Abstract |
This paper examines the reasons why different approaches might be adopted for reducing financial barriers to accessing certain health, water supply and sanitation goods and services.
The health sector has been moving towards a policy of abandoning user fees and promoting free distribution of primary health care goods and services. However, in the water and sanitation
sector it is common for households to make some financial payments. For organisations like UNICEF that are interested in suitable pro-poor policies in both the health and the water and
sanitation sectors, it is important to understand these different approaches and the appropriate measures which governments and others can take to ensure access for the poor. The economic concepts behind the categorisation of private and public goods provide a basis for examining the differences in the nature of various health, water supply and sanitation goods
and services. Primary health goods are normally required only occasionally, and they usually have low demand but significant positive externalities. They are suitable for consideration as
merit goods and to be provided free to consumers. The nature of water supplies is quite different. Water is a daily human need. A water system has substantial capital and operating costs. Moreover water requires some form of rationing to avoid over-use and waste. Providing water for free is seen to be non-viable and other approaches are required to ensure poor people
have adequate access. Sanitation has a crucial behavioural change aspect that requires financing to ensure that sanitation products are then to be taken up and used. Appropriate measures for addressing financial barriers to accessing health, water supply and sanitation goods and services will vary from product to product, based on a careful examination of the nature of the product. These might include social protection measures which go beyond the scope of the water sector itself. [authors abstract]
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