Methodology for Optimal Allocation of Government Budget to Maximize Health Coverage: The Case of Antenatal Care in Egypt

摘要

Many developing countries have invested substantial government funds to develop a public sector health care delivery system to provide a set of priority services such as immunization for children or preventive care for pregnant women. The performance of these systems is often disappointing. People seek alternatives to government provision even when it is available to them at little or no direct cost or they do not receive the priority services at all. Governments often respond to this situation only by trying to do more of what they have done already, increasing the investments in the public sector health care delivery system. This strategy can be found even in countries where government services are clearly underused (i.e., have excess capacity) and where there is also a large and possible growing set of alternative non-government providers that many people may prefer to use. This paper extends our earlier work that developed an analytical model to analyze government choices to expand coverage with priority services. It develops and tests the operational capability of the model with data for antenatal care in Egypt in 1995, augmented by additional estimations as needed. The objective of this analysis was not, however, to develop policy recommendations for Egypt, but rather to test and demonstrate the approach.