Intended for healthcare professionals


Equitable access to health care

BMJ 2007; 335 doi: (Published 25 October 2007) Cite this as: BMJ 2007;335:833
  1. James K Tumwine, professor
  1. Department of Paediatrics and Child Health, Makerere University Medical School, PO Box 7072, Kampala, Uganda
  1. jtumwine{at}

    We have adequate evidence to improve health services now in less resourced countries

    As the world grapples with the problems of poverty and ill health, most people would agree that urgent action is needed to reduce the unacceptably high number of deaths of children living in resource constrained countries.1 Three studies in this week's BMJ provide evidence to improve health services in less resourced countries.2 3 4 The first study, by Biai and colleagues, is a randomised controlled trial from Guinea Bissau in West Africa. They show that supervising healthcare workers to adhere to standard treatment protocols reduces mortality in children admitted to hospital with severe malaria.2 This may not seem surprising. What is surprising, though, and of major policy importance, is that a key part of this effective intervention was to provide a small financial incentive to health workers (equivalent to one month's rent).

    Many agencies, including …

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