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Module Reading List

Health Economics for Developing Health Systems, 2019/20, Semester 2
Tim Ensor
Tutor information is taken from the Module Catalogue

No one text fully covers the material required for the entire course. Key (and supplementary) readings will be provided for each topic. In addition the following texts cover many of the topics discussed on the module.  

Witter, S., Ensor, T., Jowett, M., & Thompson, R. (2000). Health Economics for Developing Countries: A Practical Guide, Reprinted KIT Publishers: Antwerp (basic)

McPake, B. & Normand, C. (2008). Health Economics London: Routledge, Second Edition (basic-intermediate).

I have indicated (with an *) which readings I consider to be the most important.

Health Economics and Medical Markets

Witter, Ensor et al 2000, Chapters 1-3; McPake & Normand, Chapters 2-3 (*)

Ensor, T., & Cooper, S. (2004). Overcoming barriers to health service access: influencing the demand side. Health Policy Planning ISSN: 0268-1080, 19(2), 69-79. (*)

Ensor, T. and R. Thompson (2006). The Unofficial Health Care Economy in Low and Middle-income Countries.The Elgar companion to health economics. A. Jones, Edward Elgar. (*)

Feachem RGW (2002) Commission on Macroeconomics and Health. Bulletin of the World Health Organization. 80 (2): 87-88. - and others in this issue.

Grassly N et al, (2003) The economic impact of HIV/AIDS on the education sector in Zambia’, AIDS.17: 1039-1044.

Green A (2007) An Introduction to Health Planning in Developing Countries Third Edition Oxford, OUP.

Hanson K (1992) AIDS: What Does Economics Have To Offer? Health policy and planning. 7,4, 315-328.

Grossman, M., & Kaestner, R. (1997). Effects of education on health. In J. Behrman, & N. Stacey (Eds.), The social benefits of education. Ann Arbor: University of Michigan Press. Available as an Online Course Reading in the VLE.

Leonard, K. L., G. R. Mliga and D. Haile Mariam (2002). "Bypassing Health Centres in Tanzania: Revealed Preferences for Quality." Journal of African economies. 11(4): 441-471. (*)

Lewis, M. (2007). "Informal Payments And The Financing Of Health Care In Developing And Transition Countries." Health affairs. 26(4): 985-997. (*)

McPake, B., Asiimwe,D, Mwesigye, F, Ofumbi, M, Ortenblad, L, Streefland, P, Turinde, F (1999). "Informal economic activities of public health workers in Uganda: implications for quality and accessibility of care." Social science & medicine. 49(7): 849-865.

Sahn, D. E., S. D. Younger and G. Genicot (2003). "The Demand for Health Care Services in Rural Tanzania " Oxford Bulletin of Economics and Statistics. 65(2): 241-260.

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Health Financing

Witter, Ensor et al 2000, Chapters 4 & 5; McPake & Normand, Chapters 21-24 (*)

Gottret, P., G. J. Schieber, et al., Eds. (2008). Good practices in health financing: Lessons from reforms in low- and middle-income countries. Washington, World Bank. Available online from: (*)

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User Charges

Arhin-Tenkorang, D. (2000). Mobilizing Resources for Health: The Case for User Fees Revisited, Commission on Macroeconomics and Health: 21. Available online from:

De Feranti, D. (1985). Paying for health services in developing countries : an overview. Washington, World Bank.

Chawla, M. and R. P. Ellis (2000). "The impact of financing and quality changes on health care demand in Niger." Health policy and planning. 15(1): 76-84.

Ensor T: (2004) Informal payments for health care in transition countries. Social science & medicine., 58:237-246.

Gilson L (1997) The Lessons Of User Fee Experience In Africa. Health policy and planning.12 (4) 273-85.

Gilson, L. and McIntyre, D. (2005) Removing user fees for primary care in Africa: the need for careful action. British medical journal. 331, 762-765.

Holloway K A, Gautman B R, Reeves B C (2001) The effects of different kinds of user fee on prescribing costs in rural Nepal. Health policy and planning. 16 (4): 421-427.

