Publication:
Overcoming Barriers to Health Service Access and Influencing the Demand Side Through Purchasing

dc.contributor.authorEnsor, Tim
dc.contributor.authorCooper, Stephanie
dc.date.accessioned2013-06-05T18:26:07Z
dc.date.available2013-06-05T18:26:07Z
dc.date.issued2004-09
dc.description.abstractThis paper investigates the role of demand-side barriers in impeding access to the use of health services. Demand-side barriers are defined as determinants of use of health care that are not dependent on service delivery or price or direct price of those services. They include distance, education, opportunity cost, and cultural and social barriers. There is some evidence that these barriers are at least as important in determining access to services as the quality, volume, and price of services delivered by health care providers. The paper is divided into two sections. In the first section literature on demand barriers to accessing services is reviewed. Since the literature on these barriers is so substantial, the review is restricted to an illustrative survey of the main barriers in low-, middle-, and high-income countries. The second section surveys studies that report and evaluate methods for overcoming these barriers. The literature here is substantially less voluminous even when gray and unpublished sources are included in the survey. Many of the studies relate to access to obstetrical and family planning care. In most cases evaluation is not rigorous, and it is often hard to separate the impact of the intervention itself from other confounding factors. Few of the studies reported have an explicit poverty focus, although many of the interventions are conducted in poor areas. There is a clear need for further work to examine the most cost effective ways of reducing barriers to accessing services and in particular to investigate what methods are most effective in expanding access to essential care among the poor.en
dc.identifierhttp://documents.worldbank.org/curated/en/2004/09/5643483/overcoming-barriers-health-service-access-influencing-demand-side-through-purchasing
dc.identifier.doi10.1596/13791
dc.identifier.urihttps://hdl.handle.net/10986/13791
dc.languageEnglish
dc.language.isoen_US
dc.publisherWorld Bank, Washington, DC
dc.relation.ispartofseriesHealth, Nutrition and Population (HNP) discussion paper;
dc.rightsCC BY 3.0 IGO
dc.rights.holderWorld Bank
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/igo/
dc.subjectACCESS TO HEALTH CARE
dc.subjectACCESS TO HEALTH SERVICES
dc.subjectANTENATAL CARE
dc.subjectBASIC NEEDS
dc.subjectBIRTHS
dc.subjectCHILD HEALTH
dc.subjectCHILD HEALTH STATUS
dc.subjectCHILD SURVIVAL
dc.subjectCLINICS
dc.subjectCOMMODITIES
dc.subjectCONTRACEPTIVES
dc.subjectCOST OF TREATMENT
dc.subjectDEBT
dc.subjectDEMAND
dc.subjectDETERMINANTS OF HEALTH
dc.subjectDIET
dc.subjectDISASTERS
dc.subjectDISEASES
dc.subjectEMPLOYMENT
dc.subjectEQUILIBRIUM
dc.subjectEXTERNALITIES
dc.subjectFAMILIES
dc.subjectFAMILY PLANNING
dc.subjectHEALTH CARE
dc.subjectHEALTH CARE DEMAND
dc.subjectHEALTH CARE FACILITIES
dc.subjectHEALTH CARE FINANCING
dc.subjectHEALTH CARE INFRASTRUCTURE
dc.subjectHEALTH CARE PROVIDERS
dc.subjectHEALTH CARE UTILIZATION
dc.subjectHEALTH ECONOMICS
dc.subjectHEALTH EDUCATION
dc.subjectHEALTH FACILITIES
dc.subjectHEALTH MESSAGES
dc.subjectHEALTH PROBLEMS
dc.subjectHEALTH SECTOR
dc.subjectHEALTH SERVICES
dc.subjectHEALTH STATUS
dc.subjectHEALTH SYSTEM
dc.subjectHEALTHY LIFESTYLES
dc.subjectHOSPITALS
dc.subjectHUMAN DEVELOPMENT
dc.subjectHUMAN RESOURCES
dc.subjectINCOME
dc.subjectINDUCED DEMAND
dc.subjectINFANT MORTALITY
dc.subjectINFORMATION PROBLEMS
dc.subjectINSURANCE
dc.subjectINTERVENTION
dc.subjectLAWS
dc.subjectLESSONS LEARNED
dc.subjectLIFESTYLES
dc.subjectLOW-INCOME COUNTRIES
dc.subjectMATERNAL HEALTH
dc.subjectMATERNAL MORTALITY
dc.subjectMEDICAL CARE
dc.subjectMEDICAL EQUIPMENT
dc.subjectMEDICAL TREATMENT
dc.subjectMEDICINES
dc.subjectMOTHERS
dc.subjectNUTRITION
dc.subjectNUTRITIONAL STATUS
dc.subjectOBSTETRIC CARE
dc.subjectOBSTETRIC EMERGENCIES
dc.subjectORS
dc.subjectPARENTS
dc.subjectPATIENTS
dc.subjectPHARMACISTS
dc.subjectPHYSICIANS
dc.subjectPOLIO
dc.subjectPOLIO ERADICATION
dc.subjectPREGNANCY
dc.subjectPROBABILITY
dc.subjectPRODUCTIVITY
dc.subjectPROGNOSIS
dc.subjectPROMOTING HEALTH
dc.subjectPUBLIC SECTOR
dc.subjectQUALITY OF CARE
dc.subjectSANITATION
dc.subjectSERVICE DELIVERY
dc.subjectSOCIAL DEVELOPMENT
dc.subjectSOUTH AMERICA
dc.subjectSOUTH AMERICAN
dc.subjectUGANDA
dc.subjectURBAN AREAS
dc.subjectURBAN DWELLERS
dc.subjectVACCINATIONS
dc.titleOvercoming Barriers to Health Service Access and Influencing the Demand Side Through Purchasingen
dspace.entity.typePublication
okr.date.doiregistration2025-05-05T12:05:03.660573Z
okr.doctypePublications & Research::Working Paper
okr.doctypePublications & Research
okr.docurlhttp://documents.worldbank.org/curated/en/2004/09/5643483/overcoming-barriers-health-service-access-influencing-demand-side-through-purchasing
okr.guid633391468762937183
okr.identifier.externaldocumentum000090341_20050307111459
okr.identifier.internaldocumentum5643483
okr.identifier.report31598
okr.language.supporteden
okr.pdfurlhttp://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2005/03/07/000090341_20050307111459/Rendered/PDF/315980HNP0EnsorOvercomingBarriersFinal.pdfen
okr.topicHealth Monitoring and Evaluation
okr.topicHealth Systems Development and Reform
okr.topicAgricultural Knowledge and Information Systems
okr.topicEnvironmental Economics and Policies
okr.topicHealth Economics and Finance
okr.unitHealth, Nutrition, and Population
okr.volume1 of 1
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