there are cross-country differences, the shares both of the population living in female headed households (FHHs) and of households headed by women, have been rising over time. The data show quite clearly that the probability that a woman aged 15 or older heads a household, controlling for her age, has been increasing since the early 1990s in all regions and across the entire age distribution.

Financial incentives in health: the magic bullet we were hoping for?

Adam Wagstaff's picture

After years of bad news from developing countries about high rates of health worker absenteeism, and low rates of delivery of key health interventions, along came what seemed like a magic bullet: financial incentives. Rather than paying providers whether or not they show up to work, and whether or not they deliver key interventions, doesn’t it make sense to pay them—at least in part—according to what they do? And if, after doing their cost-benefit calculations, women decide not to have their baby delivered in a health facility, not to get antenatal care, and not take their child to be immunized, then doesn’t it make sense to try to change the benefit-cost ratio by paying them to do so?

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