Mugisha F, et al. (2002). Examining out-of-pocket expenditure on health care in Nouna, Burkina Faso: implications for health policy Tropical medicine & international health. 7(2): 187-196.

James, C. D., K. Hanson, B. McPake, D. Balabanova, et al. (2006). "To retain or remove user fees?: reflections on the current debate in low- and middle-income countries." Applied Health Economics and Health Policy 5(3): 137-53. (*) Available online

McPake, B. (1993). "User Charges For Health-Services in Developing-Countries - a Review of the Economic Literature." Social science & medicine. 36(11): 1397-1405. (*)

McPake, B., A. Schmidt, E. Araujo and C. Kirunga-Tashobya (2008). Freeing up health care: a guide to removing user charges. London, Save the Children. Available online from:  

Pearson, M. (2005). Abolishing user fees in Africa? It depends…. London, HLSP Institute. Available online from:  

Xu, K., Evans, D., Kadama, P., Nabyonga, J., Ogwal, P., Nabukhonzo, P. and Aguilar, A. (2006) Understanding the impact of eliminating user fees: Utilization and catastrophic health expenditures in Uganda. Social science & medicine. 62, 866-876.

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Social Insurance

Carrin, G. and C. James (2005). “Social Health Insurance: Key Factors Affecting the Transition Towards Universal Coverage.” International social security review. 58: 45-64. (*)

Barnighausen T. and Sauerborn R. (2002) One hundred and eighteen years of the German health insurance system: are there any lessons for middle and low-income countries? Social science & medicine. Vol. 54, pp. 1559-1587.

Bjerrum A, Asante F. Determinants of health insurance membership in Ghana. 2009. Accra, Coalition Health.

Ensor T. (1999) Developing health insurance in transitional Asia. Social science & medicine. 48: 871-879.

Ensor, T. (2008). Transition to universal coverage in developing countries. Encyclopedia of Public Health. K.Heggenhougen (ed.) and G.Carrin (Economics & Finance ed.). New York, Elsevier.

Kirigia, J., L. Sambo, B. Nganda, G. Mwabu, et al. (2005). "Determinants of health insurance ownership among South African women."BMC Health Services Research [electronic resource]. 5(1): 17.

McIntyre D et al, (2003) A tale of two visions: the changing fortunes of social health insurance in South Africa, Health policy and planning. 18(1): 47-58.

McIntyre, D. (2007). Learning from Experience: Health care financing in low and middle-income countries. Cape Town, Global Forum for Health Research. Available online from:

Normand C and Weber A (1994) Social health insurance : a guidebook for planning Geneva, WHO/ILO

Wagstaff A. Social health insurance re-examined. Health economics. 19: 503–517 (2010) (*)

Tangcharoensathien V., Supachutikul A. & Lertiendumrong J. (1999) The Social security in Thailand: what lessons can be drawn? Social science & medicine. Vol. 48, pp. 913-923.

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Private Insurance

Criel, B., Van Dormael, M., Lefevre, P., Menase, U. and Van Lerberghe, W. (1998) Voluntary health insurance in Bwamanda, Democratic Republic of Congo. An exploration of its meanings to the community. Tropical medicine & international health.3, 640-653. (*)

Chanturidze T, Ugulava T, Duran A, Ensor T: Georgia Health System Review. Health Systems in Transition 2009, 11. Available online

Drechsler, D and Johannes Jütting, J (2005) Private Health Insurance for the Poor in Developing Countries? Policy Insights No. 11 OECD Development Centre. Available online from:

Mark V. Pauly, M et al (2006) Private Health Insurance In Developing Countries Health affairs. 25, no. 2 (2006): 369-379.

Sekhri, N., Savedoff, W. and Thripathi, S. (2005) Regulation of private health insurance to serve the public interest: policy issues for developing countries. Discussion Paper Number 3 - 2005. Geneva: World Health Organization. Available online from:

Sekhri N and Savedoff W. (2005). Private health insurance: implications for developing countries. Bulletin of the World Health Organization.83(2): 127-134.

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Health System Costing

Witter, Ensor et al 2000, Chapter 6; McPake & Normand, Chapter 5. (*)

Abel-Smith B and Creese A (1989) Recurrent costs in the health sector : problems and policy options in three countries Geneva, WHO.

