A Guide to Competitive Vouchers in Health provides a broad outline of the problems health systems face, the rationale behind government intervention particularly in the form of subsidies, and the different ways that governments and donors subsidize health care.
The guide provides readers with an understanding of the concept of competitive voucher schemes in health; the advantages competitive voucher schemes might offer as an instrument to delivery subsidies; circumstances where competitive voucher schemes are better suited than other instruments to deliver subsidies; and steps to follow when designing, implementing, monitoring and evaluating a competitive voucher scheme.
Aimed at raising awareness among policymakers about voucher schemes, this book helps identify situations where vouchers may better achieve health objectives and provides guidance on the choices available and the decisions to be made. It highlights some of the pitfalls that voucher schemes have experienced to date, as well as the wide variation in format that a voucher scheme can take depending upon the health problems being addressed and the objectives that the policy-maker wishes to achieve.
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World Development Report 2004 reviews traditional approaches to public service delivery and discusses how they have often failed the poor. Whether in health, education, or infrastructure, supply-side subsidy strategies to fund inputs—such as staff costs, equipment, and buildings used in delivery—have not improved the access to quality services among the poor. An important question remains for developing countries and the international development community on how to deliver and target public subsidies in ways that promote efficiency and innovation, increase accountability for performance, and leverage public resources with private participation and financing.
This guide identifies the advantages of competitive voucher schemes in delivering subsidies; describes the circumstances under which they are superior to other subsidy mechanisms; and explains how to design, implement, monitor, and evaluate a voucher scheme. It provides a broad outline of the problems faced by health systems, the rationale for government intervention, and the different ways in which governments and donors subsidize health care.
The guide does not advocate greater use of vouchers but simply raises awareness about voucher schemes, offering policymakers guidance on the choices and decisions they need to make. It also highlights some pitfalls of voucher schemes and describes the different formats vouchers can take depending on the health problems being addressed and the objectives policymakers wish to achieve.
