Institutions for health care delivery

Most developing countries face important challenges regarding both the quality and quantity of health care they provide and there is a growing consensus that health workers play an important role in this. Although contemporary analysis of development emphasizes the central role of institutions, surp...

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Bibliografische gegevens
Hoofdauteurs: Serneels, P, Lievens, T
Formaat: Working paper
Taal:English
Gepubliceerd in: 2008
Onderwerpen:
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author Serneels, P
Lievens, T
author_facet Serneels, P
Lievens, T
author_sort Serneels, P
collection OXFORD
description Most developing countries face important challenges regarding both the quality and quantity of health care they provide and there is a growing consensus that health workers play an important role in this. Although contemporary analysis of development emphasizes the central role of institutions, surprisingly little work looks at how institutions matter for health workers and health care delivery, which is the focus of this paper. One reason for the scarcity of work in this field is that it is unclear what the relevant theory is in this area. We carry out a formal exploratory analysis to identify both the problems and the institutional factors that offer an explanation. Using qualitative research on Rwanda, a country where health care problems are typical but where the institutional environment is dynamic enough to embody changes, we find that four institutional factors explain health worker performance and career choice. Ranked in order of ease of malleability they are: incentives, monitoring arrangements, professional norms and health workers’ intrinsic motivation. We discuss their role and the implications for future research.
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spelling oxford-uuid:56d0297f-a7f0-4f11-b3d6-4bcb379dd2a52022-03-26T16:52:47ZInstitutions for health care deliveryWorking paperhttp://purl.org/coar/resource_type/c_8042uuid:56d0297f-a7f0-4f11-b3d6-4bcb379dd2a5EconomicsDevelopment economicsHealth and health policyEnglishOxford University Research Archive - Valet2008Serneels, PLievens, TMost developing countries face important challenges regarding both the quality and quantity of health care they provide and there is a growing consensus that health workers play an important role in this. Although contemporary analysis of development emphasizes the central role of institutions, surprisingly little work looks at how institutions matter for health workers and health care delivery, which is the focus of this paper. One reason for the scarcity of work in this field is that it is unclear what the relevant theory is in this area. We carry out a formal exploratory analysis to identify both the problems and the institutional factors that offer an explanation. Using qualitative research on Rwanda, a country where health care problems are typical but where the institutional environment is dynamic enough to embody changes, we find that four institutional factors explain health worker performance and career choice. Ranked in order of ease of malleability they are: incentives, monitoring arrangements, professional norms and health workers’ intrinsic motivation. We discuss their role and the implications for future research.
spellingShingle Economics
Development economics
Health and health policy
Serneels, P
Lievens, T
Institutions for health care delivery
title Institutions for health care delivery
title_full Institutions for health care delivery
title_fullStr Institutions for health care delivery
title_full_unstemmed Institutions for health care delivery
title_short Institutions for health care delivery
title_sort institutions for health care delivery
topic Economics
Development economics
Health and health policy
work_keys_str_mv AT serneelsp institutionsforhealthcaredelivery
AT lievenst institutionsforhealthcaredelivery