E-drug: Income generation or revolving funds
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Please does anyone have experience of PHC programs which include community
income generating activities and/or revolving funds as ways of cost
recovery or securing sustainability of the programs, particularly the
essential drugs part of the programs.
I know that very different things are possible in different places and I
would be very grateful if anyone could summarise any cases.
Beverley Snell
Public Health Pharmacist
International Health Unit, Macfarlane Burnet Centre for Medical Research,
P O Box 254 Fairfield Australia 3078
Telephone 613 9282 2275
Fax 613 9482 3123
email <bev@burnet.edu.au>
[Note from moderator: London School of Hygiene and Tropical Medicine is a
place to start as they have been engaged in a lot of the activites in this
field, by UNICEF called the Bamako Intiative. try e.g. to Medline search for
Barbara McPake. http://www.lsthm.ac.uk/
UNICEF should have many papers, but not so much appears in their publication
list on http://www.unicef.org.
IHCAR in Sweden has also been involved in assessing some of the activites in
this field.
Several articles have appeared in World Health Forum
A small selection of articles:
McPake B et al. Community financing of health care in Africa: An evaluation
of the Bamako Initiative. Soc Sci Med 1993;36(11):1383-95
Mcpake B. User charges for health services in developing countries: A review
of the economic literature. Soc Sci Med 1993;36(11):1397-1405
Haddad S et al. Quality, cost and utilization of health services in
developing countries. A longitudinal study in Zaire. Soc Sci med 1995;40;743-53
Litvack JI et al. User fees plus quality equals improved access to health
care: results of a field experiment in Cameroon. Soc Sci Med 1993;37(3):369-83
Waddington C et al. Ten questions to ask about revolving drug funds.
Tropical Doctor April 1991
van der Geest S. Is paying for health care culturally acceptable in
Sub-Saharan Africa? Money and tradition. Soc Sci Med 1992;34:667-73
Pharmaceutical expenditures and cost recovery schemes in Sub-Saharan Africa.
WB Technical Working Paper No. 4, 1992
World Development Report 1993: Investing in Health. World Bank
Umenai T, Narula IS. Revolving drug funds and district health-system
development. Lancet 1998;351:297-8 (letter)
KM]
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