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Especially in LMICs, the combination of weak provider incentives and high fee for service user payments further enhances already existing gaps in service coverage by making care inaccessible to many communities [ 9].
The National EmONC Needs Assessment in Afghanistan found low rates of assisted vaginal delivery due, in part, to lack of equipment and weak provider skills in using vacuum extractors and forceps [ 16].
17 in Table 4) found that lack of understanding of the community financing provider payment method contributed to weak provider support for the CBI, which in turn is likely to have led to the low enrolment rates in the CBI (Criel and Waelkens 2003; Criel et al. 2005).
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In spite of the marked client orientation of research projects as evidenced by source of project funding, only 46% of institutions target special databases or publications to policy makers, suggesting a rather academic orientation of final products and a weak provider-client relationship even when projects are government-financed.
Again, this would be harmful to children, as children across the country would be left worse off in terms of higher cost, reduced benefits, and weaker provider networks.
However, biosecurity is a weakest link public good, where the total amount of protection approximately equals the level of the weakest provider [ 2, 3].
Connolly says: "The payouts from Prudential compare favourably against other stronger with-profits providers such as Aviva and Legal & General, and are hugely superior to the weaker providers such as Scottish Widows".
Several industry analysts have predicted that the loss of subscribers to some of the six major carriers -- Nextel, Verizon Wireless, T-Mobile, AT&T Wireless, Sprint PCS and Cingular Wireless -- could turn the weaker providers into acquisition targets now that customers can more easily vote with their feet.
After completing the self-assessment, providers develop an action plan which is a tool used to improve upon the weak areas the provider herself has identified.
In Tanzania, the model was applied in a context of a weaker volunteer CTC provider programme and was complementary to work being done at the facility level to expand improvement across the continuum of care.
As pointed out by the World Bank and other studies, FFS financial incentives for health service providers, together with weak regulation of health service providers, have led to over-use and unnecessary treatments and drug prescriptions.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com