In leads cyclically to low utilisation as agents

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In the developing world, many
of those in poverty underutilize the health care that is available to them, and
furthermore spend income on ineffective solutions. Much of the effective health
care that available is cheap and readily available, with high levels of
marginal benefit, particularly for the poor. These effective solutions are
largely preventative such as vaccination and mosquito nets.


There numerous reasons why
there is underutilisation: there are barriers to access as resources are
allocated inefficiently into urban areas, neglecting the rural poor, and often
the resources allocated are insufficient to support the provision of essential


There are clear and obvious
supply issues that result in inadequate healthcare systems as resources are
allocated into urban areas away from the rural poor who could benefit the most,
and as too few resources are committed resulting in poor

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In this essay, I will set out
the evidence of underutilisation, what the demand barriers between patients and
services are and how some of these problems can be solved.


Firstly, it seems prescient to understand that clearly there are two
sides to of coin with regards to low access: if poor quality care and
ineffective solutions are provided, this leads cyclically to low utilisation as
agents are not interested in the services that are offered. One obvious
solution would be to raise the quality of health care provided and see what
happens. However, even why supply side issues are improved it does not always
correspond to a matched increase in demand for services. Seva Mandir found that
even when they ran efficient monthly immunisation camps in Udaipur that up to
80% of children were left unvaccinated. (improving
immunisation coverage in rural India/p62). This suggests that there are
some other underlying behavioural norms that dictate why the poor underutilise
healthcare also. One prevalent example of underutilisation is found in a study
in Bolivia, only 4.1% of children who died were hospitalised before the fatal
before the fatal episode and 61.7% of children whose illness led to death were
not seen by medical experts, whether that be a hospital, public health centre
or private practitioner. (Aguilar AM, Alvarado R, Cordero D, Kelly P, Zamora A,
Salgado R. Mortality survey in Bolivia: the final report. Investigating and
identifying the causes of death for children under five. Arlington: Basic
Support for Institutionalizing Child Survival; 1998. (Technical Report). Furthermore,
on child mortality, another paper finds that 63% of global child deaths are
avoidable. (Child Survival Study Group.

How many child deaths can we prevent this year?). Immunisation rates are
lower among poorer families than richer ones, and these disparities carry over
into receiving the correct treatment for diarrhoea and utilisation of
reproductive health services. (Initial country­level information about
socioeconomic differentials in health, nutrition and population. Washington DC:
World Bank, Health, Population and Nutrition Group; 2003). This shows that the
poor in developing countries seek healthcare less than the richer citizens in
the same countries.


Categories: Nutrition


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