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...

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Main Authors:	Garcia Prado, Ariadna, Lao Peña, Christine
Format:	Working Paper
Language:	English en_US
Published:	World Bank, Washington, DC 2013
Subjects:	ABILITY TO PAY ACCESS TO CARE ACCESS TO HEALTH CARE AID ALTERNATIVE HEALTH CARE AUXILIARY NURSES BASIC HEALTH CARE BASIC HEALTH SERVICES CHILDBIRTH CLEANLINESS COMMUNITIES COMMUNITY HEALTH COMMUNITY HEALTH CARE COMMUNITY HEALTH SERVICES COMMUNITY INVOLVEMENT COMMUNITY PARTICIPATION COMMUNITY WORK DECISION MAKING DENTIST DIAGNOSIS DISCRETIONARY AUTHORITY DISEASES DOCTOR DOCTORS EMERGENCY CARE ESSENTIAL DRUGS EXPENDITURES EXPOSURE FAMILY PLANNING FEMALE HEALTH ADMINISTRATION HEALTH CARE HEALTH CARE FACILITIES HEALTH CARE FACILITY HEALTH CARE INSURANCE HEALTH CARE PERSONNEL HEALTH CARE PROFESSIONALS HEALTH CARE PROVIDER HEALTH CARE PROVIDERS HEALTH CARE PROVISION HEALTH CARE SERVICES HEALTH CENTERS HEALTH COVERAGE HEALTH ECONOMICS HEALTH EXTENSION HEALTH FACILITIES HEALTH ORGANIZATION HEALTH PLANS HEALTH POLICY HEALTH REFORMS HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEMS HOSPITALS HOUSEHOLDS HUMAN DEVELOPMENT HUMAN RESOURCES ILLNESS IMMUNIZATION INCOME INHABITANTS INTEGRATION INTERNATIONAL ORGANIZATIONS LEGAL FRAMEWORK MEDICAL EQUIPMENT MEDICINE MEDICINES MIDWIVES NURSE NURSES NUTRITION OUTPATIENT SERVICES PATIENT PATIENT SATISFACTION PATIENTS PERSONALITY PHARMACY PHYSICIAN PHYSICIANS PREGNANT WOMEN PRIMARY CARE PRIMARY HEALTH CARE PRIMARY HEALTH CARE SERVICES PROBABILITY PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC HEALTH CARE CENTERS QUALITY OF CARE RABIES REFERRALS REPRODUCTIVE HEALTH RURAL AREAS SOCIAL SCIENCE SPECIALIST TRADITIONAL HEALTH CARE URBAN DWELLERS VISITS WORKERS WORKING CONDITIONS
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

id	okr-10986-13609
recordtype	oai_dc
spelling	okr-10986-136092021-04-23T14:03:09Z Contracting and Providing Basic Health Care Services in Honduras : A Comparison of Traditional and Alternative Service Delivery Models Garcia Prado, Ariadna Lao Peña, Christine ABILITY TO PAY ACCESS TO CARE ACCESS TO HEALTH CARE AID ALTERNATIVE HEALTH CARE AUXILIARY NURSES BASIC HEALTH CARE BASIC HEALTH SERVICES CHILDBIRTH CLEANLINESS COMMUNITIES COMMUNITY HEALTH COMMUNITY HEALTH CARE COMMUNITY HEALTH SERVICES COMMUNITY INVOLVEMENT COMMUNITY PARTICIPATION COMMUNITY WORK DECISION MAKING DENTIST DIAGNOSIS DISCRETIONARY AUTHORITY DISEASES DOCTOR DOCTORS EMERGENCY CARE ESSENTIAL DRUGS EXPENDITURES EXPOSURE FAMILY PLANNING FEMALE HEALTH ADMINISTRATION HEALTH CARE HEALTH CARE FACILITIES HEALTH CARE FACILITY HEALTH CARE INSURANCE HEALTH CARE PERSONNEL HEALTH CARE PROFESSIONALS HEALTH CARE PROVIDER HEALTH CARE PROVIDERS HEALTH CARE PROVISION HEALTH CARE SERVICES HEALTH CENTERS HEALTH COVERAGE HEALTH ECONOMICS HEALTH EXTENSION HEALTH FACILITIES HEALTH ORGANIZATION HEALTH PLANS HEALTH POLICY HEALTH REFORMS HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEMS HOSPITALS HOUSEHOLDS HUMAN DEVELOPMENT HUMAN RESOURCES ILLNESS IMMUNIZATION INCOME INHABITANTS INTEGRATION INTERNATIONAL ORGANIZATIONS LEGAL FRAMEWORK MEDICAL EQUIPMENT MEDICINE MEDICINES MIDWIVES NURSE NURSES NUTRITION OUTPATIENT SERVICES PATIENT PATIENT SATISFACTION PATIENTS PERSONALITY PHARMACY PHYSICIAN PHYSICIANS PREGNANT WOMEN PRIMARY CARE PRIMARY HEALTH CARE PRIMARY HEALTH CARE SERVICES PROBABILITY PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC HEALTH CARE CENTERS QUALITY OF CARE RABIES REFERRALS REPRODUCTIVE HEALTH RURAL AREAS SOCIAL SCIENCE SPECIALIST TRADITIONAL HEALTH CARE URBAN DWELLERS VISITS WORKERS WORKING CONDITIONS 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). 2013-05-29T13:50:52Z 2013-05-29T13:50:52Z 2010-06 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 English en_US Health, Nutrition and Population (HNP) discussion paper; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Working Paper Publications & Research Latin America & Caribbean Honduras
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	English en_US
topic	ABILITY TO PAY ACCESS TO CARE ACCESS TO HEALTH CARE AID ALTERNATIVE HEALTH CARE AUXILIARY NURSES BASIC HEALTH CARE BASIC HEALTH SERVICES CHILDBIRTH CLEANLINESS COMMUNITIES COMMUNITY HEALTH COMMUNITY HEALTH CARE COMMUNITY HEALTH SERVICES COMMUNITY INVOLVEMENT COMMUNITY PARTICIPATION COMMUNITY WORK DECISION MAKING DENTIST DIAGNOSIS DISCRETIONARY AUTHORITY DISEASES DOCTOR DOCTORS EMERGENCY CARE ESSENTIAL DRUGS EXPENDITURES EXPOSURE FAMILY PLANNING FEMALE HEALTH ADMINISTRATION HEALTH CARE HEALTH CARE FACILITIES HEALTH CARE FACILITY HEALTH CARE INSURANCE HEALTH CARE PERSONNEL HEALTH CARE PROFESSIONALS HEALTH CARE PROVIDER HEALTH CARE PROVIDERS HEALTH CARE PROVISION HEALTH CARE SERVICES HEALTH CENTERS HEALTH COVERAGE HEALTH ECONOMICS HEALTH EXTENSION HEALTH FACILITIES HEALTH ORGANIZATION HEALTH PLANS HEALTH POLICY HEALTH REFORMS HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEMS HOSPITALS HOUSEHOLDS HUMAN DEVELOPMENT HUMAN RESOURCES ILLNESS IMMUNIZATION INCOME INHABITANTS INTEGRATION INTERNATIONAL ORGANIZATIONS LEGAL FRAMEWORK MEDICAL EQUIPMENT MEDICINE MEDICINES MIDWIVES NURSE NURSES NUTRITION OUTPATIENT SERVICES PATIENT PATIENT SATISFACTION PATIENTS PERSONALITY PHARMACY PHYSICIAN PHYSICIANS PREGNANT WOMEN PRIMARY CARE PRIMARY HEALTH CARE PRIMARY HEALTH CARE SERVICES PROBABILITY PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC HEALTH CARE CENTERS QUALITY OF CARE RABIES REFERRALS REPRODUCTIVE HEALTH RURAL AREAS SOCIAL SCIENCE SPECIALIST TRADITIONAL HEALTH CARE URBAN DWELLERS VISITS WORKERS WORKING CONDITIONS
