 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Malcom Potts, MD, PhD, FRCOG, Bixby Professor, School of Public Health, University of California, NA, Berkeley, CA 94707, 510-642-6915, potts@socrates.berkeley.edu
Most foreign aid to support health care in low income countries is transferred as cash inputs, either to a government departments or to an NGO. Usually, this entails both the donor and recipient in a great deal of paper work. Outputs are sometimes difficult to measure and corruption and/or inefficiencies can be difficult to monitor. Output based xx agree a price for a service and pay by the number of items of service delivered. IUD insertion in Korea in the 1960s and 1970s, STD treatment in Guatemala in the 1990s and VCT in contemporary Kenya are documented examples of successful output based services. Output based services have the advantage that the same payment can be offered to the government, NGOs and the private sector, encouraging competition and extending coverage to low income areas. When appropriate, coupons can be given to consumers to cash in with providers. The payments made make for easy evaluation by the donor and receiving flexible money encourages autonomy and innovation among recipients of external support. Like input based payments, output based services can be corrupted, primarily by creating factious clients. However, controls can be devised and the levels of malfeasance and inefficiency are likely to be less than for input based support.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.