A report by the UK Institute of Development Studies suggests that public healthcare services often provide limited benefits to the poor. Strategies to address this situation should be based on an understanding of how the poor react to health crises, and the use they make of the diverse health resources already available. Meanwhile, health services have evolved in many countries to include a diverse range of healthcare providers who are often unsupervised and unregulated.
People can obtain drugs and medical items from a variety of public and private sources.
They pay a combination of fees and informal charges for most services, including those provided by the government. There may also be social costs. Prolonged stress on households reduces their ability to respond to future shocks. On a large scale it can result in increased criminal activity, civil disturbance and population movement. They need to accept that they are no longer the only healthcare provider and identify their specific responsibilities.