Primary Health Care in Practice: Is It Effective?

Maureen Lewis, Gunnar Eskeland and Ximena Traa-Valerezo

No 55, Working Papers from Center for Global Development

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.

Keywords: health care; El Salvador; public health spending (search for similar items in EconPapers)
JEL-codes: D1 H4 I11 I12 I18 (search for similar items in EconPapers)
Pages: 41 pages
Date: 2005-02
New Economics Papers: this item is included in nep-hea
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Citations: View citations in EconPapers (1)

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