High And Middle Income Countries

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In low and middle income countries (LMICs), because of the limited resources and the powerful countervailing incentives which encourage deviant behaviour to exist, traditional mechanism such as licensing and certification are frequently fail to control behaviour (Ensor & Weinzierl, 2007). Many studies showed that LMICs used traditional methods to regulate the health system. For example, in Zimbabwe and Tanzania the regulation mostly focus on licensing of facilities and registration of practitioner and pharmaceutical products (Kumaranayake, et al., 2000). Licensing of facilities is a compulsory process, based on inspections. Often administrated by government entities to allow health care facilities to enter the market and operate after it…show more content…
On the other hand, licensing has several drawbacks. Firstly, it imposes a minimum standard for entering the market but it does not provide information on the good and bad performers to the purchaser weather individual or state. Nevertheless, it gives a little incentive to distinguish high performers and help to improve the organisations on that (Ensor & Weinzierl, 2007). Moreover, although the volume of some services being considered as an important determinant of the quality, licensing mainly focuses on physical adequacy such as staffing and beds and the volume of the facilities services does not included (Ensor & Palmer, 2009). Furthermore, the licensure and registration of private organisations are not widespread and when institutions are found to be operating below standards levels, there are few penalties or sanctions (Chee et al., 2009). For these reasons, Ensor & Palmer, (2009) argue that self-regulation considers a good alternative in countries with capacity or financial constraints and thus face difficulties to maintain effective licensing of health care providers. Accreditation is one of the regulation mechanism which addresses performance or capability of organisational only. It is usually a voluntary method administrated by non-governmental bodies (NGO), where external peer reviewers assist and evaluate a health care facilities compliance with
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