Creese A and Parker D (1994) Cost analysis in primary health care : a training manual for programme managers Geneva, WHO.

Barnum H and Kutzin J (1993) Public hospitals in developing countries : resource use, cost, financing Baltimore: John Hopkins University Press. (*)

Flessa, S  (2009) Costing of health care services in developing countries : a prerequisite for affordability, sustainability and efficiency Lang, Frankfurt am Main.

Hongoro C and McPake B (2003) Hospital costs of high-burden diseases: malaria and pulmonary tuberculosis in a high HIV prevalence context in Zimbabwe, Tropical medicine & international health.8 (3): 242-250.

Hanson K; Gilson L (1996) Cost, resource use and financing methodology for district health services : a practical manual. 2nd ed. New York – UNICEF; 162p Bamako Initiative technical report; No. 34.

Walker D, et al (2002) An economic analysis of midwifery training programmes in South Kalimantan, Indonesia. Bulletin of the World Health Organization.80 (1): 47-55.

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Economic Evaluation

Methods for economic evaluation of healthcare:

  • Drummond, M.F., Sculpher, M.J., Claxton, K., Stoddart, G.L. and Torrance, G.W. 2015. Methods for the economic evaluation of health care programmes. Oxford university press.
    • o This text is written using predominantly UK examples but nevertheless provides a useful and up to date guide to methods for economic evaluation. Chapters 2 and 4 are especially useful.
    • o Note: the 4th edition of this book referenced here is much improved and more up to date than earlier versions.
  • Claxton KP, Revill P, Sculpher M, Wilkinson T, Cairns J, Briggs A. The Gates Reference Case for Economic Evaluation: The Bill and Melinda Gates Foundation; 2014.

Available here:

  • Bill and Melinda Gates Foundation. 2014. The Gates Reference Case: What it is, why it’s important, and how to use it.

Available here:


The development of health economic evaluation globally:

  • Pitt, C., Goodman, C. and Hanson, K. 2016. Economic evaluation in global perspective: a bibliometric analysis of the recent literature. Health economics. 25(S1), pp.9-28.

 Utilities: QALYs and DALYs:

(Especially chapters 10 and 11)

  • Gold M, Stevenson D, Fryback D. HALYs and QALYs and DALYs, Oh My: Similarities and differences in summary measures of population health. Annual Review of Public Health 23: 115-134
  • Weinstein MC, Torrance G, McGuire A., QALYs: the basics, Value health. 2009 Mar;12 Suppl 1:S5-9.

 Cost-effectiveness thresholds:

  • Loganathan, T., Ng, C. W., Lee, W. S., Hutubessy, R. C., Verguet, S., & Jit, M. (2017). Thresholds for decision-making: informing the cost-effectiveness and affordability of rotavirus vaccines in Malaysia. Health policy and planning33(2), 204-214.
    • o This paper touches on many of the issues covered in the taught sessions (not just thresholds), illustrated with an example cost-utility analysis. It also references several other useful texts.
  • Robinson, L. A., Hammitt, J. K., Chang, A. Y., & Resch, S. (2016). Understanding and improving the one and three times GDP per capita cost-effectiveness thresholds. Health policy and planning32(1), 141-145.
  • Woods, B., Revill, P., Sculpher, M. and Claxton, K., 2016. Country-level cost-effectiveness thresholds: initial estimates and the need for further research. Value in health19(8), pp.929-935.
  • Ochalek, J., Lomas, J. and Claxton, K., 2018. Estimating health opportunity costs in low-income and middle-income countries: a novel approach and evidence from cross-country data. BMJ global health, 3(6), p.e000964. Available online

 If you’re interested in the ongoing threshold debate see:

  • Blog post from Center for Global Development , which includes links to open letter from Tony Culyer to director of WHO and the letter in response:

 Example economic evaluation of healthcare:


