Household experiences of ill-health and risk protection mechanisms. (Editorial)

Abstract

This Editorial serves as an introduction to a Special Issue on Managing Risks: Household Illness Costs, Coping Strategies and Access to Social Protection. Health is at the core of the Millennium Development Goals, working through the contribution of improved health to poverty reduction as well as through the direct health and disease control targets. The message that investing in health is an important means for economic development, as well as being an end in itself, was strongly conveyed by the WHO Commission for Macroeconomics and Health, which advocated for a dramatic increase in development assistance to deliver priority services and strengthen health systems. Illness-related impoverishment can result both from direct consequences of having to pay for health services, as well as the indirect effects of illness and health expenditure on household productive activities and livelihood resources. Household responses to such events can make them more vulnerable to future health shocks, through, for example, the sale of productive assets or running down household savings. Much of the contemporary discussion around issues of financial risk protection, and broader discussions around social protection, revolve around the need for developing mechanisms to protect households against the risks of large health expenditures, and to strengthen household resources for managing such shocks in ways that limit impoverishing consequences. The implications of current and evolving health financing arrangements, and the related policy question of how systems can be designed to allow cross-subsidy in favour of the poor, form one of the research themes of the Consortium for Research on Equitable Health Systems (CREHS), a group of eight research groups in seven countries which is funded by the UK Department for International Development