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Hardship financing of healthcare among rural poor in Orissa, India
Erika Binnendijk, Ruth Koren, David M Dror
BMC Health Services Research , 2012, DOI: 10.1186/1472-6963-12-23
Abstract: Using survey data of 5,383 low-income households in Orissa, one of the poorest states of India, we investigate factors influencing the risk of hardship financing with the use of a logistic regression.Overall, about 25% of the households (that had any healthcare cost) reported hardship financing during the year preceding the survey. Among households that experienced a hospitalization, this percentage was nearly 40%, but even among households with outpatient or maternity-related care around 25% experienced hardship financing.Hardship financing is explained not merely by the wealth of the household (measured by assets) or how much is spent out-of-pocket on healthcare costs, but also by when the payment occurs, its frequency and its duration (e.g. more severe in cases of chronic illnesses). The location where a household resides remains a major predictor of the likelihood to have hardship financing despite all other household features included in the model.Rural poor households are subjected to considerable and protracted financial hardship due to the indirect and longer-term deleterious effects of how they cope with out-of-pocket healthcare costs. The social network that households can access influences exposure to hardship financing. Our findings point to the need to develop a policy solution that would limit that exposure both in quantum and in time. We therefore conclude that policy interventions aiming to ensure health-related financial protection would have to demonstrate that they have reduced the frequency and the volume of hardship financing.While we know that the biggest part of health expenditures in India is paid by health-seekers themselves when getting care, we know much less about how those costs are met. Evidence confirms that out-of-pocket spending on healthcare absorb more than one quarter of household resources net of food costs in at least one-tenth of all households in India [1]. All over India, the level of out-of-pocket spending is 69.5% of total
Finance for the Poor: An Assessment of the Performance of Microfinance Institutions in Nigeria
WA Ademu
African Research Review , 2012,
Abstract: The introduction of microfinance in the Nigerian financial system is an attempt to provide the poor with access to micro-financial services. Micro-banks that are supposed to provide these services are faced with many challenges. Among these are: inability to reach a greater number of the poor; funding of commercial sectors at the expense of the poor s activities; lack of sufficient knowledge of the financial needs of the poor and in-depth understanding of the financial services requirements of the poor; lack of capacity of the clients to utilize the credit facilities and lack of institutional capacity of micro-banks for their own management and operations; the urban-biased location of these micro-banks across the country; the financial unsoundness of the MFBs. These challenges can be addressed by taking the following measures: adoption of more flexible credit procurement procedures by microfinance institutions; establishment of credit guarantee scheme by the federal government for the poor; building the capacity of micro-bank and that of the poor and their confidence in the formal financial institutions and making microfinance universal for commercial banks to participate.
Microfinance Banking in Nigeria: Problems and Prospects
International Journal of Finance and Accounting , 2012, DOI: 10.5923/j.ijfa.20120105.04
Abstract: Since the advent of microfinance banking in Bangladesh in the mid 1970’s, several countries have copied this financing model. The seeming popularity of this model among developing countries is predicated on poverty reduction prospect it offers. The Nigerian government cued into this popular thinking in 2005 when it inaugurated the microfinance banking scheme. This was founded to provide finance to economically active poor excluded from financing by conventional banks, provide employment, engender rural development and reduce poverty. This paper theoretically examines the challenges these banks have had to grapple with from their inception. Furthermore, it scans the business environment to assess the prospects of microfinance banks in Nigeria. The paper shows that microfinance banking in Nigeria faces enormous challenges in infrastructural inadequacies, social misconception, poor legal and regulatory framework, unbridled competition from other financial institutions,abandonment of core microfinance function and paucity of qualified manpower. Despite this plethora of challenges, the study identified several areas where opportunities exist for these banks. The growing entrepreneurial awareness, increasing government interest, large unbanked rural area and high population of poor people were identified as some of these opportunities. The paper argues that with proper regulatory interventions and commitment of other stakeholders to the core mission of microfinance banking, its challenges can be addressed and its prospects enhanced. This paper therefore concludes that the future of microfinance banking in Nigeria is bright.
