A holistic project design is essential for increasing public health-care utilization. Ultimately, the project aimed at increasing public health-care utilization, which is influenced by both supply- and demand-side interventions. The interventions appropriately addressed the supply side through improvements in health facilities, equipment, and human resources. While these infrastructure improvements are crucial, increased attention to the process of care (e.g., clinical guidelines, job aids, measurement of worker performance; referral between primary care and hospitals) could have increased the project’s impact. In addition, though the project supported some community-level IEC activities, the project could have considered additional demand-side measures (e.g., linkage with any existing conditional cash transfer programs; financing of transport/per diem costs for traveling patients; removal of formal/informal user fees) to improve public service utilization, particularly in primary care.
Second Health Care in the Central Highlands Project