Primary Health Care in Practice: Is it Effective?

41 Pages Posted: 2 Jul 2007

See all articles by Maureen Lewis

Maureen Lewis

World Bank

Gunnar S. Eskeland

Norwegian School of Economics (NHH) - Department of Business and Management Science; Foundation for Research in Economics and Business Administration

Ximena Traa-Valerezo

World Bank

Date Written: February 2005

Abstract

Primary health care is accepted as the model for delivering basic health care to low income populations in developing countries. Using El Salvador as a case study, the paper draws on three data sets and a qualitative survey to assess health care access and utilization across public and private sector options (including NGOs). Multivariate analysis is used to estimate the quantitative determinants of health seeking behavior. Physical and financial access is generally good. Households do not value the community health workers, and prefer high cost private care, even the poorest families, because of the lower waiting times and higher probability of successful treatment. Similarly, higher level public facilities—health centers and hospitals—are preferred because they are less costly in terms of time as they offer "one stop shopping" and do not require multiple visits, and treatment success is higher than among health posts, health units or community health workers. These results combined with the small size of El Salvador suggest that alternative strategies to community health workers may be a more cost effective approach. While prevention is desirable, community health workers do not have the skills or services that the communities value, which makes them less effective in promoting prevention. Alternative modes of reaching the community could reduce costs and raise the effectiveness of public health spending.

Suggested Citation

Lewis, Maureen and Eskeland, Gunnar S. and Traa-Valerezo, Ximena, Primary Health Care in Practice: Is it Effective? (February 2005). Available at SSRN: https://ssrn.com/abstract=997385 or http://dx.doi.org/10.2139/ssrn.997385

Maureen Lewis (Contact Author)

World Bank ( email )

1818 H Street, N.W.
Washington, DC 20433
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Gunnar S. Eskeland

Norwegian School of Economics (NHH) - Department of Business and Management Science ( email )

Helleveien 30
Bergen, NO-5045
Norway
+4755959699 (Phone)

Foundation for Research in Economics and Business Administration ( email )

Breiviksveien 40
Bergen, N-5045
Norway
+47 55959699 (Phone)

Ximena Traa-Valerezo

World Bank ( email )

1818 H Street, N.W.
Washington, DC 20433
United States

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