Health Policy and Planning; 19(2): 69-79
© Oxford University Press
2004
Review article |
Overcoming barriers to health service access: influencing the demand side
International Programme, Centre for Health Economics, University of York, York, UK
Evidence suggests that demand-side barriers may be as important as supply factors in deterring patients from obtaining treatment. Yet relatively little attention is given, either by policy makers or researchers, to ways of minimizing their effect. These barriers are likely to be more important for the poor and other vulnerable groups, where the costs of access, lack of information and cultural barriers impede them from benefiting from public spending.
Demand barriers present in low- and middle-income countries and evidence on the effectiveness of interventions to overcome these obstacles are reviewed. Demand barriers are also shown to be important in richer countries, particularly among vulnerable groups. This suggests that while barriers are plentiful, there is a dearth of evidence on ways to reduce them. Where evidence does exist, the data and methodology for evaluating effectiveness and cost-effectiveness is insufficient. An increased focus on obtaining robust evidence on effective interventions could yield high returns. The likely nature of the interventions means that pragmatic policy routes that go beyond the traditional boundaries of the public health sector are required for implementing the findings.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  S. M. Ahmed, Md. A. Hossain, and M. R. Chowdhury Informal sector providers in Bangladesh: how equipped are they to provide rational health care? Health Policy Plan., November 1, 2009; 24(6): 467 - 478. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Russo and B. McPake Medicine prices in urban Mozambique: a public health and economic study of pharmaceutical markets and price determinants in low-income settings Health Policy Plan., October 20, 2009; (2009) czp042v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. O Parkhurst and F. Ssengooba Assessing access barriers to maternal health care: measuring bypassing to identify health centre needs in rural Uganda Health Policy Plan., September 1, 2009; 24(5): 377 - 384. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Forde and D. Zeuner Financial incentives to promote social mobility BMJ, August 25, 2009; 339(aug25_2): b3219 - b3219. [Full Text]
|
|
|
|
|
|
M. Perkins, E. Brazier, E. Themmen, B. Bassane, D. Diallo, A. Mutunga, T. Mwakajonga, and O. Ngobola Out-of-pocket costs for facility-based maternity care in three African countries Health Policy Plan., July 1, 2009; 24(4): 289 - 300. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Reniers and R. Tesfai Health services utilization during terminal illness in Addis Ababa, Ethiopia Health Policy Plan., July 1, 2009; 24(4): 312 - 319. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Rechel, N. Spencer, C. Blackburn, R. Holland, and B. Rechel Impact of health reforms on child health services in Europe: the case of Bulgaria Eur J Public Health, June 1, 2009; 19(3): 326 - 330. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. R Adhikari, N. M Maskay, and B. P Sharma Paying for hospital-based care of Kala-azar in Nepal: assessing catastrophic, impoverishment and economic consequences Health Policy Plan., March 1, 2009; 24(2): 129 - 139. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Shaw and M. Carrozza Is Access Sufficient? An Examination of the Effects of the MedShare Program to Expand Access to Prescription Drugs for Indigent Populations Eval Rev, December 1, 2008; 32(6): 526 - 546. [Abstract] [PDF]
|
|
|
|
|
|
A. Sepehri, S. Moshiri, W. Simpson, and S. Sarma Taking account of context: how important are household characteristics in explaining adult health-seeking behaviour? The case of Vietnam Health Policy Plan., November 1, 2008; 23(6): 397 - 407. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. E. Kruk, M. R. Prescott, and S. Galea Equity of Skilled Birth Attendant Utilization in Developing Countries: Financing and Policy Determinants Am J Public Health, January 1, 2008; 98(1): 142 - 147. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Noirhomme, B. Meessen, F. Griffiths, P. Ir, B. Jacobs, R. Thor, B. Criel, and W. Van Damme Improving access to hospital care for the poor: comparative analysis of four health equity funds in Cambodia Health Policy Plan., July 1, 2007; 22(4): 246 - 262. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. D. Allegri and R. Sauerborn Community based health insurance in developing countries BMJ, June 23, 2007; 334(7607): 1282 - 1283. [Full Text] [PDF]
|
|
|
|
 |
|
 J. E Lawn, A. Costello, C. Mwansambo, and D. Osrin Countdown to 2015: will the Millennium Development Goal for child survival be met? Arch. Dis. Child., June 1, 2007; 92(6): 551 - 556. [Abstract] [Full Text] [PDF]
|
|