Do faith-inspired health care providers in Africa reach the poor more than other providers?

Faith-inspired institutions (FIIs) commonly have as their stated mission a desire to provide quality health services to all, and in particular a commitment to serve the poor, for example, by providing services in remote areas where there are none, or by making services more affordable for those in need. Yet it is unclear whether they are able to fulfil this commitment in the current contexts in which they operate – for example by serving the poor proportionately more than other (wealthier) households, or being utilized by the poor more than other providers. Using data from 14 recent nationally representative household surveys in Africa, this paper suggests that when compared with public providers on a broad macro scale, FIIs currently tend to serve the poor slightly less than other population groups. The data also suggest that on average, beyond differences between countries, FIIs do not serve the poor proportionately more than public providers (the most relevant comparison, given that non-religious for-profit private providers tend to be more oriented towards serving wealthier groups). This does not mean that FIIs do not make special efforts to reach the poor, for example by subsidizing them in order to make services more affordable. However, it suggests that in current African health contexts, FIIs may no longer be that different from public providers in the clientele they serve.