Contracting and Providing Basic Health Care Services in Honduras : A Comparison of Traditional and Alternative Service Delivery Models
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 comm...
| Main Authors: | , |
|---|---|
| Format: | Working Paper |
| Language: | English en_US |
| Published: |
World Bank, Washington, DC
2013
|
| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/2010/06/12605593/contracting-providing-basic-health-care-services-honduras-comparison-traditional-alternative-service-delivery-models http://hdl.handle.net/10986/13609 |
| Summary: | 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'. 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). |
|---|