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Chapter 4: Case Studies
4.1. Purpose and methodology
In this chapter we present the findings of four in-depth case studies. The purpose of the case studies
is to drill down on the status of access to health for the poor and to analyse the past and current policy
efforts to reduce health inequities. Specifically, the case studies will answer the following questions:
a) What is the structure of the access to health services and health coverage systems in the
country? How has it evolved over time?
b) What is the status of access to health services by the poor in the country?
c) What are the efforts/policies and related tools in place to improve the level of access to health
services especially by the poor in the country? What is potential sustainability of these efforts
and are they coherent with the national policies?
d) Is there any available regulatory framework to improve the access to health services in the
country? If yes, how has it been able to include the poor?
e) Who are the various actors in the country’s health system and how are they integrated? What
is the role of NGO’s, international organizations and donors working in the country to improve
access to health services especially by the poor?
f) What are the challenges and learnings regarding access to health services and health coverage
systems?
g) What is the status of data and information management systems for access to health services
in the case country?
Each case study is based on extensive literature review and insights from key informant interviews.
The contents of the analysis have been synthesised to keep the length of the report manageable and to
enable comparisons across the case studies. After each case study has been presented, the report is
devoted to a section on learning lessons based on the comparison of the cases.
The case studies have been chosen to reflect the geographic distribution of the OIC member countries,
and to showcase wide variations in terms of health outcomes and health inequities. We have chosen
Indonesia, Uganda, Turkey and Tunisia. These countries span most of the regions of the OIC and they
include one case when remarkable progress has been made in terms of expanding access to health for
the poor, namely Turkey. Indonesia and Tunisia have shown some remarkable progress (notably on
malnutrition for the former) but the picture is still mixed and much still remains to be done. Uganda is
the poorest country of the group and thus face some acute budgetary and institutional constraints.
Nonetheless some worthy developments have been ongoing.