spellingShingle	ABILITY TO PAY ACCESS TO CARE ACCESS TO HEALTH CARE AID ALTERNATIVE HEALTH CARE AUXILIARY NURSES BASIC HEALTH CARE BASIC HEALTH SERVICES CHILDBIRTH CLEANLINESS COMMUNITIES COMMUNITY HEALTH COMMUNITY HEALTH CARE COMMUNITY HEALTH SERVICES COMMUNITY INVOLVEMENT COMMUNITY PARTICIPATION COMMUNITY WORK DECISION MAKING DENTIST DIAGNOSIS DISCRETIONARY AUTHORITY DISEASES DOCTOR DOCTORS EMERGENCY CARE ESSENTIAL DRUGS EXPENDITURES EXPOSURE FAMILY PLANNING FEMALE HEALTH ADMINISTRATION HEALTH CARE HEALTH CARE FACILITIES HEALTH CARE FACILITY HEALTH CARE INSURANCE HEALTH CARE PERSONNEL HEALTH CARE PROFESSIONALS HEALTH CARE PROVIDER HEALTH CARE PROVIDERS HEALTH CARE PROVISION HEALTH CARE SERVICES HEALTH CENTERS HEALTH COVERAGE HEALTH ECONOMICS HEALTH EXTENSION HEALTH FACILITIES HEALTH ORGANIZATION HEALTH PLANS HEALTH POLICY HEALTH REFORMS HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEMS HOSPITALS HOUSEHOLDS HUMAN DEVELOPMENT HUMAN RESOURCES ILLNESS IMMUNIZATION INCOME INHABITANTS INTEGRATION INTERNATIONAL ORGANIZATIONS LEGAL FRAMEWORK MEDICAL EQUIPMENT MEDICINE MEDICINES MIDWIVES NURSE NURSES NUTRITION OUTPATIENT SERVICES PATIENT PATIENT SATISFACTION PATIENTS PERSONALITY PHARMACY PHYSICIAN PHYSICIANS PREGNANT WOMEN PRIMARY CARE PRIMARY HEALTH CARE PRIMARY HEALTH CARE SERVICES PROBABILITY PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC HEALTH CARE CENTERS QUALITY OF CARE RABIES REFERRALS REPRODUCTIVE HEALTH RURAL AREAS SOCIAL SCIENCE SPECIALIST TRADITIONAL HEALTH CARE URBAN DWELLERS VISITS WORKERS WORKING CONDITIONS Garcia Prado, Ariadna Lao Peña, Christine Contracting and Providing Basic Health Care Services in Honduras : A Comparison of Traditional and Alternative Service Delivery Models
geographic_facet	Latin America & Caribbean Honduras
relation	Health, Nutrition and Population (HNP) discussion paper;
description	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).
format	Publications & Research :: Working Paper
author	Garcia Prado, Ariadna Lao Peña, Christine
author_facet	Garcia Prado, Ariadna Lao Peña, Christine
author_sort	Garcia Prado, Ariadna
title	Contracting and Providing Basic Health Care Services in Honduras : A Comparison of Traditional and Alternative Service Delivery Models
title_short	Contracting and Providing Basic Health Care Services in Honduras : A Comparison of Traditional and Alternative Service Delivery Models
title_full	Contracting and Providing Basic Health Care Services in Honduras : A Comparison of Traditional and Alternative Service Delivery Models
title_fullStr	Contracting and Providing Basic Health Care Services in Honduras : A Comparison of Traditional and Alternative Service Delivery Models
title_full_unstemmed	Contracting and Providing Basic Health Care Services in Honduras : A Comparison of Traditional and Alternative Service Delivery Models
title_sort	contracting and providing basic health care services in honduras : a comparison of traditional and alternative service delivery models
publisher	World Bank, Washington, DC
publishDate	2013
url	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
_version_	1764423904957300736

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

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