Markets, information asymmetry and health care: Towards new social contracts

Bloom, Gerald; Standing, Hilary; Lloyd, Robert

doi:10.1016/j.socscimed.2008.01.034

Cited by 171 publications

(154 citation statements)

References 36 publications

Supporting

Mentioning

151

Contrasting

Unclassified

Order By: Relevance

“…Many developing country health systems are now heavily marketised and the boundaries between "public" and "private" provision have become increasingly blurred as government health workers often set up their own independent practices alongside their public facility jobs. 25 This is the case in Bangladesh, where staff at all levels may have private patients, work in a variety of arrangements (see Table 3) and charge a fee for their services. Table 3 shows the type and number of the 303 providers and how few were employed in a public facility.…”

Section: Who Were the Providers?mentioning

confidence: 99%

“…Table 6 provides information on the treatment pathways of women who sought care for sexual problems, smelly and irritating discharge, and prolapse. While some women relied on only one provider, a significant number resorted to a second or third provider for treatment, implying that the first (and in fewer cases the second) [21][22][23][24][25][26][27][28][29][30][31] had not successfully treated the problem. For the sexual problems described in Table 6, treatments that the 265 providers said they prescribed for improving sexual function ranged from vitamins, tablets and herbal tonics (36.6% of providers), to medicinal plants (10% of providers), amulets (6.2%) and massage creams and oils (3%).…”

Section: Who Were the Providers?mentioning

confidence: 99%

“…food). Similarly, many providers emphasised that they would follow up patients in the [21][22][23][24][25][26][27][28][29][30][31] marketplace or the village, or even visit them at home. The absence of class differences and the social proximity of local informal providers and, in particular, flexibility on payment, were an incentive to poor women, who were already constrained by restricted mobility and lack of earning power.…”

Section: Who Were the Providers?mentioning

confidence: 99%

See 2 more Smart Citations

The sexual and reproductive health care market in Bangladesh: where do poor women go?

Rashid

Akram

Standing

2011

Reproductive Health Matters

Self Cite

View full text Add to dashboard Cite

This article was published in the Reproductive Health Matters [ © 2011 Reproductive Health Matters. ] and the definite version is available at : http://dx.doi.org/10.1016/S0968-8080(11)37551-9 The Journal's website is at: http://www.rhm-elsevier.com/article/S0968-8080(11)37551-9/abstractIn Bangladesh, the formal public health system provides few services for common sexual and reproductive health problems such as white discharge, fistula, prolapse, menstrual problems, reproductive and urinary tract infections, and sexual problems. Recent research has found that poor women and men resort to informal providers for these problems instead. This paper draws on interviews with 303 providers and 312 women from two rural and one urban area of Bangladesh from July 2008 to January 2009. Both informal and formal markets played an important role in treating these problems, including for the poor, but the treatments were often unlikely to resolve the problems. Providers ranged from village doctors without formal training to qualified private practitioners. The health system is heavily marketised and boundaries between "public" and "private" are blurred. There exists a huge, neglected domain of sexual and reproductive health needs which are a source of silent suffering and for which there are no trained health staff providing treatment in government facilities. The complexity of this situation calls for engaged debate in Bangladesh on how to improve the quality of existing services, discourage or prevent obviously harmful practices, and develop financing mechanisms to enable women to access effective treatment, regardless of the source, for these neglected problems.Publishe

show abstract

Section: Who Were the Providers?mentioning

confidence: 99%

Section: Who Were the Providers?mentioning

confidence: 99%

Section: Who Were the Providers?mentioning

confidence: 99%

See 1 more Smart Citation

The sexual and reproductive health care market in Bangladesh: where do poor women go?