Bridging the SME Financing Gap in Ghana: The Role of Microfinance Institutions  [PDF]
Isaac Quaye, Eugene Abrokwah, Alfred Sarbah, Joseph Yaw Osei
Open Journal of Business and Management (OJBM) , 2014, DOI: 10.4236/ojbm.2014.24040
Abstract: Financing Small and Medium-Scale Enterprises (SMEs) to achieve the desirable growth and expansion has been topical for governments, policymakers, non-governmental organizations (NGOs), financial and non-financial institutions. The recent upsurge in the interest of finding ways of bridging the financing gap faced by SMEs by these stakeholders have been necessitated by the enormous contributions of SMEs to the economic development and growth of countries in areas of job creation, GDP and entrepreneurial skill development. This research therefore sought to access the role of one of the stakeholders, microfinance institutions (MFIs) in helping to bridge the financing gap faced by SMEs in Ghana. The research established that there was indeed the existence of SME financing gap in the country as most of them were denied access to credit by commercial banks and other financial institutions. The research revealed that the operations of microfinance institutions (MFIs) are having positive impact on SMEs. The study also revealed some risk mitigation tools used by MFIs in granting loans to SMEs which included provision of collateral security in the form of land or any other valuable asset, business records, credit history among others. The research concluded with some recommendations on how the SME financing gap can further be bridged by MFIs and other stakeholders which included provision of support services to SMEs by MFIs such as training services in credit management as well as the need for MFIs to improve service delivery such as faster loan approval times.
Demand for healthcare in India  [cached]
Brijesh C. Purohit
Healthcare in Low-resource Settings , 2013, DOI: 10.4081/hls.2013.e7
Abstract: In a developing country like India, allocation of scarce fiscal resources has to be based on a clear understanding of how investments in the heath sector are going to affect demand. Three aspects like overall healthcare demand, consumer decisions to use public and/or private care and role of price/quality influencing poor/rich consumer’s decisions are critical to assessing the equity implications of alternative policies. Our paper addresses these aspects through examining the pattern of healthcare demand in India. Data from the National Family Health Survey are used to model the healthcare choices that individuals make. We consider what these behavioral characteristics imply for public policy. This analysis aims to study disparities between rural and urban areas from all throughout India to five Indian states representing three levels of per capita incomes (all-India average, rich and poor). Results evidence that healthcare demand both in rural and urban areas is a commodity emerging as an essential need. Choices between public or private provider are guided by income and quality variables mainly with regard to public healthcare denoting thus a situation of very limited alternatives in terms of availing private providers. These results emphasize that existing public healthcare facilities do not serve the objective of providing care to the poor in a satisfactory manner in rural areas. Thus, any financing strategy to improve health system and reduce disparities across rich-poor states and rural-urban areas should also take into account not only overcoming inadequacy but also inefficiency in allocation and utilization of healthcare inputs.
Impact Assessment of the Role of Microfinance Banks in Financing Small Scale Enterprises in Delta State, Nigeria
Edafiaje, A. L.
International Journal of Economic Development Research and Investment , 2011,
Abstract: This survey was aimed at determining the role of Microfinance Banks (MFBs) in financing small scale enterprises in Ozoro and Warri parts of Delta State, Nigeria. The population of the study comprised all the MFBs in the two selected parts of Delta State. For the sake of convenience, purposive sampling was employed to select six MFBn branches ( three from each part) for the study. Ten respondents were randomly selected from each of the MFBs and administered copies of a well structured questionnaire used as instrument for data collection. The study showed that Microfinance service, particularly, those sponsored by government, have resulted in an increased level of credit disbursement and gains in agricultural production and other activities, the effects were short- lived, due to the unsustainable nature of the programme. Microfinance banks should increase the interval between asking for loans repayment and the time of granting the loans as this renders useless the study or verification of the borrower feasibility study, more especially under an inflationary period.
