Haïti and the health marketplace: the role of the private, informal market in filling the gaps left by the state

Durham, Jo; Michael, Marcos; Hill, Peter S; Paviignani, E.

doi:10.1186/s12913-015-1088-5

Cited by 18 publications

(21 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One of the consequences of ineffective governments in many low- and middle-income countries is that they leave space for informal providers to deliver a large proportion of health services [2, 3]. This is the case in the health care markets within the communities in many low- and middle-income countries.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, regulation of the health care market may be ineffective due to the limited capacity (technical and financial) and incentives to monitor and enforce the rules governing the demand and supply of health services [3, 5]. These lead to a situation in which patients tend to shop around, receiving sub-optimal or inappropriate care and incurring costs and complications until they eventually (if they do) find the appropriate health care provider who is able to successfully manage their condition [2, 6–8]…”

Section: Introductionmentioning

confidence: 99%

“…Their practice may be herbal or based on modern medicine, and may also be general or specific for procedures such as deliveries or bone-setting [1]. Informal providers thrive within local health care markets without institutions that facilitate appropriate health care transactions [2, 8–10]. The prevalence of informal providers varies widely from one community and country to another—from 88% and 96% of all providers in some communities in Bangladesh [11, 12] to 77% in Uganda [13] and between 51% and 55% in India [14, 15].…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, support for community-led initiatives has not been considered as a strategy for reducing the presence of and preference for informal providers [1, 2]. Community engagement in primary health care (PHC) has been extensively promoted in many low- and middle-income countries by establishing community health committees which are linked to the public sector health facility (typically the only formal health service provider) in the community.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Information, regulation and coordination: realist analysis of the efforts of community health committees to limit informal health care providers in Nigeria

et al. 2016

View full text Add to dashboard Cite

One of the consequences of ineffective governments is that they leave space for unlicensed and unregulated informal providers without formal training to deliver a large proportion of health services. Without institutions that facilitate appropriate health care transactions, patients tend to navigate health care markets from one inappropriate provider to another, receiving sub-optimal care, before they find appropriate providers; all the while incurring personal transaction costs. But the top-down interventions to address this barrier to accessing care are hampered by weak governments, as informal providers are entrenched in communities. To explore the role that communities could play in limiting informal providers, we applied the transaction costs theory of the firm which predicts that economic agents tend to organise production within firms when the costs of coordinating exchange through the market are greater than within a firm. In a realist analysis of qualitative data from Nigeria, we found that community health committees sometimes seek to limit informal providers in a manner that is consistent with the transaction costs theory of the firm. The committees deal not through legal sanction but by subtle influence and persuasion in a slow and faltering process of institutional change, leveraging the authority and resources available within their community, and from governments and NGOs. First, they provide information to reduce the market share controlled by informal providers, and then regulation to keep informal providers at bay while making the formal provider more competitive. When these efforts are ineffective or insufficient, committees are faced with a “make-or-buy” decision. The “make” decision involves coordination to co-produce formal health services and facilitate referrals from informal to formal providers. What sometimes results is a quasi-firm—informal and formal providers are networked in a single but loose production unit. These findings suggest that efforts to limit informal providers should seek to, among other things, augment existing community responses.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Information, regulation and coordination: realist analysis of the efforts of community health committees to limit informal health care providers in Nigeria

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Despite the larger role the governments took in the other countries examined, Haiti's COVID-19 health care response was nancially supported primarily by the private sector (60%). Hospitals and newly established screening clinics from the private sector worked together with the Haitian Ministry of Health to screen Haitians, however, health care facilities from the private sector were not regulated by government o cials (hence the paucity of government screening guidelines) [27].…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of COVID-19 guidelines from six countries: a qualitative study in the US, China, South Korea, the UK, Brazil and Haiti

Yoo

Dutra

Fanfan

et al. 2020

Preprint

View full text Add to dashboard Cite

Background On January 30, 2020, the WHO declared the outbreak of COVID-19 a Public Health Emergency of International Concern. Within only a few weeks, the outbreak took on pandemic proportions, affecting over 100 countries. This rapid increase in confirmed cases made the prevention and control of COVID-19 critical on both national and global scales in order to prevent the healthcare systems from being overwhelmed. Government guidelines provide a fundamental resource for communities, as they guide citizens on how to protect themselves against COVID-19, however, they also provide critical guidance for policy makers and healthcare professionals for taking action to slow the spread of COVID-19. Objective We aimed to identify the differences and similarities between six different countries' (U.S., China, South Korea, UK, Brazil and Haiti) government provided community and healthcare system guidelines, and to explore the relationship between guideline issue dates and the prevalence/incidence of COVID-19 cases. Research design and Methods: To make these comparisons, this exploratory qualitative study used document analysis of government guidelines issued to the general public and to healthcare professionals. Results The major differences in the evaluation and testing criteria in the guidelines across the six countries centered around the priority of testing for COVID-19 in the general population, which was strongly dependent on each country’s healthcare capacity. However, the most similar guidelines pertained to the clinical signs and symptoms of COVID-19, and methods to prevent its contraction. Conclusion In the initial stages of the outbreak, certain strategies were universally employed to control the deadly virus’s spread, including quarantining the sick, contact tracing, and social distancing. However, each country dealt with differing healthcare capacities, risks, threats, political and socioeconomic challenges, and distinct healthcare systems and infrastructure. Acknowledging these differences highlights the importance of examining the various countries’ response to the COVID-19 pandemic with a nuanced view, as each of these factors shaped the government guidelines distributed to each country’s communities and healthcare systems.

show abstract

Government-NGO relationship: regulatory constraints and uncertain policy implementation in Vietnam

Nguyen

2023

SN Soc Sci

View full text Add to dashboard Cite

Haïti and the health marketplace: the role of the private, informal market in filling the gaps left by the state

Cited by 18 publications

References 19 publications

Information, regulation and coordination: realist analysis of the efforts of community health committees to limit informal health care providers in Nigeria

Information, regulation and coordination: realist analysis of the efforts of community health committees to limit informal health care providers in Nigeria

Comparative analysis of COVID-19 guidelines from six countries: a qualitative study in the US, China, South Korea, the UK, Brazil and Haiti

Government-NGO relationship: regulatory constraints and uncertain policy implementation in Vietnam

Contact Info

Product

Resources

About