Prepaid financing of primary health care in Guinea-Bissau : an assessment of 18 village health posts

Abstract

With population growth increasing and budgets declining, the need for cost recovery in health care has grown. This paper discusses a prepayment scheme for drugs and limited primary health care at 18 village health posts in Guinea-Bissau. At these health posts, adverse selection was reduced because enrollment in each village was almost universal. The villager provided construction materials and labor and indicated their willingness to pay more if drugs were available on a timely basis. Villagers'willingness to prepay was often linked to better service, with drugs more readily available and midwidves better trained. Still, the quality of service at village health posts can only be as good as the support they get from the rest of the health care system. Authorities must strengthen health center support services and improve the drug resupply system.Health Monitoring&Evaluation,Health Systems Development&Reform,Housing&Human Habitats,Agricultural Knowledge&Information Systems,Regional Rural Development