Microfinance  [PDF]
Ranjana M.Chavan
Golden Research Thoughts , 2013, DOI: 10.9780/22315063
Abstract: Microfinance sector has grown rapidly over the past few decades. Nobel Laureate Muhammad Yunus is credited with laying the foundation of the modern MFIs with establishment of Grameen Bank, Bangladesh in 1976. Today it has evolved into a vibrant industry exhibiting a variety of business models. The microfinance sector is having a healthy growth rate, there have been a number of concerns related to the sector, like grey areas in regulation, transparent pricing, low financial literacy etc. In addition to these concerns there are a few emerging concerns like cluster formation, insufficient funds, multiple lending and over-indebtedness which are arising because of the increasing competition among the MFIs.
Impact Analysis of Microfinance in Nigeria  [cached]
Babajide Abiola
International Journal of Economics and Finance , 2011, DOI: 10.5539/ijef.v3n4p217
Abstract: This paper applies the financing constraints approach to study whether microfinance institutions improved access to credit for microenterprises in Nigeria or not. According to this approach, microenterprises with improved access to credit rely less on internal funds for their investments. Thus, investment sensitivity to internal funds of micro enterprises in Lagos State (a municipal with significant presence of Microfinance Banks (MFBs) was compared to that of micro enterprises in Ekiti State (a municipal with no (or limited) presence of MFBs) using a cross sectional survey method and Microfinance Institutions (MFI) branch location data. Results indicate that MFBs alleviated micro businesses’ financing constraints. This approach is applicable to evaluating microfinance impact in other countries.
Choices of health care financing schemes for resource poor country: An analysis of Nepal’s experiences  [PDF]
Shiva Raj Adhikari
Health (Health) , 2013, DOI: 10.4236/health.2013.58176

An appropriate health care financing scheme can improve the efficient, equitable, and effective use of health care resources; however, each popular health care financing scheme has some advantages and disadvantages. The designing of health care financing strategy to fit with the country specific features is not straightforward. In resource poor country, allocation of resources for health care services are always critical and frequently unstable due to nuances annual budget process, small fiscal space, uncertainties in contributions of external development partners. Considerable quantities of country specific researches require for the choice of an appropriate health care financing scheme. The paper illustrates possible better options for the government to pursue the goal of ensuring that the poor receive more benefits. The paper compares the benefit incidences and cost of services with different options purposed for primary health care services by utilizing recently collected data from different hospitals in Nepal. The paper offers an alternative policy such as a universal free care below the district level services; but in the district level which is top level of primary care, “extended targeted free health care” may be an efficient, fair, and relatively simple approach.

Three methods to monitor utilization of healthcare services by the poor
Abbas Bhuiya, SMA Hanifi, Farhana Urni, Shehrin Mahmood
International Journal for Equity in Health , 2009, DOI: 10.1186/1475-9276-8-29
Abstract: Data used in this paper came from two sources- Chakaria Health and Demographic Surveillance System (HDSS) of ICDDR,B and from a special study conducted during 2006 among patients attending the public and private health facilities in Chakaria, Bangladesh. The outcome variables included use of skilled attendants for delivery and use of facilities. Rate-ratio, rate-difference, concentration index, benefit incidence ratio, sequential sampling, and Lot Quality Assurance Sampling were used to assess how pro-poor is the use of skilled attendants for delivery and healthcare facilities.Poor are using skilled attendants for delivery far less than the better offs. Government health service facilities are used more than the private facilities by the poor.Benefit incidence analysis and sequential sampling techniques could assess the situation realistically which can be used for monitoring utilization of services by poor. The visual display of the findings makes both these methods attractive. LQAS, on the other hand, requires small fixed sample and always enables decision making.With some extra efforts monitoring of the utilization of healthcare services by the poor at the facilities can be done reliably. If monitored, the findings can guide the programme and facility managers to act in a timely fashion to improve the effectiveness of the programme in reaching the poor.Achievement of equity by way of improving the condition of the poor and disadvantaged in all aspects of life including health is one of the core goals of the contemporary development paradigm. It has been argued that unless performance indicators are examined by socioeconomic status of the population, improvement in average statistics may hide the presence of persistent or worsening inequities in a society [1]. This clearly indicates the need for monitoring the health and development indicators by socioeconomic status of the population. However, the challenge is to generate healthcare utilization data by socioecono
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