Cost Sharing for Primary Health Care: Lessons from Yemenby Abdul W. Al Serouri, Dina Balabanova, Souad Al Hibshi
The dilemma of how to meet the primary health needs of the population, especially poor people, with decreasing government resources, is a real issue for government, policy makers, and donors in Yemen. The Oxfam-supported research project that led to this study was initiated in April 2000 in the context of health sector reform, and examined the perceptions of users and providers of cost-sharing schemes in Yemen. This study, drawn from the findings of the research, seeks to demonstrate the impact of cost sharing on the population of Yemen, and specifically on poor and vulnerable people. The authors show that health care is increasingly unaffordable for the majority of the population, particularly in rural areas. They aim to alert decision makers to features of cost-sharing policies that are likely to hamper equitable access to services, and prevent quality improvements and sustainability. The study highlights the essential elements for an equitable health-financing policy in Yemen: affordable and locally available drugs and services, rational drug use, improved staff training, and continuous support and supervision by the implementing agency.
The critical issues raised in this research will be extremely valuable in wider discussions of the planning and evaluation of health sector reform.
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