  • Fernandes, S., Sicuri, E., Kayentao, K., van Eijk, A. M., Hill, J., Webster, J., ... & Hanson, K. (2015). Cost-effectiveness of two versus three or more doses of intermittent preventive treatment for malaria during pregnancy in sub-Saharan Africa: a modelling study of meta-analysis and cost data. The Lancet Global Health3(3), e143-e153. Available online
  • Lo, N. C., Bogoch, I. I., Blackburn, B. G., Raso, G., N'Goran, E. K., Coulibaly, J. T., ... & Andrews, J. R. (2015). Comparison of community-wide, integrated mass drug administration strategies for schistosomiasis and soil-transmitted helminthiasis: a cost-effectiveness modelling study. The Lancet Global Health3(10), e629-e638. Available online
  • Vassall, A., Pickles, M., Chandrashekar, S., Boily, M. C., Shetty, G., Guinness, L., ... & Group, C. I. (2014). Cost-effectiveness of HIV prevention for high-risk groups at scale: an economic evaluation of the Avahan programme in south India. The Lancet Global Health2(9), e531-e540. Available online


  • McBain, R. K., Salhi, C., Hann, K., Salomon, J. A., Kim, J. J., & Betancourt, T. S. (2015). Costs and cost-effectiveness of a mental health intervention for war-affected young persons: decision analysis based on a randomized controlled trial. Health policy and planning31(4), 415-424.

Life years saved:

  • Pitt, C., Tawiah, T., Soremekun, S., ten Asbroek, A. H., Manu, A., Tawiah-Agyemang, C., ... & Hanson, K. (2016). Cost and cost-effectiveness of newborn home visits: findings from the Newhints cluster-randomised controlled trial in rural Ghana. The Lancet Global Health4(1), e45-e56. Available online

 DALYs, QALYs & Life years saved:

  • Nayagam, S., Conteh, L., Sicuri, E., Shimakawa, Y., Suso, P., Tamba, S., ... & Thursz, M. (2016). Cost-effectiveness of community-based screening and treatment for chronic hepatitis B in The Gambia: an economic modelling analysis. The Lancet Global Health4(8), e568-e578 Available online

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Demery, L. (2000). Benefits incidence: a practitioner's guide. Washington, World Bank. Available online from: (*)

Gwatkin, D., A. Wagstaff and A. S. Yazbeck (2005). Reaching the Poor Health, Nutrition, and Population Services What Works, What Doesn’t, and Why. Washington, World Bank. Available online from:

O'Donnell, O., E. van Doorslaer, R. P. Rannan-Eliya, A. Somanathan, et al. (2007). "The Incidence of Public Spending on Healthcare: Comparative Evidence from Asia." The World Bank economic review. 21(1): 93-123.

Owen O'Donnell, E. v. Doorslaer, A. Wagstaff and M. Lindelow (2007). Analyzing Health Equity Using Household Survey Data: A Guide to Techniques and Their Implementation. Washington, World Bank. (*) Available online from: - a how to manual, very useful

Institute of Policy Studies (2001). Equity in financing and delivery of health services in Bangladesh, Nepal and Sri Lanka: results of the tri-country study. Colombo, with Data International, Dhaka and Nepal Health Economics Association. – I will post a copy on the VLE.

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Provider Payment Systems

Witter, Ensor et al 2000, Chapter 12 (*)

Basinga, P., Gertler, P.J., Binagwaho, A., Soucat, A.L.B., Sturby, J.R., & Vermeersch, C.M.J. (2010). Paying primary health care centers for performance in Rwanda. Washington: World Bank. Available online from:

Bloom, E., E. King, I. Bhushan, M. Kremer, et al. (2006). Contracting for Health: Evidence from Cambodia. Available online from: 

Eggleston, K. (2009). Incentives in China's healthcare delivery system. Stanford, CA: Stanford University. Available online from:

Schwartz, J. B. and I. Bhushan (2004). "Improving immunization equity through a public-private partnership in Cambodia." Bulletin of the World Health Organization. 82(9): 661-7.

Opwora, A., Kabare, M., Molyneux, S., & Goodman, C. (2009). The Implementation and Effects of Direct Facility Funding in Kenya's Health Centres and Dispensaries. Nairobi: Kenya Medical Research Institute funded by Consortium for Research on Equitable Health Systems. Available online from:

Langenbrunner, J.C., Cashin, C., & O'Dougherty, S. (2009). Designing and implementing health care provider payment systems : how-to manuals Washington D.C.: The World Bank.

