Local governance and community financing of primary care: Evidence from Nepal

Bishai, David, Niessen, Louis W. and Shrestha, Mohan (2002) Local governance and community financing of primary care: Evidence from Nepal. Health Policy and Planning, 17 (2). pp. 202-6. ISSN 0268-1080

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Improved community participation in the financing of primary health care (PHC) is important for sustaining quality and availability of care in developing countries. This study asks whether the social status of members on a local support committee is associated with community contributions to PHC. A survey of PHC financing was conducted at 42 health facilities in two rural districts of Nepal (Jumla and Nawal Parasi). Complete data were available for 37 clinics. At each health facility, a trained interviewer collected information from the clinic administrator about the caste characteristics of the Village Development Committees (VDC) and the financial contributions made by VDCs towards the operation of the health facilities. Bivariate and multivariate logistic regression assessed the likelihood of financial contribution as it related to the caste and gender composition of the VDC as well as other characteristics of the VDC and the facility. VDCs with a majority of committee members in castes other than the highest two had higher odds of contributing to the health centre. We conclude that local development committees with a greater representation of middle and low caste members are more likely to contribute financially to the local health facility. Future research must determine the factors that lead some villages to include low caste villagers in local government.

Item Type: Article
Uncontrolled Keywords: consumer participation,data collection,financial support,health planning councils,health services research,humans,interviews as topic,local government,logistic models,nepal,power (psychology),primary health care,program development,quality of health care,rural health services,social class
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Health Economics
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Depositing User: Pure Connector
Date Deposited: 24 Jan 2014 12:52
Last Modified: 14 Aug 2023 11:30
URI: https://ueaeprints.uea.ac.uk/id/eprint/46815

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