Role of Communities in Resource Mobilization and Risk Sharing : A Synthesis Report

Most community finance schemes have evolved in the context of severe economic constraints, political instability, and lack of good governance. Usually government taxation capacity is weak, formal mechanisms of social protection for vulnerable popul...

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Main Authors: Preker, Alexander S., Carrrin, Guy, Dror, David M., Jakab, Melitta, Hsiao, William, Arhin, Dyna
Format: Working Paper
Language:English
en_US
Published: World Bank, Washington, Dc 2013
Subjects:
GNP
Online Access:http://documents.worldbank.org/curated/en/2001/09/3582693/role-communities-resource-mobilization-risk-sharing-synthesis-report
http://hdl.handle.net/10986/13692
id okr-10986-13692
recordtype oai_dc
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 HEALTH SYSTEMS DEVELOPMENT & REFORM
HEALTH CARE
HEALTH FINANCE
HEALTH FINANCING
RURAL HEALTH CARE
HEALTH INSURANCE
HEALTH CARE ADMINISTRATION ADVERSE SELECTION
CAPITAL FORMATION
CARTELS
CHILDBIRTH
CITIZENS
CLEAN WATER
COLLECTIVE ACTION
COMMUNITY HEALTH
COMMUNITY MEMBERS
COMMUNITY NETWORKS
COMMUNITY PARTICIPATION
COUNTRY COVERAGE
CULTURAL ENVIRONMENT
DEBT
DEBT RELIEF
DEVELOPING COUNTRIES
DEVELOPMENT NETWORK
DEVELOPMENT ORGANIZATIONS
DONOR COMMUNITY
ECONOMIC DEVELOPMENT
ECONOMIC EXCHANGE
ECONOMICS
EMPLOYMENT
ETHNIC GROUPS
EXTENDED FAMILIES
EXTERNALITIES
FAMILIES
FINANCIAL RESOURCES
FINANCING MECHANISMS
GNP
GOOD GOVERNANCE
GROWTH RATE
HEALTH CARE
HEALTH CARE FINANCING
HEALTH CARE SYSTEMS
HEALTH INSURANCE
HEALTH OUTCOMES
HEALTH POLICY
HEALTH SECTOR
HEALTH SERVICES
HOUSEHOLD SURVEY
HOUSING
HUMAN DEVELOPMENT
HYGIENE
IMPROVED ACCESS
INCOME
INCOME DISTRIBUTION
INCOME HOUSEHOLDS
INCOME INDIVIDUALS
INCOME LEVELS
INCOME POPULATIONS
INFORMAL EMPLOYMENT
INFORMAL SECTOR
INSURANCE
INTERNATIONAL DEVELOPMENT
INTERNATIONAL LABOUR
ISOLATION
LOCAL COMMUNITY
LOCAL ORGANIZATIONS
LOW- INCOME COUNTRIES
LOW-INCOME COUNTRIES
MACROECONOMICS
MANAGEMENT CAPACITY
MORAL HAZARD
NUTRITION
PATIENTS
POLICY MEASURES
POLICY OPTIONS
POLITICAL INSTABILITY
POOR COMMUNITIES
POOR COUNTRIES
POOR HOUSEHOLDS
POPULATION GROUPS
POVERTY ALLEVIATION
POVERTY LINE
PRIVATE INSURANCE
PROPERTY RIGHTS
PUBLIC EXPENDITURE
PUBLIC GOODS
PUBLIC HEALTH
PUBLIC POLICY
PUBLIC RESOURCES
PUBLIC SECTOR
PUBLIC SERVICES
RELIGIOUS GROUPS
RESOURCE ALLOCATION
