IDEAS home Printed from
MyIDEAS: Log in (now much improved!) to save this article

Approaches to overcoming constraints to effective health service delivery: a review of the evidence

Listed author(s):
  • Valeria Oliveira-Cruz

    (Health Policy Unit, London School of Hygiene and Tropical Medicine, London, UK)

  • Kara Hanson

    (Health Policy Unit, London School of Hygiene and Tropical Medicine, London, UK)

  • Anne Mills

    (Health Policy Unit, London School of Hygiene and Tropical Medicine, London, UK)

Registered author(s):

    This paper reviews the current evidence base regarding efforts to overcome constraints to effective health service delivery in low and middle-income countries. A systematic literature review was chosen as the approach to gather and analyse existing knowledge about how to improve the 'close-to-client' health system. We focused on three levels of constraints: community and household, the health services delivery level itself, and health sector policy and strategic management. In total, 116 studies were reviewed and their main findings presented. The results should be interpreted with caution due to the considerable limitations in the existing evidence base. Copyright © 2003 John Wiley & Sons, Ltd.

    If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

    File URL:
    File Function: Link to full text; subscription required
    Download Restriction: no

    Article provided by John Wiley & Sons, Ltd. in its journal Journal of International Development.

    Volume (Year): 15 (2003)
    Issue (Month): 1 ()
    Pages: 41-65

    in new window

    Handle: RePEc:wly:jintdv:v:15:y:2003:i:1:p:41-65
    DOI: 10.1002/jid.965
    Contact details of provider: Web page:

    References listed on IDEAS
    Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

    in new window

    1. Santoso, Budiono, 1996. "Small group intervention vs formal seminar for improving appropriate drug use," Social Science & Medicine, Elsevier, vol. 42(8), pages 1163-1168, April.
    2. Stock-Iwamoto, Christel & Korte, Rolf, 1993. "Primary health workers in North East Brazil," Social Science & Medicine, Elsevier, vol. 36(6), pages 775-782, March.
    3. Robinson, Sheila A. & Larsen, Donald E., 1990. "The relative influence of the community and the health system on work performance: A case study of community health workers in Colombia," Social Science & Medicine, Elsevier, vol. 30(10), pages 1041-1048, January.
    4. Dong, Hengjin & Bogg, Lennart & Rehnberg, Clas & Diwan, Vinod, 1999. "Drug policy in China: pharmaceutical distribution in rural areas," Social Science & Medicine, Elsevier, vol. 48(6), pages 777-786, March.
    5. Frankenberg, E. & Thomas, D., 2000. "Women's Health and Pregnancy Outcomes: Does Access to Services Make a Difference?," Papers 00-04, RAND - Labor and Population Program.
    6. Oshiname, Frederick O. & Brieger, William R., 1992. "Primary care training for patent medicine vendors in rural Nigeria," Social Science & Medicine, Elsevier, vol. 35(12), pages 1477-1484, December.
    7. McPake, Barbara & Hanson, Kara & Mills, Anne, 1993. "Community financing of health care in Africa: An evaluation of the Bamako initiative," Social Science & Medicine, Elsevier, vol. 36(11), pages 1383-1395, June.
    8. Pérez-Cuevas, Ricardo & Guiscafré, Hector & Muñoz, Onofre & Reyes, Hortensia & Tomé, Patricia & Libreros, Vita & Gutiérrez, Gonzalo, 1996. "Improving physician prescribing patterns to treat rhinopharyngitis. Intervention strategies in two health systems of Mexico," Social Science & Medicine, Elsevier, vol. 42(8), pages 1185-1194, April.
    9. Mcpake, Barbara & Hongoro, Charles, 1995. "Contracting out of clinical services in Zimbabwe," Social Science & Medicine, Elsevier, vol. 41(1), pages 13-24, July.
    10. Homedes, Nuria & Ugalde, Antonio, 2001. "Improving the use of pharmaceuticals through patient and community level interventions," Social Science & Medicine, Elsevier, vol. 52(1), pages 99-134, January.
    11. Ofori-Adjei, David & Arhinful, Daniel K., 1996. "Effect of training on the clinical management of malaria by medical assistants in Ghana," Social Science & Medicine, Elsevier, vol. 42(8), pages 1169-1176, April.
    12. Kafle, Kumud K. & Gartoulla, Ritu Prasad & Pradhan, Y. M. S. & Shrestha, A. D. & Karkee, S. B. & Quick, Jonathan D., 1992. "Drug retailer training: Experiences from Nepal," Social Science & Medicine, Elsevier, vol. 35(8), pages 1015-1025, October.
    13. Litvack, Jennie I. & Bodart, Claude, 1993. "User fees plus quality equals improved access to health care: Results of a field experiment in Cameroon," Social Science & Medicine, Elsevier, vol. 37(3), pages 369-383, August.
    14. Gilson, Lucy, 1995. "Management and health care reform in sub-Saharan Africa," Social Science & Medicine, Elsevier, vol. 40(5), pages 695-710, March.
    15. Curtale, Filippo & Siwakoti, Bhola & Lagrosa, Cecilia & LaRaja, Massimo & Guerra, Ranieri, 1995. "Improving skills and utilization of Community Health Volunteers in Nepal," Social Science & Medicine, Elsevier, vol. 40(8), pages 1117-1125, April.
    16. Foster, Susan, 1991. "Supply and use of essential drugs in sub-Saharan Africa: Some issues and possible solutions," Social Science & Medicine, Elsevier, vol. 32(11), pages 1201-1218, January.
    17. Chernichovsky, Dov & Bayulken, Caroline, 1995. "A pay-for-performance system for civil service doctors: The Indonesian experiment," Social Science & Medicine, Elsevier, vol. 41(2), pages 155-161, July.
    Full references (including those not matched with items on IDEAS)

    This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

    When requesting a correction, please mention this item's handle: RePEc:wly:jintdv:v:15:y:2003:i:1:p:41-65. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Wiley-Blackwell Digital Licensing)

    or (Christopher F. Baum)

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If references are entirely missing, you can add them using this form.

    If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.