221. Dave P. (1991), ‘Community and Self Financing in Voluntary Health Programmes in India’, Health Policy and Planning, 6(1): 20-31.

Alternative methods of mobilizing additional revenue for the health sector have been under greater scrutiny in recent years. Increased contributions from the community have been identified as an important financing option. To date, however, there has been little systematic documentation or analysis of experiences with different health financing methods. The voluntary sector in India provides a rich array of financing experiences. This paper describes the health financing experiences of 12 voluntary organizations in India. Community and self-financing methods are described, and then evaluated on the basis of three criteria: yield, equity, and risks shared in prepayment/insurance schemes. The survey shows that India’s voluntary sector demonstrates much experimentation and innovation with community and self-financing methods, incuding user charges, community-based prepayment schemes, fund raising, commercial schemes, and in-kind contributions. There is mixed success with financing efforts. All groups were concerned about the need to protect non-affording patients from charges, and they adopted different methods to address these equity concerns. One organization successfully involved the community in the planning of a prepayment/insurance scheme. It is noted that these financing methods can be further strengthened with better planning, management, monitoring and evaluation.