HEU
Health Economic Unit

ALPS project

Training materials on promoting equitable access to health care for households (ALPS project)

Background

The idea for developing this set of training materials arose from the ‘Affordability Ladder Programme’ (ALPS). ALPS was a multi-country research initiative, which focused on the experience of households of illness and of seeking health care. As the name would suggest, a key focus of ALPS was that of affordability and other aspects of access to health care for households. The ALPS team recognised major gaps in training materials that focus on illness and health services that included devoting little or no attention to:

  • the perspective of households;
  • the issues of equity;
  • defining access as well as the factors that constitute access.

On this basis, it was decided to develop a set of training materials that present participants with an equity ‘lens’ through which to view the challenges of promoting health system access, focusing attention on households’ experience of illness and health service access.

Funders and collaborators

The development of these training materials was funded by the Rockefeller Foundation, and undertaken by the Health Economics Unit in collaboration with other ALPS research teams (including Marga Institute,Sri Lanka Centre for Development Studies; Department of Public Health,University of Liverpool; Indian Institute of Management, Bangalore).

Target audience

The training materials can be used for a diverse set of target groups, but are primarily aimed at current and future health sector managers. The materials are presented in a format that can be used for a one-week short course for health sector managers. However, the materials are sufficiently flexible to be used in different contexts. In particular, it is envisaged that the case studies can be used on an ad-hoc basis in post-graduate programmes such as Masters in Public Health programmes.

Use of materials

The materials are available to download free of charge. We encourage others to make use of these materials and merely request that the materials be used in their current format without amendment (so as to acknowledge the source of the materials). We would also request that you send an e-mail to Veloshnee Govender to let us know what training programmes you have used the materials and to provide feedback on your experience of using the materials.

Overview of training materials

Introduction and overview of training materials – This file provides an overview of all of the materials, information on how to use the materials and a suggested timetable for a week-long short course using these materials

Case studies and facilitator notes

The material is focused around a series of case studies and facilitator notes.

  1. Training materials on access to health care
  2. Country case studies

1. Training materials on access to health care

“Health service acceptability issues”
by Di McIntyre and Lucy Gilson

Objectives

  • To develop an understanding of the acceptability dimension of health service access, from both the household and frontline health care provider perspectives;
  • To explore ways in which health service acceptability can be promoted.

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“Availability of health services and resource allocation”
by Di McIntyre

Objectives

  • To develop an understanding of the various factors that together constitute the availability dimension of access; and
  • To develop an understanding of how resource allocation processes can contribute to improved health service access.

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“Affordability of drugs in the context of the World Trade Organisation: The case of India”
by Di McIntyre, Aditi Iyer, Shon John, Gita Sen, Asha George

Objectives

  • To develop a critical understanding of the TRIPS Agreement;
  • To develop an awareness of the power relations in patent protection;
  • To consider the potential impact of the TRIPS Agreement on households; and
  • To explore strategies to ensure the affordability of drugs in the context of the TRIPS Agreement.

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2. Country case studies

“Tax and insurance funding for health systems”
by Health Economics Unit, University of Cape Town

Objectives

  • Develop an understanding of the key health care financing functions of revenue collection, pooling of funds and purchasing in relation to tax and insurance mechanisms;
  • Develop an understanding of the role of tax and insurance in the funding of health services in different contexts, particularly in relation to:
  • Providing financial protection to households against the costs of illness, and
  • Promoting cross-subsidies in the overall health system; and
  • Critically evaluate issues relating to achieving universal coverage.

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“Health insurance in Chile”
by Vimbayi Mutyambizi

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“Universal health insurance in Costa Rica”
by Di McIntyre

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“Health insurance in Ghana”
by Di McIntyre

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“Health insurance in South Africa”
by Vimbayi Mutyambizi

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“National health insurance in South Korea”
by Vimbayi Mutyambizi

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“Universal tax funded health insurance in Sri Lanka”
by Di McIntyre

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“Care seeking experiences of households in Sri Lanka”
by Myrtle Perera, Philippa Bird, Godfrey Gunatilleke

Objectives

  • To develop an understanding of care seeking experience and health service access issues;
  • To consider the relevance of both direct and indirect costs of health care use; and
  • To develop an understanding of the household level impacts of illness and health care use and the strategies used by households to cope with these impacts.

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For more information about these training materials, contact Veloshnee Govender.

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