Africa's Changing Markets for Health and Veterinary Services : The New Institutional Issues

by Leonard, David K.

• ISBN13: 9780312232665
• ISBN10: 0312232667
• Format: Trade Book
• Copyright: 2000-09-02
• Publisher: Palgrave Macmillan

Summary

Under the pressure of Structural Adjustment, health and veterinary services in Africa have increasingly relied on user fees and private markets. In this book, a collaborative group of African and American physicians, veterinarians, and social scientists explore the different experiences of the two services with marketization through survey research in six African countries. They demonstrate that the markets for these services will function well only if important problems in the institutions that govern them are solved.

Author Biography

David K. Leonard is Dean of International and Area Studies, University of California at Berkeley.

Table of Contents

List of Figures	viii
List of Tables	ix
Abbreviations	xv
Biographical Notes	xvii
Abstracts	xviii
Preface	xxiv
Why Human and Animal Health Services?	xxv
Theory and Policy Relevance	xvii
Value Premises	xxviii
Themes	xxix
The Project's History	xxxviii
The New Institutional Economics and the Restructuring of Animal Health Services in Africa	1	(39)
David K. Leonard
The New Institutional Economics and the Performance of the African State	6	(6)
The Implicit Economic Theories Underlying Privatization	12	(2)
Making Privatization Effective: Efficiency, Professionalism, and Monopoly	14	(17)
Principal/Agent Theory and the Veterinary Profession	31	(8)
Conclusions	39	(1)
Traditional Insurance Mechanisms and the Choice of Health Care Providers in Ethiopia	40	(27)
Damen Haile Mariam
The Conceptual Framework and Proposed Estimation	42	(4)
Data and Methods	46	(4)
Effects of Determinants	50	(14)
Conclusions	64	(3)
The Importance of Proximity, Transport, and Gender as Transaction Costs in the Use of Veterinary Services in Zimbabwe	67	(26)
Pamela S.A. Woods
VLT Gender, Workload, and Transport Type	71	(1)
Results and Discussion	72	(16)
Calculated Breeding Index	88	(3)
Conclusions	91	(2)
Incentives and Rural Health Care Delivery: Cameroon I	93	(32)
Kenneth L. Leonard
Traditional Healers	95	(1)
Incentives to Provide Effort and the Benefit of Skill	96	(6)
The Survey Data	102	(6)
Empirical Analysis	108	(5)
Policy Simulations	113	(10)
Conclusions	123	(2)
Health Care Quality and the Choice of Care Providers: Cameroon II	125	(20)
Sylvester Ndeso-Atanga
Quality and the Choice of Providers for Curative Care	127	(11)
Utilization of Maternal and Child Health Services	138	(3)
Reasons for Choice of Delivery Clinic	141	(1)
Multivariate Analysis	142	(1)
Conclusions	143	(2)
Can Private Veterinarians Survive in Uganda?	145	(23)
Lee M.P.K. Koma
Results and Analysis	150	(9)
The Veterinarian Survey: Priorities and Practices	159	(6)
Conclusions	165	(3)
Veterinary Professionals in Senegal: Allocation of Priorities and Working Behavior	168	(35)
Cheikh Ly
Research Method	177	(2)
Results and Discussion	179	(22)
Conclusions	201	(2)
Decentralization and the Quality of Health Care in Tanzania	203	(21)
Gilbert R. Mliga
Methodology	205	(6)
Organization of Health Services and Degree of Decentralization	211	(7)
Discussion of Results	218	(2)
Conclusions and Policy Implications	220	(4)
Management and the Impact of Auxiliaries on Pastoral Production and Veterinary Services Delivery in Senegal	224	(36)
Cheikh Ly
Methodology	231	(2)
Results and Discussion	233	(12)
Evaluating Alternative Systems: TRA, FLT, and SLT	245	(12)
Conclusion: The Veterinary Matrix in Operation	257	(3)
Lessons from the New Institutional Economics for the Structural Reform of Human Health Services in Africa	260	(33)
David K. Leonard
The Context	260	(4)
Insurance	264	(4)
The Decentralization of Incentives	268	(4)
Reducing the Principal/Agent Problem	272	(2)
Moral Hazard	274	(11)
Adverse Selection	285	(5)
Conclusions	290	(3)
Consolidated Bibliography	293	(17)
Index of Persons	310	(3)
Index of Subjects	313