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Proceedings of the 13

th

Meeting of the

COMCEC Poverty Alleviation Working Group

6

consequences of health. He explained as example that everyday thousands of children die of reasons

which are often preventable. It is worse for the children from poor families. And same for the poor

regions of the world. Developing countries carries the lion share of the maternal death. If you are a

pregnant mother fromAfghanistan or Somalia, you have about 48 times higher chance of pregnancy

related death compared to a Europe. The richer regions like Europe or North America have more

access to trained and formal healthcare compared to Africa or Asia. And then there are perils of

being women who have always been victim of illnesses due to socio-cultural and biological reasons

coupled with compromised access to healthcare.

Then the methods and materials that has been used to produce the report was explained. The study

pursued three strands of inquiry: First, the conceptual discussions around access to health for the

poor was summarized. This allowed to answer (1) and to lay the framework to tackle the

subsequent questions. Then the analysis of the current status and trends regarding the access to

health services in the world and within the OIC, with a special especially on the poor was conducted.

A range of existing data on demand for health, physical availability of healthcare, financial access to

health, health risk factors and health outcomes to shed light on trends and current situations within

the OIC and between OIC and non-OIC member states, at different levels of wealth and for different

regions of the world was used for that. Then four in-depth case studies were conducted to better

understand how to (or not to) enhance access to health for the poor; Indonesia, Uganda, Turkey,

Tunisia. The case studies were selected to represent each OIC region and to provide a variety of

situations regarding to past and present health access situations as struggling (first and second)

and best (third and fourth) cases. Finally, we draw some common lessons based on the case studies

and then suggest recommendations to improve the performance of access to health services within

the OIC member states with a specific emphasis on the poor.

Dr. Ahmed then explained that access to health is the ability of a person and/or group to ensure a

set of quality health services. He discussed a popular framework which described ability as

personal or groups’ convenience and/or cost related to one’s efforts in ensuring health. According

to the framework, the core of access to health a) availability, b) cost (financial affordability), c)

geographical accessibility and d) acceptability of health services. Dr. Ahmed criticized the

framework as it lacks in two specific aspects among others; a. not enough emphasis on providers’

attitude towards service provision and people’s perspective of seeking healthcare. Based on the

current stand, considering the changing context and rapid growth of technology, the dimensions of

access to health is now considered as; a. Physical accessibility (good services are within reasonable

reach of everybody), b. Financial affordability (people’s ability to pay without financial hardship),

c. Acceptability (people’s willingness to seek services) and d. Information accessibility was later

added to this framework. It is the right of the people to seek, receive and contribute health related

information. He then argued that to understand people’s perspective of access to health, these

dimensions should be viewed in light of people’s care seeking dimensions; demand, availability,

awareness, utilization of healthcare and related structural factors, i.e. policy landscape.

Dr. Ahmed then provided a brief scenario of global disparity related to access to health and

discussed the global response in light of millennium development goals (MDG). He described that,

everyday thousands of children die of reasons which are often preventable. It is worse for the