[Equity and exclusion from health care. From research to action, the experiences from one non-government organization].
Poverty is an important issue for health services needing to meet costs, but not wanting to exclude the poorest from health cover. This article describes the main themes and conclusions of the analysis performed by the International Center for Development and Research (CIDR) at the request of, and supported by Unicef. The work included a research program initiated by the BIMU aimed at identifying strategies adapted to favoring "access to health services for all". Surveys were conducted in the Comoro Islands, Conakry in Guinea, and Ethiopia to determine the extent to which the communities themselves could find solutions to the problem of access to health care for the poor. Quantitative data, and the analysis by the community studies were consistent with the view that poverty is only one of several reasons for exclusion from health cover. Seasonal exclusion affected a larger proportion of the population. Although the communities were able to identify the poorest members, the idea of helping them when ill was not acceptable. Indeed, other community members feel that they themselves are often excluded from health care cover. This makes it inappropriate to propose a system to cover only the poorest. For the communities generally, the right to health care implies finding appropriate solutions for the community as a whole, and not only for the poorest. This study highlights the need to establish systems appropriate for the different forms of exclusion, both seasonal and permanent.
de La Rocque
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Centre international de développement et de recherche, Autrches, France.
D003256:Community Participation; D017507:Comoros; D005002:Ethiopia; D016701:Guinea; D006297:Health Services Accessibility; D006302:Health Services Research / Q000458:organization & administration*; D006801:Humans; D007390:International Agencies / Q000458:organization & administration*; D011203:Poverty; D012621:Seasons; D012935:Social Justice; D014480:United Nations
Equité et exclusions des services de santé. De la recherche à l'action, l'expérience d'une ONG.