ZEF Bonn

Thailand. The findings of this recently finished research suggest that barriers to
modern health care access can be overcome by community-financing (CF) schemes
even in the context of extreme poverty. However, the determinants of participation
in CF schemes have also shown a differentiation within the strata of the poor.
Differences in access exist among the various countries. Whereas in Rwanda and
India income turned out to be a non-significant variable in explaining participation,
the probability of participation increases with a higher disposable income in
Thailand and Senegal. This finding can be taken as an indication of implicit design
and implementation features that allow communities to overcome the inability of
the poorest of the poor in a community to participate in such schemes.
Regarding the scheme design, it seems that the fee collection procedure is of utmost
importance for the integration of the poor within the community. Fees could be
collected in cash or kind; there could be exemption mechanisms for the poorest;
and the period when the premium is collected also matters. Finally, demandtargeted
subsidies by charitable organisations or the government can help to promote
the participation of the poor. These findings have important policy implications.
Participation in local organisations is not cost-free and requires a minimum of income
which the most disadvantaged often do not have at their disposal. Therefore,
donors and policy-makers should be aware that it may be very difficult, even impossible,
to reach the poorest part of the population when promoting participation in
local organisations and institutions. In order to reach the poorest members of the
community, the cost of participation would have to be reduced by the institutions
themselves or the public sector would have to subsidise their premiums.
2.2 Access to information
In the area of technical change, a focus of ZEF's research on
poverty and equity lies on information and communication technologies
(ICTs). Scholars within economics, geography and from
a business administration-background address the related ICT
research issues. These technologies have the potential to substantially
reduce
problems of the poor resulting from a lack of information.
Accessibility of ICTs and the Internet in particular is partly an
issue of the physical availability of the service but is also related
to complex socio-economic problems such as income, education,
political influence, etc. The poor, especially those who reside in
the rural areas where even the basic telecom services may not be
available, are suffering from precisely the lack of communication
on markets with the outside world and information that may
enable them to escape poverty, such as that on public services.
A study on the rural telecom service in Lao PDR was undertaken
to identify the impact of the basic telecom service, voice telephones,
on the welfare of rural households. A household survey
shows that telephone users were likely to be literate, to have
completed more years of education than non-users, and to be
more skilled. Despite this general pattern we also found that
usage rates were quite substantial among the low-income group
and those carrying out less-skilled jobs. Households from the
poorer quintiles spend almost the same amount on telecom ser-
Research
Access to information and
communication technologies
in Bangladesh
33