RISK MANAGEMENT
RISK SHARING
RURAL AREAS
SAFETY
SAFETY NET
SAFETY NETS
SAVINGS
SERVICE DELIVERY
SOCIAL CAPITAL
SOCIAL EXCLUSION
SOCIAL INCLUSION
SOCIAL INSURANCE
SOCIAL MOBILIZATION
SOCIAL NETWORKS
SOCIAL POLICIES
SOCIAL POLICY
SOCIAL PROTECTION
SOCIAL SECURITY
SOCIAL SERVICES
TAX EVASION
TAX REVENUES
TAX STRUCTURE
TAXATION
TECHNICAL SUPPORT
UNEMPLOYMENT
URBAN AREAS
VACCINATION
WELFARE ECONOMICS
WORKERS
spellingShingle HEALTH SYSTEMS DEVELOPMENT & REFORM
HEALTH CARE
HEALTH FINANCE
HEALTH FINANCING
RURAL HEALTH CARE
HEALTH INSURANCE
HEALTH CARE ADMINISTRATION ADVERSE SELECTION
CAPITAL FORMATION
CARTELS
CHILDBIRTH
CITIZENS
CLEAN WATER
COLLECTIVE ACTION
COMMUNITY HEALTH
COMMUNITY MEMBERS
COMMUNITY NETWORKS
COMMUNITY PARTICIPATION
COUNTRY COVERAGE
CULTURAL ENVIRONMENT
DEBT
DEBT RELIEF
DEVELOPING COUNTRIES
DEVELOPMENT NETWORK
DEVELOPMENT ORGANIZATIONS
DONOR COMMUNITY
ECONOMIC DEVELOPMENT
ECONOMIC EXCHANGE
ECONOMICS
EMPLOYMENT
ETHNIC GROUPS
EXTENDED FAMILIES
EXTERNALITIES
FAMILIES
FINANCIAL RESOURCES
FINANCING MECHANISMS
GNP
GOOD GOVERNANCE
GROWTH RATE
HEALTH CARE
HEALTH CARE FINANCING
HEALTH CARE SYSTEMS
HEALTH INSURANCE
HEALTH OUTCOMES
HEALTH POLICY
HEALTH SECTOR
HEALTH SERVICES
HOUSEHOLD SURVEY
HOUSING
HUMAN DEVELOPMENT
HYGIENE
IMPROVED ACCESS
INCOME
INCOME DISTRIBUTION
INCOME HOUSEHOLDS
INCOME INDIVIDUALS
INCOME LEVELS
INCOME POPULATIONS
INFORMAL EMPLOYMENT
INFORMAL SECTOR
INSURANCE
INTERNATIONAL DEVELOPMENT
INTERNATIONAL LABOUR
ISOLATION
LOCAL COMMUNITY
LOCAL ORGANIZATIONS
LOW- INCOME COUNTRIES
LOW-INCOME COUNTRIES
MACROECONOMICS
MANAGEMENT CAPACITY
MORAL HAZARD
NUTRITION
PATIENTS
POLICY MEASURES
POLICY OPTIONS
POLITICAL INSTABILITY
POOR COMMUNITIES
POOR COUNTRIES
POOR HOUSEHOLDS
POPULATION GROUPS
POVERTY ALLEVIATION
POVERTY LINE
PRIVATE INSURANCE
PROPERTY RIGHTS
PUBLIC EXPENDITURE
PUBLIC GOODS
PUBLIC HEALTH
PUBLIC POLICY
PUBLIC RESOURCES
PUBLIC SECTOR
PUBLIC SERVICES
RELIGIOUS GROUPS
RESOURCE ALLOCATION
RISK MANAGEMENT
RISK SHARING
RURAL AREAS
SAFETY
SAFETY NET
SAFETY NETS
SAVINGS
SERVICE DELIVERY
SOCIAL CAPITAL
SOCIAL EXCLUSION
SOCIAL INCLUSION
SOCIAL INSURANCE
SOCIAL MOBILIZATION
SOCIAL NETWORKS
SOCIAL POLICIES
SOCIAL POLICY
SOCIAL PROTECTION
SOCIAL SECURITY
SOCIAL SERVICES
TAX EVASION
TAX REVENUES
TAX STRUCTURE
TAXATION
TECHNICAL SUPPORT
UNEMPLOYMENT
URBAN AREAS
VACCINATION
WELFARE ECONOMICS
WORKERS
Preker, Alexander S.
Carrrin, Guy
Dror, David M.
