2023-09-28 14:46:10 +00:00
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abstract: 'There is growing concern that health policies and programmes may be
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contributing to disparities in health and wealth between and within
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households in low-income settings. However, there is disagreement
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concerning which combination of health and non-health sector
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interventions might best protect the poor. Potentially promising
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interventions include those that build on the social resources that have
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been found to be particularly critical for the poor in preventing and
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coping with illness costs. In this paper we present data on the role of
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one form of social resourcecommunity-based organizations (CBOs) - in
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household ability to pay for health care on the Kenyan coast. Data were
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gathered from a rural and an urban setting using individual interviews
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(n = 24), focus group discussions (n = 18 in each setting) and
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cross-sectional surveys (n = 294 rural and n = 576 urban households). We
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describe the complex hierarchy of CBOs operating at the strategic,
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intermediate and local level in both settings, and comment on the
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potential of working through these organizations to reach and protect
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the poor. We highlight the challenges around several interventions that
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are of particular international interest at present: community-based
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health insurance schemes; micro-finance initiatives; and the removal of
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primary care user fees. We argue the importance of identifying and
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building upon organizations with a strong trust base in efforts to
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assist households to meet treatment costs, and emphasize the necessity
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of reducing the costs of services themselves for the poorest households.'
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affiliation: 'Molyneux, C (Corresponding Author), Ctr Geog Med Res, Wellcome Trust
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Collaborat Res Programme, KEMRI, POB 230, Kilifi, Kenya.
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Ctr Geog Med Res, Wellcome Trust Collaborat Res Programme, KEMRI, Kilifi, Kenya.
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Med San Frontieres Holland, NL-1001 EA Amsterdam, Netherlands.
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Univ Witwatersrand, Ctr Hlth Policy, Johannesburg, South Africa.
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Univ London London Sch Hyg \& Trop Med, London WC1E 7HT, England.'
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author: Molyneux, Catherine and Hutchison, Beryl and Chuma, Jane and Gilson, Lucy
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author-email: SMolyneux@kilifi.kemri-wellcome.org
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author_list:
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- family: Molyneux
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given: Catherine
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- family: Hutchison
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given: Beryl
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- family: Chuma
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given: Jane
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- family: Gilson
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given: Lucy
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da: '2023-09-28'
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doi: 10.1093/heapol/czm031
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files: []
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issn: 0268-1080
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journal: HEALTH POLICY AND PLANNING
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keywords: 'illness; ability to pay; social relations; community-based
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organizations; community financing; user fees; micro-finance; trust'
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keywords-plus: 'SUB-SAHARAN AFRICA; PRIVATE-SECTOR; LOW-INCOME; INSURANCE; EXPERIENCE;
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VIEWPOINT; COUNTRIES; DELIVERY; SERVICES; POVERTY'
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language: English
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month: NOV
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number: '6'
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number-of-cited-references: '50'
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orcid-numbers: 'Gilson, Lucy/0000-0002-2775-7703
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Molyneux, Catherine/0000-0001-9522-416X'
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pages: 381-392
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papis_id: 3c1e3ea9b209b80cba1087a98d8e535a
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ref: Molyneux2007rolecommunitybased
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researcherid-numbers: 'Gilson, Lucy/R-8846-2019
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Molyneux, Catherine/HGB-8464-2022'
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times-cited: '29'
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title: The role of community-based organizations in household ability to pay for health
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care in Kilifi District, Kenya
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000251036200004
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usage-count-last-180-days: '0'
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usage-count-since-2013: '11'
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volume: '22'
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web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
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year: '2007'
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