Proceedings of the 13th 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