Jakab, Melitta
Hsiao, William
Arhin, Dyna
Role of Communities in Resource Mobilization and Risk Sharing : A Synthesis Report
relation HNP discussion paper series;
description Most community finance schemes have evolved in the context of severe economic constraints, political instability, and lack of good governance. Usually government taxation capacity is weak, formal mechanisms of social protection for vulnerable populations absent, and government oversight of the informal health sector lacking. In this context of extreme public sector failure, community involvement in financing health care provides a critical though insufficient first step in the long march toward improved access to health care by the poor and social protection against the cost of illness. It should be regarded as a complement to-not as a substitute for-strong government involvement in health care financing and risk management related to the cost of illness. Based on an extensive survey of the literature, the main strengths of community financing schemes are the extent of outreach penetration achieved through community participation, their contribution to financial protection against illness, and increase in access to health care by low-income rural and informal sector workers. Their main weaknesses are the low volume of revenues that can be mobilized from poor communities, the frequent exclusion of the very poorest from participation in such schemes without some form of subsidy, the small size of the risk pool, the limited management capacity that exists in rural and low-income contexts, and their isolation from the more comprehensive benefits that are often available through more formal health financing mechanisms and provider networks. The authors conclude by proposing concrete public policy measures that governments can introduce to strengthen and improve the effectiveness of community involvement in health care financing. This includes: (a) increased and well-targeted subsidies to pay for the premiums of low-income populations; (b) use of insurance to protect against expenditure fluctuations and use of reinsurance to enlarge the effective size of small risk pools; (c) use of effective prevention and case management techniques to limit expenditure fluctuations; (d) technical support to strengthen the management capacity of local schemes; and (e) establishment and strengthening of links with the formal financing and provider networks.
format Publications & Research :: Working Paper
author Preker, Alexander S.
Carrrin, Guy
Dror, David M.
Jakab, Melitta
Hsiao, William
Arhin, Dyna
author_facet Preker, Alexander S.
Carrrin, Guy
Dror, David M.
Jakab, Melitta
Hsiao, William
Arhin, Dyna
author_sort Preker, Alexander S.
title Role of Communities in Resource Mobilization and Risk Sharing : A Synthesis Report
title_short Role of Communities in Resource Mobilization and Risk Sharing : A Synthesis Report
title_full Role of Communities in Resource Mobilization and Risk Sharing : A Synthesis Report
title_fullStr Role of Communities in Resource Mobilization and Risk Sharing : A Synthesis Report
title_full_unstemmed Role of Communities in Resource Mobilization and Risk Sharing : A Synthesis Report
title_sort role of communities in resource mobilization and risk sharing : a synthesis report
publisher World Bank, Washington, Dc
publishDate 2013
url http://documents.worldbank.org/curated/en/2001/09/3582693/role-communities-resource-mobilization-risk-sharing-synthesis-report
http://hdl.handle.net/10986/13692
_version_ 1764424448661782528
