Experiences in paying for health care in India's voluntary sector

This article summarizes the results of four in-depth case studies on the financing and costs of the health care programmes of well-known non-government organizations (NGOs) in India. These organizations have shown a high degree of creativity and innovation in developing varied sources of financing to reduce dependency and enable them to sustain their programmes. Government funds play a major role in supporting these voluntary health activities, with less significant roles played by foreign donations, user charges, pre-paid memberships, and public fund raising. Some effective methods of assuring access for poor clients while developing self financing are described. Cost studies of the NGOs' health schemes indicate that they operate at least as efficiently as public services and primarily supplement rather than substitute for such services. Suggestions for further development of voluntary sector financing are put forward.