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Weak Links in the Chain II: A Prescription for Health Policy in Poor Countries

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  • Deon Filmer

    () (Lead Economist in the Economic Policy Group, Poverty Reduction and Economic Management Network, World Bank.)

  • Jeffrey S. Hammer
  • Lant H. Pritchett

Abstract

In an earlier article, the authors outline some reasons for the disappointingly small effects of primary health care programs and identified two weak links standing between spending and increased health care. The first was the inability to translate public expenditure on health care into real services due to inherent difficulties of monitoring and controlling the behavior of public employees. The second was the "crowding out" of private markets for health care, markets that exist predominantly at the primary health care level. This article presents an approach to public policy in health that comes directly from the literature on public economics. It identifies two characteristic market failures in health. The first is the existence of large externalities in the control of many infectious diseases that are mostly addressed by standard public health interventions. The second is the widespread breakdown of insurance markets that leave people exposed to catastrophic financial losses. Other essential considerations in setting priorities in health are the degree to which policies address poverty and inequality and the practicality of implementing policies given limited administrative capacities. Priorities based on these criteria tend to differ substantially from those commonly prescribed by the international community. Copyright 2002, Oxford University Press.

Suggested Citation

  • Deon Filmer & Jeffrey S. Hammer & Lant H. Pritchett, 2002. "Weak Links in the Chain II: A Prescription for Health Policy in Poor Countries," World Bank Research Observer, World Bank Group, vol. 17(1), pages 47-66.
  • Handle: RePEc:oup:wbrobs:v:17:y:2002:i:1:p:47-66
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    Citations

    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Best readings in global health
      by Karen Grepin in Karen Grepin's Global Health Blog on 2009-05-26 04:19:00

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    Cited by:

    1. Owen O’Donnell & Ravi P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Deni Harbianto & Charu C. Garg & Piya Hanvoravongchai & Mohammed N. Huq & Anup Karan & Gabriel M. Leung & Badri Raj , 2010. "Who benefits from public spending on health care in Asia?," Working Papers id:2626, eSocialSciences.
    2. van Doorslaer, Eddy & O'Donnell, Owen, 2008. "Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings," WIDER Working Paper Series DP2008/04, World Institute for Development Economic Research (UNU-WIDER).
    3. Sonia Bhalotra, 2007. "Spending to save? State health expenditure and infant mortality in India," Health Economics, John Wiley & Sons, Ltd., vol. 16(9), pages 911-928.
    4. Lant Pritchett & Salimah Samji & Jeffrey Hammer, 2012. "It’s All About MeE: Using Structured Experiential Learning (‘e’) to Crawl the Design Space," CID Working Papers 249, Center for International Development at Harvard University.
    5. Meera Chatterjee & Ruth Levine & Nirmala Murthy & Shreelata Rao-Seshadri, 2008. "Sparing Lives : Better Reproductive Health for Poor Women in South Asia, Summary for Policymakers," World Bank Other Operational Studies 7848, The World Bank.
    6. Gauri, Varun, 2004. "Social Rights and Economics: Claims to Health Care and Education in Developing Countries," World Development, Elsevier, vol. 32(3), pages 465-477, March.
    7. Liu, Dan & Tsegai, Daniel W., 2011. "The New Cooperative Medical Scheme (NCMS) and its implications for access to health care and medical expenditure: Evidence from rural China," Discussion Papers 116746, University of Bonn, Center for Development Research (ZEF).
    8. Nazmul Chaudhury & Jeffrey Hammer & Michael Kremer & Karthik Muralidharan & F. Halsey Rogers, 2006. "Missing in Action: Teacher and Health Worker Absence in Developing Countries," Journal of Economic Perspectives, American Economic Association, vol. 20(1), pages 91-116, Winter.
    9. Krause, Brooke Laura, 2013. "Childhood Malnutrition and Educational Attainment: An Analysis using Oxford's Young Lives Longitudinal Study in Peru," 2013 Annual Meeting, August 4-6, 2013, Washington, D.C. 150598, Agricultural and Applied Economics Association.
    10. McGuire, James W., 2006. "Basic health care provision and under-5 mortality: A Cross-National study of developing Countries," World Development, Elsevier, vol. 34(3), pages 405-425, March.
    11. Krause, Brooke Laura, 2012. "Childhood Malnutrition and Educational Attainment: An Analysis using Oxford’s Young Lives Longitudinal Study in Peru," Master's Theses 146072, University of Minnesota, Department of Applied Economics.
    12. Lant Pritchett & Salimah Samji & Jeffrey Hammer, 2013. "It‘s All About MeE: Using Structured Experiential Learning (“e”) to Crawl the Design Space," Working Papers 322, Center for Global Development.

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