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Health Policy |
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Priorities in Health |
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Projects |
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Documents |
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Priority Countries |
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| Priorities in Health |
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Access to health services
Access to health care remains a major challenge in the context of international health. Economic, social, political, administrative, geographic and cultural factors all converge to influence health seeking behaviour and access to health services. Unaffordable health care costs represent the most important barrier for poor people to access health services. These include also so-called “hidden costs” such as transport, lost working time, the costs of having to buy materials or drugs that aren’t available at health facilities or even “under-the-table-payments”. Cultural acceptability also determines a person’s health seeking behaviour. In many settings, “modern” and “traditional” health services still compete with each other. Especially poor population groups are more likely to turn to traditional ways of medicine. Key factors determining access to appropriate health care services are the social and economic conditions of a household. Health behaviour within a household is a dynamic process which depends on knowledge, resources, information, skills and available technologies and services. Lack of adequate education, cultural reasons and gender inequalities especially prevent women from accessing basic medical services. Besides gender differences, disparities in access to health care are even more accentuated by old age and poor economic status. The relationship between poverty and access to health care can be seen as part of a larger vicious cycle, whereby poverty leads to ill health, and ill health reinforces and further entrenches poverty. There is no universal explanation that can be applied across different country settings as the cultural, socio-economic and political context varies considerably. However, access to health care for the poor is determined by several key factors:
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| Related SDC Projects |
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Tajik Swiss Health Reform and Family Medicine Project
(Related Country:
Tajikistan)
Project Sino is assisting the Ministry of Health and districts (=rayons) of the Republic of Tajikistan in carrying forward health reforms and strengthening of family medicine services. The population of four rayons (Varzob, Dangara, Turzunsade and Shakrinov) is the prime beneficiary of the project.
 Project Documentation
Remssy - Emergency Services
(Related Country:
Romania)
The Romanian health system is still undergoing profound transformations and does not yet provide comprehensive health services. In this situation access to emergency care is of utmost importance to the general population. For this reason, starting with 1994, Swiss cooperation has been deeply involved in the reform of the emergency medical services in Romania.
Project Documentation
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| SDC Documents |
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Information Brief Unsafe Abortion
(09.2008)
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Scaling-up of ART in health systems: An update on recent progress
(03.2008)
User fees in health
(12.2006)
Reaching the poorest and most vulnerable with health services
(07.2004)
Access of the urban poor and vulnerable to health services
(04.2003)
Equity and access in the health sector in 5 countries of E. Europe and Central Asia
(11.2002)
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| Resources |
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Bringing Services to Hard to Reach Populations
Public Hospital Strengthening
Becoming poverty-focused: implications for health actors
Health, poverty and vulnerability
Health System Responsiveness
WHO topics page: Poverty
WHO: Poverty and Health and Development key papers and journal articles |
| Organisations |
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Equinet Africa |
| Basics |
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Poverty and Health
World Development Report 2004: Making Services Work For Poor People
Improving Health of the World's Poorest People
Creating the prospect of living a life in dignity
Poverty and access to health care in developing countries |