Friday, August 20, 2010

[EQ] Contracting and Providing Basic Health Care Services in Honduras: A Comparison of Traditional and Alternative Service Delivery Models

Contracting and Providing Basic Health Care Services in Honduras:
A Comparison of Traditional and Alternative Service Delivery Models

Ariadna Garcia Prado and Christine Lao Peña
Health Nutrition and Population (HNP) Discussion Paper – June 2010

World Bank's Human Development Network.

            Available online PDF [40p.] at: http://bit.ly/avxYkk

 

“……This 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”. We compare these models based on access, quality, costs, productivity, and management autonomy.

 

Employing non-parametric tests as well as a probit model, we find that there are significant differences between these two models in terms of quality, management autonomy, and patient’s willingness to return, in favor of the alternative model. 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.

 

Our 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 would 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)…..”

 

 

Content:

1. introduction

2. an analytical framework to study both service delivery models

3. sample and methodology

4. health care supply and demand

4.1. access

4.2. quality

4.3. management autonomy

4.4. determinants of utilization of health care facilities

5. cost and productivity analysis

6. conclusion and policy discussion

references

annex 1. sample of alternative and traditional models and the socioeconomic status of the catchment area

annex 2. services provided in each type of health care facility

annex 3.a. traditional facilities: main characteristics

annex 3.b. alternative facilities: main characteristics



 
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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
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[EQ] Joint Colloquium: The Campbell and Cochrane Collaborations - Bringing Evidence-Based Decision-Making to New Heights

The Joint Colloquium is hosted by: The Campbell and Cochrane Collaborations


The Campbell & Cochrane Collaborations are international collaborations dedicated to producing & keeping up-to-date systematic reviews for evidence-based decision-making on the following topics: education, crime and justice, social welfare and health.


BRINGING EVIDENCE-BASED DECISION-MAKING TO NEW HEIGHTS

Website: http://bit.ly/bhHdIS


18 -22 October 2010 - Keystone, Colorado USA

The Joint Colloquium is made possible through generous funding provided by:
Agency for Healthcare Research & Quality, Department of Veterans Affairs Eastern Colorado Health Care System, University of Colorado School of Medicine, University Physicians Inc, JAMA Evidence & McGraw Hill, Jerry Lee Foundation, University of Colorado Denver Dept Dermatology, Colorado Injury Control Research Center, and
Pan American Health Organization PAHO/WHO

 

Plenary sessions include: using evidence to deal with emergent global issues; presenting evidence effectively to practitioners & consumers; and issues of equity & inclusion of low middle income countries.

 

Plenary Speakers:

Patricia Schroeder (Keynote) Former House of Representatives, US Congress

Barney Cohen National Research Council

Fiona Godlee Editor-in-Chief, BMJ

Julia Littell Bryn Mawr College

Susan Love Love/Avon Army of Women

Mary Frances Luce Duke University

Joia Mukherjee Partners in Health

Eamon Noonan The Campbell Collaboration

Zulma Ortiz UNICEF Argentina

Prathap Tharyan South Asian Cochrane Center

Bob Wachter University of California, San Francisco

David Weisburd Hebrew University and George Mason University

Ming Ming Zhang Chinese Cochrane Center

 

 

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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[EQ] Outlook: Chagas Disease

Outlook: Chagas Disease

Nature - Vol. 465, No. 7301 suppl. ppS3-S22 (24 June 2010) - DOI:doi:10.1038/465S3a

Website: http://www.nature.com/nature/outlook/chagas/index.html

“…..Chagas disease is one of the most neglected of the tropical diseases, yet millions of people are infected with it. There are only two available drugs to treat it, both of which are more than 40 years old and neither of which is ideal.

As the global population has become more internationally mobile, Chagas disease has spread from Latin America to become a worldwide threat.

This Outlook highlights some of the progress in understanding and treating Chagas disease over its 101 years of recent history and outlines the challenges still to be met….”