Moreno-Serra, R. and A. Wagstaff (2009). System-Wide Impacts of Hospital Payment Reforms: Evidence from Central and Eastern Europe and Central Asia, World Bank Available online

Palmer, N. and A. Mills (2006). Contracting health service provision in resource and information-poor settings. The Elgar companion to health economics. A. Jones, Edward Elgar.

Peacock S. J. & Richardson, J. R. 2007. Supplier-induced demand: re-examining identification and misspecification in cross-sectional analysis. Eur J Health Econ ISSN: 1618-7598; 1618-7601, 8, 267-77.

Robyn, P. J., R. Sauerborn and T. Barnighausen (2013). "Provider payment in community-based health insurance schemes in developing countries: a systematic review." Health Policy Plan ISSN: 0268-1080 28(2): 111-122.

Soeters, R. and F. Griffiths (2003). "Improving government health services through contract management: a case from Cambodia." Health policy and planning. 18(1): 74-83.

Wodchis, W.P., Ross, J.S., & Detsky, A.S. (2007). Is P4P really FFS? Journal of the American Medical Association. 298(15), 1797-1799.

Yip, W. and K. Eggleston (2001). "Provider payment reform in China: the case of hospital reimbursement in Hainan province." Health economics. 10: 325-339. (*)

Yip, W. and K. Eggleston (2004). "Addressing government and market failures with payment incentives: Hospital reimbursement reform in Hainan, China." Social science & medicine. 58: 267-277.

Robyn, P. J., R. Sauerborn and T. Barnighausen (2013). "Provider payment in community-based health insurance schemes in developing countries: a systematic review." Health Policy Plan ISSN: 0268-1080 28(2): 111-122.

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Pay For Performance

Basinga, P., Gertler, P.J., Binagwaho, A., Soucat, A.L.B., Sturby, J.R., & Vermeersch, C.M.J. (200). Paying primary health care centers for performance in Rwanda. Washington: World Bank. Available online

Borghi, J., Singh, N. S., Brown, G., Anselmi, L. & Kristensen, S. 2018. Understanding for whom, why and in what circumstances payment for performance works in low and middle income countries: protocol for a realist review. BMJ Global Health, 3, e000695. Available online

Cheryl Cashin, Y- Ling Chi, Peter C. Smith, Michael Borowitz and Sarah Thomson (2014 Paying for Performance in Health Care Implications for health system performance and accountability ISBN: 9789264224568, World Health Organisation, Open University Press.

Eijkenaar, F., M. Emmert, M. Scheppach and O. Schoffski (2013). "Effects of pay for performance in health care: a systematic review of systematic reviews." Health policy. ISSN: 0168-8510 110(2-3): 115-130.

Fan, V. Y., D. Duran, R. Silverman and A. Glassman (2013). "Performance-based financing at the Global Fund to Fight AIDS, Tuberculosis and Malaria: an analysis of grant ratings and funding, 2003-12." Lancet Glob Health 1(3): e161-168. Available online

Gillam, S. J., A. N. Siriwardena and N. Steel (2012). "Pay-for-performance in the United Kingdom: impact of the quality and outcomes framework: a systematic review." Ann Fam Med ISSN: 1544-1709; 1544-1717 (Electronic) 10(5): 461-468.

Meessen, B., L. Musango, J. P. Kashala and J. Lemlin (2006). "Reviewing institutions of rural health centres: the Performance Initiative in Butare, Rwanda." Trop Med Int Health ISSN: 1360-2276 11(8): 1303-1317.

Nocera, A. (2010). "Performance-based hospital funding: a reform tool or an incentive for fraud?" Med J Aust 192(4): 222-224. Available online

Witter, S., A. Fretheim, F. L. Kessy and A. K. Lindahl (2012). "Paying for performance to improve the delivery of health interventions in low- and middle-income countries." Cochrane Database ISSN: 1464-780X Syst Rev 2: CD007899. Available online

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Budgeting and Resource Allocation

Brambleby P (1995) A Survivor’s Guide To Programme Budgeting Health policy. 33(2): 127-145.

