Sustainable and Accessible Health Care in Developing Countries



The Amsterdam Institute for Global Health & Development (AIGHD), PharmAccess and the Centre for Global Economic History (CGEH) have joined forces in a new exploratory research project, focusing on how to develop and organize a sustainable and accessible healthcare system in developing countries, especially in Africa. This co-operation between AIGHD, PharmAccess, and the CGEH has been initiated by PharmAccess because of their explicit interest to use history as a source of inspiration for developing new instruments within the field of development aid. To this purposes, PharmAccess does not only focus on medical and health insurance-issues, but also on the institutional context regarding the problems in development aid.



This research aims to provide insight into the problems PharmAccess is dealing with. The research focuses on four main actors in this sphere of action:


  1. The government as organizer of health care;
  2. The functioning of the private health care sector;
  3. The organization of health care through forms of collective action;
  4. Health care insurance systems provided by private organizations.


The main issue of the research activities is further specify the relations between trust, discount rates, investment and institutions, in order to break the vicious circle where health care providers do not invest to improve quality, because of the uncertainty of receiving payments from their patients, and patients do not take out health care insurance, because of the low quality of care provided and the invisibility of the short-term link between investment (fees) and profit (health services). Both the government and the organization of (private) providers of health care insurances play an important role in improving trust.


The research activities will focus on Western-Europe for the historical perspective; and for the present-day cases, the focus will be on sub-Saharan African countries. The reseracht will consist of research of scientific literature on development aid, research and analysis of cases developed by PharmAcess in developing countries, and research of scientific literature on historical examples of institutions in Western-Europe.


Project participants


Co-ordinating researcher

Elwyn Davies (AIGHD / Utrecht University)


Projectcode Utrecht University




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