Research theme 2: which innovations can make the private and public health sectors work for the poor?

What factors influence the behaviour of health service providers and users? What innovative strategies enable poor people to make better use of available medical kno w ledge and health-related commodities (e.g. new types of regulatory partnerships, empowering citizens, and new ways to identify good performers through franchising and use of information technology)?

The overall goal of this theme is to identify and support innovations that make public and private health providers work well for the poor. In all partner countries government health facilities are important sources of health care for the poor. However, the services they provide are often of variable quality and people incur significant costs in accessing them. Poor people also rely heavily on a variety of private providers, often paying a lot of money for low quality care. The present situation means that many people do not gain access to effective services and they often waste a considerable amount of money.

Consortium members are exploring a variety of strategies for improving the performance of health service providers. These include alternative models of social finance including vouchers and social insurance, approaches for linking public finance to performance and strategies for making health service providers more accountable to patients and the community. Country teams are exploring ways to improve the quality of a wide variety of providers, from large hospitals to private medicine vendors and informal health workers. The major factor in selecting providers is the degree to which they are used by the poor.

The objectives of the theme group are as follows:

1. to document the most important providers of health services to the poor
2. to understand the major influences on the performance of public and private providers of health care and drugs to the poor
3. to assess alternative strategies for improving performance of these providers
4. to disseminate knowledge of practical approaches for improving provider performance to policy makers and other relevant actors
5. to contribute to efforts rapidly to improve access to effective health services by the poor