Rashid

Akram

Standing

2011

Reproductive Health Matters

Self Cite

View full text Add to dashboard Cite

show abstract

“…It builds on the arguments of Gilson (2003) on the importance of relationships of trust to health systems, and on two papers that analyse the health sector as a knowledge economy, making widely available the benefits of specialised medical knowledge and commodities, such as drugs Bloom, Standing & Lloyd 2008). These papers argue that societies have established complicated institutional arrangements to support the development of trust-based relationships between providers and users of health-related goods and services.…”

Section: Building Institutions For An Effective and Fair Health Systemmentioning

confidence: 99%

Building institutions for health and health systems in contexts of rapid change

Bloom

Wolcott

2013

Social Science & Medicine

Self Cite

View full text Add to dashboard Cite

More details/abstract: Many Asian countries are in the midst of multiple interconnected social, economic, demographic, technological, institutional and environmental transitions. These changes are having important impacts on health and well-being and on the capacity of health systems to respond to health-related problems. This paper focuses on the creation of institutions to overcome information asymmetry and encourage the provision of safe, effective and affordable health services in this context of complexity and rapid change. It presents a review of literature on different approaches to the analysis of the management of system development and institution-building. There is a general agreement that the outcome of an intervention depends a great deal on the way that a large number of agents respond. Their response is influenced by the institutional arrangements that mediate relationships between health sector actors and also by their understandings and expectations of how other actors will respond. The impact of a policy or specific intervention is difficult to predict and there is a substantial risk of unintended outcomes. This creates the need for an iterative learning approach in which widespread experimentation is encouraged, good and bad experiences are evaluated and policies are formulated on the basis of the lessons learned. This enables actors to learn their roles and responsibilities and the appropriate responses to new incentive structures. The paper concludes with an outline of the information needs of managers of health system change in societies in the midst of rapid development. Version: Accepted Author ManuscriptTerms of use: NOTICE: this is the author's version of a work that was accepted for publication in Social Science and Medicine. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. AbstractMany Asian countries are in the midst of multiple interconnected social, economic, demographic, technological, institutional and environmental transitions. These changes are having important impacts on health and wellbeing and on the capacity of health systems to respond to health-related problems. This paper focuses on the creation of institutions to overcome information asymmetry and encourage the provision of safe, effective and affordable health services in this context of complexity and rapid change. It presents a review of literature on different approaches to the analysis of the management of system development and institution-building. There is a general agreement that the outcome of an intervention depends a great deal on the way that a large number of agents respond. Their response is influenced by the institutional arrangements that mediate relationships between health sector actors and also by their understandings and expectations of how other actors will respond. The impact of a...

show abstract

“…Although some of these funds were paid as fees to government facilities they were also used to purchase health-related goods and services in the market. A number of studies suggest that more than half of health care visits are to informal providers in a number of countries (Sudhinaraset et al 2013) The spread of health markets has been associated with a variety of factors that include economic crisis and prolonged financial constraints in the public sector, major increases in the role of markets in development strategies and growing demand for health services linked to rising incomes, ageing populations and rapid growth in access to communications media (Bloom and Standing 2008). The creation of appropriate institutional arrangements to encourage good performance by market actors has lagged behind this development.…”

Section: Introductionmentioning

confidence: 99%

Engaging with Health Markets in Low and Middle‐Income Countries

2014

Self Cite

View full text Add to dashboard Cite

SummaryMany low and middle-income countries have pluralistic health systems with a variety of providers of health-related goods and services in terms of their level of training, their ownership (public or private) and their relationship with the regulatory system. The development of institutional arrangements to influence their performance has lagged behind the spread of these markets. This paper presents a framework for analysing a pluralistic health system. The relationships between private providers of health services and government, or other organisations that represent the public interest, strongly influence their performance in meeting the needs of the poor. Their impact on the pattern of service delivery depends on how the relationships are managed and the degree to which they respond to the interests of the population. Many governments of low and middle-income countries are under pressure to increase access to safe, effective and affordable health services. In a context of economic growth, it should be possible to improve access by the poor to health services substantially. Innovations in information technologies and in low cost diagnostics are creating important new opportunities for achieving this. It will be important to mobilise both public and private providers of health-related goods and services. This will involve big changes in the roles and responsibilities of all health sector actors. Governments, businesses and civil society organizations will need to learn how to make pluralist health systems work better through experimentation and systematic learning about what works and why.

show abstract

Markets, information asymmetry and health care: Towards new social contracts

Cited by 171 publications

References 36 publications

The sexual and reproductive health care market in Bangladesh: where do poor women go?

The sexual and reproductive health care market in Bangladesh: where do poor women go?

Building institutions for health and health systems in contexts of rapid change

Engaging with Health Markets in Low and Middle‐Income Countries

Contact Info

Product

Resources

About