Department of Health and Social Security (1976). Sharing resources for health in England : report of the Resource Allocation Working Party.. Dhaka, London: Her Majesty's Stationery Office.

Diderichsen, F. (2004). Resource Allocation for Health Equity: Issues and Methods. Washington, World Bank. Available online from: (*)

Ensor T, Bakhtigul A. (2001). Use of business planning methods to monitor global health budgets in Turkmenistan. Bulletin of the World Health Organization.78(8): 1945-1053.

Ensor, T., A. Hossain, P. D. Sen, L. Ali, et al. (2004). Geographic Resource Allocation in Bangladesh, Chapter 5. Health policy research in South Asia : building capacity for reform. A. Yazbeck and D. Peters. Washington, World Bank. Health, Nutrition and Population Series. Available as an Online Course Reading in the VLE.

Ensor T. (2005) Formula funding for health care: international review (report to World Bank which provides an overview of the main issues – I can provide a copy) (*)

Green A, Ali B, Naeem A and Ross D (2000) The allocation and budgetary mechanisms for decentralised health systems: experiences from Balochistan, Pakistan Bulletin of the World Health Organization. 78 (8), pp. 1024-1035.

Green A (1992) Financial management in times of severe resource constraints: the role of the district manager Tropical Doctor. 24 pp. 7-10.

Pearson M. (2002) Allocating public resource for health: developing pro-poor approaches. DFID Health Systems Resource Centre. Available online from:

Rice, N. and P. C. Smith (2002). Strategic resource allocation and funding decisions. Funding health care : options for Europe. J. Figueras, M. McKee, E. Mossialos and R. Saltman. Buckingham, UK & Philadelphia, USA, Open University Press: 309. Available as an Online Course Reading in the VLE. (*)

Smith, P. C. (2003). "Formula funding of public services: an economic analysis." Oxford review of economic policy. 19(2): 301-322.

WHO (1984) Programme Budgeting As Part Of The Managerial Process For National Health Development Guiding Principle, Geneva, WHO

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Demand Side Financing

Bellows, N. M., B. W. Bellows, et al. (2011). “The use of vouchers for reproductive health services in developing countries: systematic review.” Tropical medicine & international health. 16(1): 84-96. (*)

Das, A., D. Rao, et al. (2011). “India’s Janani Suraksha Yojana: further review needed (comment on the Lim article).” Lancet. 377: 295-296.

Ensor, T. (2004). “Consumer-led demand side financing in health and education and its relevance for low and middle income countries.” International Journal of Health Planning and Management 19: 267-285.

Gertler, P. and S. Boyce (2001). “An Experiment in Incentive-based Welfare: The impact of Progresa on health in Mexico.” University of California, Berkeley: 30-37. Available online from:

Ir, P., D. Hoeremans, et al. (2010). “Using targeted vouchers and health equity funds to improve access to skilled birth attendants for poor women: a case study in three rural health districts in Cambodia.” BMC Pregnancy and Childbirth [electronic resource]. 10(1).

Lim, S. S., L. Dandona, et al. “India's Janani Suraksha Yojana, a conditional cash transfer programme to increase births in health facilities: an impact evaluation.” Lancet. 375(9730): 2009-23. (*)

Murray, S. F., B. M. Hunter, R. Bisht, T. Ensor and D. Bick (2014). "Effects of demand-side financing on utilisation, experiences and outcomes of maternity care in low- and middle-income countries: a systematic review." BMC Pregnancy Childbirth 14: 30. Available online

Pearson, M. (2001). Demand side financing for health care. London, DFID Health Systems Resource Centre.

Powell-Jackson, T., J. Morrison, et al. (2009). “The experiences of districts in implementing a national incentive programme to promote safe delivery in Nepal.” BMC Health Services Research [electronic resource]. 9 (97).

Schmidt, J.O., Ensor, T., Hossain, A., & Khan, S. (2010). Vouchers as demand side financing instruments for health care: A review of the Bangladesh maternal voucher scheme. Health policy.

This list was last updated on 29/03/2019