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Financing health services in Africa : an assessment of alternative approaches


  • Mwabu, Germano


This paper outlines a strategy for financing health services in sub-Saharan Africa. The individual components of the strategy are as follows: general tax revenues, international finance, a system of user charges, community finance, health insurance, and contributions from nongovernmental organizations, including the private sector. The author states that financial positions of public health care systems in sub-Saharan Africa would be greatly enhanced if governments in the region were to adopt policies that would use each of the above sources of finance. Since a strong financial base is a prerequisite for an effective health care system, such policies would considerably improve the health status of the population. It is important that for each country different policies be pursued at various levels of society, and in different sectors of the economy.

Suggested Citation

  • Mwabu, Germano, 1990. "Financing health services in Africa : an assessment of alternative approaches," Policy Research Working Paper Series 457, The World Bank.
  • Handle: RePEc:wbk:wbrwps:457

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    References listed on IDEAS

    1. Yoder, Richard A., 1989. "Are people willing and able to pay for health services?," Social Science & Medicine, Elsevier, vol. 29(1), pages 35-42, January.
    2. Ellis, Randall P., 1987. "The revenue generating potential of user fees in Kenyan government health facilities," Social Science & Medicine, Elsevier, vol. 25(9), pages 995-1002, January.
    3. Gertler, Paul & Locay, Luis & Sanderson, Warren, 1987. "Are user fees regressive? : The welfare implications of health care financing proposals in Peru," Journal of Econometrics, Elsevier, vol. 36(1-2), pages 67-88.
    4. Reinhardt, Uwe E, 1989. "Economists in Health Care: Saviors, or Elephants in a Porcelain Shop?," American Economic Review, American Economic Association, vol. 79(2), pages 337-342, May.
    5. Michael Grossman, 1972. "The Demand for Health: A Theoretical and Empirical Investigation," NBER Books, National Bureau of Economic Research, Inc, number gros72-1, December.
    6. Mwabu, Germano M, 1989. "Nonmonetary Factors in the Household Choice of Medical Facilities," Economic Development and Cultural Change, University of Chicago Press, vol. 37(2), pages 383-392, January.
    7. Cross, Peter N. & Huff, Maggie A. & Quick, Jonathan D. & Bates, James A., 1986. "Revolving drug funds: Conducting business in the public sector," Social Science & Medicine, Elsevier, vol. 22(3), pages 335-343, January.
    8. ALan Williams, 1988. "Priority setting in public and private health care: a guide through the ideological jungle," Working Papers 036chedp, Centre for Health Economics, University of York.
    9. Bitran-Dicowsky, Ricardo & Dunlop, David W., 1989. "The determinants of hospital costs : an analysis of Ethiopia," Policy Research Working Paper Series 249, The World Bank.
    10. Bonair, Ann & Rosenfield, Patricia & Tengvald, Karin, 1989. "Medical technologies in developing countries: Issues of technology development, transfer, diffusion and use," Social Science & Medicine, Elsevier, vol. 28(8), pages 769-781, January.
    11. Akin, John S, et al, 1986. "The Demand for Primary Health Care Services in the Bicol Region of the Philippines," Economic Development and Cultural Change, University of Chicago Press, vol. 34(4), pages 755-782, July.
    12. Vogel, R.J., 1988. "Cost Recovery In The Health Care Sector - Selected Country Studies In West Africa," Papers 82, World Bank - Technical Papers.
    13. Williams, Alan, 1988. "Priority setting in public and private health care : A guide through the ideological jungle," Journal of Health Economics, Elsevier, vol. 7(2), pages 173-183, June.
    14. Dunlop, David W., 1983. "Health care financing: Recent experience in Africa," Social Science & Medicine, Elsevier, vol. 17(24), pages 2017-2025, January.
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    Cited by:

    1. Ardeshir Sepehri & Robert Chernomas, 2001. "Are user charges efficiency- and equity-enhancing? A critical review of economic literature with particular reference to experience from developing countries," Journal of International Development, John Wiley & Sons, Ltd., vol. 13(2), pages 183-209.
    2. Gertler, Paul J. & Hammer, Jeffrey S., 1997. "Strategies for pricing publicly provided health services," Policy Research Working Paper Series 1762, The World Bank.


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