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What makes Health Demand-Side Financing Schemes Work in Low-and Middle-Income Countries? A Realist Review

This realist review explored causal pathways of the possible consumer effects of health sector demand-side financial (DSF) incentives, their contextual factors and mechanisms in low-and-middle-income countries. We searched six electronic data bases and identified 659 abstracts with different evaluat...

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Autores principales: Gopalan, Saji S., Das, Ashis, Mutasa, Ronald
Formato: Online Artículo Texto
Lenguaje:English
Publicado: PAGEPress Publications, Pavia, Italy 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274495/
https://www.ncbi.nlm.nih.gov/pubmed/25553311
http://dx.doi.org/10.4081/jphr.2014.304
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author Gopalan, Saji S.
Das, Ashis
Mutasa, Ronald
author_facet Gopalan, Saji S.
Das, Ashis
Mutasa, Ronald
author_sort Gopalan, Saji S.
collection PubMed
description This realist review explored causal pathways of the possible consumer effects of health sector demand-side financial (DSF) incentives, their contextual factors and mechanisms in low-and-middle-income countries. We searched six electronic data bases and identified 659 abstracts with different evaluation designs. Based on methodological rigor and content relevance, only 24 studies published up to April 2013 were selected for the final review. A conceptual framework consisting of various program theories on potential context-mechanism-outcome (C-M-O) configuration of DSF initiative was designed, tested and adapted during the review. Synthesized results were presented as a C-M-O configuration for each of the consumer –side effect. DSF was effective to improve health seeking behaviour considerably and health status to some extent. The causal pathway of DSF’s functioning and effectiveness was not linear. Key demand-side contextual factors which affected DSF’s consumer-side effects were background characteristics of the beneficiaries including their socio-cultural beliefs, motivations, and level of health awareness. At the supply-side, service availability status and provider incentives were contextual determinants. The mechanisms which enabled the interaction of contextual influence were consumer and provider accountability and consumer trust on providers. In order to enhance DSF programs’ effectiveness, their design and implementation should carefully consider the potential contextual elements that may influence the causal pathways.
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spelling pubmed-42744952014-12-31 What makes Health Demand-Side Financing Schemes Work in Low-and Middle-Income Countries? A Realist Review Gopalan, Saji S. Das, Ashis Mutasa, Ronald J Public Health Res Brief Report This realist review explored causal pathways of the possible consumer effects of health sector demand-side financial (DSF) incentives, their contextual factors and mechanisms in low-and-middle-income countries. We searched six electronic data bases and identified 659 abstracts with different evaluation designs. Based on methodological rigor and content relevance, only 24 studies published up to April 2013 were selected for the final review. A conceptual framework consisting of various program theories on potential context-mechanism-outcome (C-M-O) configuration of DSF initiative was designed, tested and adapted during the review. Synthesized results were presented as a C-M-O configuration for each of the consumer –side effect. DSF was effective to improve health seeking behaviour considerably and health status to some extent. The causal pathway of DSF’s functioning and effectiveness was not linear. Key demand-side contextual factors which affected DSF’s consumer-side effects were background characteristics of the beneficiaries including their socio-cultural beliefs, motivations, and level of health awareness. At the supply-side, service availability status and provider incentives were contextual determinants. The mechanisms which enabled the interaction of contextual influence were consumer and provider accountability and consumer trust on providers. In order to enhance DSF programs’ effectiveness, their design and implementation should carefully consider the potential contextual elements that may influence the causal pathways. PAGEPress Publications, Pavia, Italy 2014-12-02 /pmc/articles/PMC4274495/ /pubmed/25553311 http://dx.doi.org/10.4081/jphr.2014.304 Text en ©Copyright S.S. Gopalan et al. http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Brief Report
Gopalan, Saji S.
Das, Ashis
Mutasa, Ronald
What makes Health Demand-Side Financing Schemes Work in Low-and Middle-Income Countries? A Realist Review
title What makes Health Demand-Side Financing Schemes Work in Low-and Middle-Income Countries? A Realist Review
title_full What makes Health Demand-Side Financing Schemes Work in Low-and Middle-Income Countries? A Realist Review
title_fullStr What makes Health Demand-Side Financing Schemes Work in Low-and Middle-Income Countries? A Realist Review
title_full_unstemmed What makes Health Demand-Side Financing Schemes Work in Low-and Middle-Income Countries? A Realist Review
title_short What makes Health Demand-Side Financing Schemes Work in Low-and Middle-Income Countries? A Realist Review
title_sort what makes health demand-side financing schemes work in low-and middle-income countries? a realist review
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274495/
https://www.ncbi.nlm.nih.gov/pubmed/25553311
http://dx.doi.org/10.4081/jphr.2014.304
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