The coverage for the health equity fund (HEF) scheme supported by the program increased from three pilot provinces to cover all eight target provinces. This resulted in a higher number of eligible beneficiaries and health service utilization by the poor. Despite this, a large percentage of the eligible beneficiaries were not accessing the free HEF-funded services. There are many reasons: (i) potential beneficiaries didn't know about the services, suggesting a need for better social marketing; (ii) services at health facilities are still substandard; (iii) most ethnic and poor villages are geographically remote, with no health facilities; and (iv) cultural beliefs that favor the use of traditional medicine or birthing at home. District health services need to be more proactive and reach out to communities in remote areas. Assisted birthing in the home would help, while growth monitoring, nutrition and food security, and proper immunization of infants, children and adults could make substantial impacts on the population's health and nutritional status.
Health Sector Development Program