Garcia Prado, AriadnaLao Peña, Christine2013-05-292013-05-292010-06https://hdl.handle.net/10986/13609This study uses data from health facility and patient exit surveys carried out in 2006 in Honduras to examine the characteristics of two basic health care provision models: a traditional Ministry of Health (MOH) public health care one versus a community based one also known as 'alternative' or 'public-social'. The author compare these models based on access, quality, costs, productivity, and management autonomy. While the alternative model has higher unit costs for drugs, it also has higher labor productivity. The fact that alternative providers are held accountable through performance-based contracts and that their personnel are hired on a contractual basis and can be demoted or even fired may account for their stronger performance relative to traditional providers whose personnel are centrally hired civil service staff. The findings support the alternative model as a viable option to expand services to other areas of Honduras that lack health services, compensating for the MOH's insufficient capacity to deliver and manage health care services in poor and remote areas. Some elements of this model such as performance-based agreements and other incentives can be also incorporated in the management and implementation of the traditional MOH health units in order to improve their performance. As the alternative models increase in number, it will be important to continue to evaluate their performance and to also analyze whether facility performance differs based on type of management (for example, whether the facility is managed by a municipality or an association of municipalities, a non-government organization, or community based organization).en-USCC BY 3.0 IGOABILITY TO PAYACCESS TO CAREACCESS TO HEALTH CAREAIDALTERNATIVE HEALTH CAREAUXILIARY NURSESBASIC HEALTH CAREBASIC HEALTH SERVICESCHILDBIRTHCLEANLINESSCOMMUNITIESCOMMUNITY HEALTHCOMMUNITY HEALTH CARECOMMUNITY HEALTH SERVICESCOMMUNITY INVOLVEMENTCOMMUNITY PARTICIPATIONCOMMUNITY WORKDECISION MAKINGDENTISTDIAGNOSISDISCRETIONARY AUTHORITYDISEASESDOCTORDOCTORSEMERGENCY CAREESSENTIAL DRUGSEXPENDITURESEXPOSUREFAMILY PLANNINGFEMALEHEALTH ADMINISTRATIONHEALTH CAREHEALTH CARE FACILITIESHEALTH CARE FACILITYHEALTH CARE INSURANCEHEALTH CARE PERSONNELHEALTH CARE PROFESSIONALSHEALTH CARE PROVIDERHEALTH CARE PROVIDERSHEALTH CARE PROVISIONHEALTH CARE SERVICESHEALTH CENTERSHEALTH COVERAGEHEALTH ECONOMICSHEALTH EXTENSIONHEALTH FACILITIESHEALTH ORGANIZATIONHEALTH PLANSHEALTH POLICYHEALTH REFORMSHEALTH SERVICEHEALTH SERVICE DELIVERYHEALTH SERVICESHEALTH STATUSHEALTH SYSTEMHEALTH SYSTEMSHOSPITALSHOUSEHOLDSHUMAN DEVELOPMENTHUMAN RESOURCESILLNESSIMMUNIZATIONINCOMEINHABITANTSINTEGRATIONINTERNATIONAL ORGANIZATIONSLEGAL FRAMEWORKMEDICAL EQUIPMENTMEDICINEMEDICINESMIDWIVESNURSENURSESNUTRITIONOUTPATIENT SERVICESPATIENTPATIENT SATISFACTIONPATIENTSPERSONALITYPHARMACYPHYSICIANPHYSICIANSPREGNANT WOMENPRIMARY CAREPRIMARY HEALTH CAREPRIMARY HEALTH CARE SERVICESPROBABILITYPUBLIC HEALTHPUBLIC HEALTH CAREPUBLIC HEALTH CARE CENTERSQUALITY OF CARERABIESREFERRALSREPRODUCTIVE HEALTHRURAL AREASSOCIAL SCIENCESPECIALISTTRADITIONAL HEALTH CAREURBAN DWELLERSVISITSWORKERSWORKING CONDITIONSWorld Bank10.1596/13609