spelling okr-10986-136922021-04-23T14:03:09Z Role of Communities in Resource Mobilization and Risk Sharing : A Synthesis Report Preker, Alexander S. Carrrin, Guy Dror, David M. Jakab, Melitta Hsiao, William Arhin, Dyna HEALTH SYSTEMS DEVELOPMENT & REFORM HEALTH CARE HEALTH FINANCE HEALTH FINANCING RURAL HEALTH CARE HEALTH INSURANCE HEALTH CARE ADMINISTRATION ADVERSE SELECTION CAPITAL FORMATION CARTELS CHILDBIRTH CITIZENS CLEAN WATER COLLECTIVE ACTION COMMUNITY HEALTH COMMUNITY MEMBERS COMMUNITY NETWORKS COMMUNITY PARTICIPATION COUNTRY COVERAGE CULTURAL ENVIRONMENT DEBT DEBT RELIEF DEVELOPING COUNTRIES DEVELOPMENT NETWORK DEVELOPMENT ORGANIZATIONS DONOR COMMUNITY ECONOMIC DEVELOPMENT ECONOMIC EXCHANGE ECONOMICS EMPLOYMENT ETHNIC GROUPS EXTENDED FAMILIES EXTERNALITIES FAMILIES FINANCIAL RESOURCES FINANCING MECHANISMS GNP GOOD GOVERNANCE GROWTH RATE HEALTH CARE HEALTH CARE FINANCING HEALTH CARE SYSTEMS HEALTH INSURANCE HEALTH OUTCOMES HEALTH POLICY HEALTH SECTOR HEALTH SERVICES HOUSEHOLD SURVEY HOUSING HUMAN DEVELOPMENT HYGIENE IMPROVED ACCESS INCOME INCOME DISTRIBUTION INCOME HOUSEHOLDS INCOME INDIVIDUALS INCOME LEVELS INCOME POPULATIONS INFORMAL EMPLOYMENT INFORMAL SECTOR INSURANCE INTERNATIONAL DEVELOPMENT INTERNATIONAL LABOUR ISOLATION LOCAL COMMUNITY LOCAL ORGANIZATIONS LOW- INCOME COUNTRIES LOW-INCOME COUNTRIES MACROECONOMICS MANAGEMENT CAPACITY MORAL HAZARD NUTRITION PATIENTS POLICY MEASURES POLICY OPTIONS POLITICAL INSTABILITY POOR COMMUNITIES POOR COUNTRIES POOR HOUSEHOLDS POPULATION GROUPS POVERTY ALLEVIATION POVERTY LINE PRIVATE INSURANCE PROPERTY RIGHTS PUBLIC EXPENDITURE PUBLIC GOODS PUBLIC HEALTH PUBLIC POLICY PUBLIC RESOURCES PUBLIC SECTOR PUBLIC SERVICES RELIGIOUS GROUPS RESOURCE ALLOCATION RISK MANAGEMENT RISK SHARING RURAL AREAS SAFETY SAFETY NET SAFETY NETS SAVINGS SERVICE DELIVERY SOCIAL CAPITAL SOCIAL EXCLUSION SOCIAL INCLUSION SOCIAL INSURANCE SOCIAL MOBILIZATION SOCIAL NETWORKS SOCIAL POLICIES SOCIAL POLICY SOCIAL PROTECTION SOCIAL SECURITY SOCIAL SERVICES TAX EVASION TAX REVENUES TAX STRUCTURE TAXATION TECHNICAL SUPPORT UNEMPLOYMENT URBAN AREAS VACCINATION WELFARE ECONOMICS WORKERS Most community finance schemes have evolved in the context of severe economic constraints, political instability, and lack of good governance. Usually government taxation capacity is weak, formal mechanisms of social protection for vulnerable populations absent, and government oversight of the informal health sector lacking. In this context of extreme public sector failure, community involvement in financing health care provides a critical though insufficient first step in the long march toward improved access to health care by the poor and social protection against the cost of illness. It should be regarded as a complement to-not as a substitute for-strong government involvement in health care financing and risk management related to the cost of illness. Based on an extensive survey of the literature, the main strengths of community financing schemes are the extent of outreach penetration achieved through community participation, their contribution to financial protection against illness, and increase in access to health care by low-income rural and informal sector workers. Their main weaknesses are the low volume of revenues that can be mobilized from poor communities, the frequent exclusion of the very poorest from participation in such schemes without some form of subsidy, the small size of the risk pool, the limited management capacity that exists in rural and low-income contexts, and their isolation from the more comprehensive benefits that are often available through more formal health financing mechanisms and provider networks. The authors conclude by proposing concrete public policy measures that governments can introduce to strengthen and improve the effectiveness of community involvement in health care financing. This includes: (a) increased and well-targeted subsidies to pay for the premiums of low-income populations; (b) use of insurance to protect against expenditure fluctuations and use of reinsurance to enlarge the effective size of small risk pools; (c) use of effective prevention and case management techniques to limit expenditure fluctuations; (d) technical support to strengthen the management capacity of local schemes; and (e) establishment and strengthening of links with the formal financing and provider networks. 2013-05-30T16:03:15Z 2013-05-30T16:03:15Z 2001-09 http://documents.worldbank.org/curated/en/2001/09/3582693/role-communities-resource-mobilization-risk-sharing-synthesis-report http://hdl.handle.net/10986/13692 English en_US HNP discussion paper series; 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