Community financing in primary health care

Based on reports from over 100 projects in more than 40 developing countries, this study investigates community financing of primary health care projects. The report reviews five major methods of community financing. Personal service fees, drug sales, and voluntary labor are the most common. China"s production-based prepayment system, however, reaches the most people. Ad hoc contributions play a minor role in health care financing. The feasibility of community financing within an overall national financing scheme and the strengths and weaknesses of alternative community mechanisms, especially for payment of health workers and drug costs, are discussed. The insufficiency of any one mechanism used in isolation is stressed. A brief assessment of the potential and limitations of community financing concludes the report. Appended are tables of specific types of community financing projects, a comparison of international and national finance schemes, a list of AID-supported projects using unsalaried community health workers, brief but numerous case descriptions, and a 79-item bibliography (1964-82).