Outlook Editorial

Chagas diseaseMichelle Grayson

Nature 465, S3 (24 June 2010) doi:10.1038/465S3a Full Text | PDF

“….Chagas disease is arguably the archetypal neglected disease. Millions of people — the vast majority in Latin America — are infected, yet it is seldom discussed. It has struggled to achieve even a fraction of the notoriety of other neglected diseases, such as malaria. Its prevalence in immigrants to Spain, Portugal, the United States and other parts of the world has gone largely unnoticed. Even those who live in endemic areas are rarely aware of it…”

Feature

Chagas disease 101Julie Clayton

Nature 465, S4—S5 (24 June 2010) doi:10.1038/nature09220 Full Text | PDF

‘…It is 101 years since Carlos Chagas discovered the parasite responsible for the disease that now bears his name. What progress has been made since this discovery? Here Julie Clayton gives the low-down on Chagas disease…”

Opinion

Chagas disease: a new worldwide challengeJosé Rodrigues Coura & Pedro Albajar Viñas

Nature 465, S6—S7 (24 June 2010) doi:10.1038/nature09221

Full Text | PDF

 

Feature

Who, how, what and where?Nature 465, S8—S9 (24 June 2010) doi:10.1038/nature09222

Full Text | PDF

 

Feature

Country by countryAnna Petherick

Nature 465, S10—S11 (24 June 2010) doi:10.1038/nature09223

Full Text | PDF

 

Feature

Chagas disease: pushing through the pipelineJulie Clayton

Nature 465, S12—S15 (24 June 2010) doi:10.1038/nature09224

Full Text | PDF

 

Feature

The promise of T. cruzi genomicsJulie Clayton

Nature 465, S16—S17 (24 June 2010) doi:10.1038/nature09225

Full Text | PDF

 

Feature

Chagas disease in the ChacoAnna Petherick

Nature 465, S18—S20 (24 June 2010) doi:10.1038/nature09226

Full Text | PDF

 

Feature

Campaigning for Chagas diseaseAnna Petherick

Nature 465, S21—S22 (24 June 2010) doi:10.1038/nature09227

Full Text | PDF

 

News and Views

Parasitology: Triple genome triumph —  Declan Butler

Nature 436, 337—337 (21 July 2005) doi:10.1038/436337b

Full Text | PDF

 

Commentary Immunology south of the equator in the Americas

Gabriel A. Rabinovich, Alexis M. Kalergis, Norberto W. Zwirner & Wilson Savino

Nature Immunology 9, 1087—1090 (2008) doi:10.1038/ni1008-1087

Abstract | Full Text | PDF

 

Perspective

Trypanosoma cruzi surface mucins: host-dependent coat diversity

Carlos A. Buscaglia, Vanina A. Campo, Alberto C. C. Frasch & Javier M. Di Noia

Nature Reviews Microbiology 4, 229—236 (March 2006) doi:10.1038/nrmicro1351

Abstract | Full Text | PDF

 

Article

Drug-induced cure drives conversion to a stable and protective CD8+ T central memory response in chronic Chagas disease

Juan M. Bustamante, Lisa M. Bixby & Rick L. Tarleton

Nature Medicine 14, 542—550 (20 April 2008) doi:10.1038/nm1744

Abstract | Full Text | PDF

 

Perspective

The Trypanosoma cruzi-host-cell interplay: location, invasion, retentionLuciana O. Andrade & Norma W. Andrews

Nature Reviews Microbiology 3, 819—823 (9 September 2005) doi:10.1038/nrmicro1249

Abstract | Full Text | PDF

 

 

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
------------------------------------------------------------------------------------
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Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
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IMPORTANT: This transmission is for use by the intended
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confidential information. If you are not the intended
recipient or a person responsible for delivering this
transmission to the intended recipient, you may not
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any action in reliance on it. If you received this transmission
in error, please dispose of and delete this transmission.

Thank you.