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Density versus Quality in Health Care Provision: Using Household Data to Make Budgetary Choices in Ethiopia |
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| Authors: | Collier Paul; Dercon Stefan; Mackinnon John |
| Institution: | Paul Collier is Director of the Development Economics Research Group at the World Bank. His e-mail address is pcollier{at}worldbank.org. Stefan Dercon is a University Lecturer in Economics at Oxford University, linked to the Centre for the Study of African Economies. His e-mail address is stefan.dercon{at}economies.ox.ac.uk. John Mackinnon is an independent researcher and advisor on development issues. His e-mail address is jwm1962{at}aol.com. |
| Abstract: | Usage of health facilities in Ethiopia is among the lowest inthe world; raising usage rates is probably critical for improvinghealth outcomes. The government has diagnosed the principalproblem as the lack of primary health facilities and is devotinga large share of the health budget to building more facilities.But household data suggest that usage of health facilities issensitive not just to the distance to the nearest facility butalso to the quality of health care provided. If the qualityof weak facilities were raised to that currently provided bythe majority of facilities in Ethiopia, usage would rise significantly.National data suggest that given the current density and qualityof service provision, additional expenditure on improving thequality of service delivery will be more cost-effective thanincreasing the density of service provision. The budget allocationrule presented in the article can help local policymakers makedecisions about how to allocate funds between improving thequality of care and decreasing the distance to the nearest healthcare facility. |
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