Contracts have played a central role in public sector reforms in developed countries over the last decade, and research increasingly highlights their varied nature. In low and middle income countries the use of contracts is encouraged but little attention has been paid to features of the setting...

This paper adopts three approaches to classifying countries by level of constraint, in order to inform the choice of strategies for expanding access to health interventions in different contexts. We find substantial heterogeneity across the 84 low-income and (all) sub-Saharan African countries...

A key issue in the expansion of access to priority health services is how best to implement scaling up efforts. In this paper, we explore the relative merits of vertical and horizontal delivery modes; review the literature on the impact of vertical programmes on health systems and on experiences...

This paper analyses household coping strategies for illness in four Lao villages. The villagers dealt with health expenditure themselves, using coping mechanisms which drew mainly on social networks within the community. They strongly believed in the principle of paying user fees and did not...

This paper reviews the current evidence base regarding efforts to overcome constraints to effective health service delivery in low and middle-income countries. A systematic literature review was chosen as the approach to gather and analyse existing knowledge about how to improve the...

The Commission on Macroeconomics and Health recommended a significant expansion in funding for health interventions in poor countries. However, there are a range of constraints to expanding access to health services: as well as an absolute lack of resources, access to health interventions is...

Measurement of health system performance increasingly includes the views of healthcare users, yet little research has focussed on general population satisfaction with health systems. This study is the first to examine public satisfaction with health systems in the former Soviet Union (fSU). Data...

In 1983 The Economics of Health in Devloping Countries was published. This was a basic text, designed to illuminate ways in which economic concepts and techniques can be applied to health and health services, each chapter eviewing `the state of the art' in a particular area. Since 1983, there...

Despite the emphasis placed during the last two decades on public delivery of comprehensive and equitable primary care (PC) to developing country populations, coverage remains far from universal and the quality often poor. Users frequently patronise private providers, ranging from informal drug...

Fee exemption schemes are widely recommended but little analysed. This paper analyses the operation of the Free Medical Care Project in Thailand, which enables those classified as poor to receive free treatment at government facilities. The paper concentrates in particular on the size and...