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...
| Main Authors: | , , , , , |
|---|---|
| Format: | Working Paper |
| Language: | English en_US |
| Published: |
World Bank, Washington, Dc
2013
|
| Subjects: | |
| 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 |