Access to health care in developing countries: breaking down demand side barriers Acesso aos cuidados de saúde nos países em desenvolvimento: rompendo barreiras contra a demanda
IntroductionA large body of evidence confirms that many people in the developing world go without health care from which they could benefit greatly. The poor in developing countries are even less likely than the better off to receive effective health care. Concern for the level and distribution of health in the developing world demands that measures be taken to redress both facts. What are these measures? What policies can increase the utilization of effective health care, particularly by the poor in developing countries?There are two sides to the access problem. On the supply side, good quality, effective health care may not be offered. On the demand side, individuals may not utilize services from which they could benefit. The two are obviously related. Poor quality care will arouse little interest from the public. A high level of demand, made effective by purchasing power, will induce the provision of quality care. Solving the access problem requires tackling both demand and supply side issues. Given the space constraint, this paper will concentrate on the demand side, although a recurring theme will be that the response to demand side measures is dependent on supply side conditions. There is an urgent need to establish mechanisms that can increase the availability and improve the quality of health care in the developing world. For present purposes, let us suppose that effective health care interventions can REVISÃO REVIEW 2820Cad. Saúde Pública, Rio de Janeiro, 23(12):2820