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Are health services protecting the livelihoods of the urban poor in Sri Lanka? Findings from two low-income areas of Colombo

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  • Russell, Steven
  • Gilson, Lucy

Abstract

Investing in pro-poor health services is central to poverty reduction and achievement of the Millennium Development Goals. As health care financing mechanisms have an important influence over access and treatment costs they are central to the debates over health systems and their impact on poverty. This paper examines people's utilisation of health care services and illness cost burdens in a setting of free public provision, Sri Lanka. It assesses whether and how free health care protected poor and vulnerable households from illness costs and illness-induced impoverishment, using data from a cross-sectional survey (423 households) and longitudinal case study household research (16 households). The findings inform policy debates about how to improve protection levels, including the contribution of free health care services to poverty reduction. Assessment of policy options that can improve health system performance must start from a better understanding of the demand-side influences over performance.

Suggested Citation

  • Russell, Steven & Gilson, Lucy, 2006. "Are health services protecting the livelihoods of the urban poor in Sri Lanka? Findings from two low-income areas of Colombo," Social Science & Medicine, Elsevier, vol. 63(7), pages 1732-1744, October.
    • Handle: RePEc:eee:socmed:v:63:y:2006:i:7:p:1732-1744
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    References listed on IDEAS

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    3. Russell, Steven, 2005. "Treatment-seeking behaviour in urban Sri Lanka: Trusting the state, trusting private providers," Social Science & Medicine, Elsevier, vol. 61(7), pages 1396-1407, October.
    4. Berman, Peter & Kendall, Carl & Bhattacharyya, Karabi, 1994. "The household production of health: Integrating social science perspectives on micro-level health determinants," Social Science & Medicine, Elsevier, vol. 38(2), pages 205-215, January.
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    Cited by:

    1. Pal, Rama, 2010. "Borrowing for hospitalization in India," MPRA Paper 29404, University Library of Munich, Germany.
    2. Axel Demenet, 2016. "Health Shocks and Permanent Income Loss: the Household Business Channel," Working Papers DT/2016/11, DIAL (Développement, Institutions et Mondialisation).
    3. Storeng, Katerini Tagmatarchi & Baggaley, Rebecca F. & Ganaba, Rasmané & Ouattara, Fatoumata & Akoum, Mélanie S. & Filippi, Véronique, 2008. "Paying the price: The cost and consequences of emergency obstetric care in Burkina Faso," Social Science & Medicine, Elsevier, vol. 66(3), pages 545-557, February.
    4. Rama Pal, 2012. "Measuring incidence of catastrophic out-of-pocket health expenditure: with application to India," International Journal of Health Economics and Management, Springer, vol. 12(1), pages 63-85, March.
    5. Arnousse Beaulière & Siaka Touré & Pierre-Kébreau Alexandre & Koko Koné & Alex Pouhé & Bertin Kouadio & Neige Journy & Jérôme Son & Virginie Ettiègne-Traoré & François Dabis & Serge Eholié & Xavier An, 2010. "The Financial Burden of Morbidity in HIV-Infected Adults on Antiretroviral Therapy in Côte d'Ivoire," PLOS ONE, Public Library of Science, vol. 5(6), pages 1-7, June.
    6. Asankha Pallegedara, 2018. "Impacts of chronic non-communicable diseases on households’ out-of-pocket healthcare expenditures in Sri Lanka," International Journal of Health Economics and Management, Springer, vol. 18(3), pages 301-319, September.
    7. Murray, Susan F. & Akoum, Mélanie S. & Storeng, Katerini T., 2012. "Capitals diminished, denied, mustered and deployed. A qualitative longitudinal study of women's four year trajectories after acute health crisis, Burkina Faso," Social Science & Medicine, Elsevier, vol. 75(12), pages 2455-2462.
    8. Salem Deenadayalan Vaishnavi & Umakant Dash, 2009. "Catastrophic payments for health care among households in urban Tamil Nadu, India," Journal of International Development, John Wiley & Sons, Ltd., vol. 21(2), pages 169-184.

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