This paper contributes to the understanding of access to care in low and middle-income settings. It synthesizes findings from a linked series of studies on user and provider beliefs and practices. Existing theoretical frameworks often conceptualize access as a one-stop contact with the health system, obstructed by a range of obstacles. These fail to address the complexities involved in accessing health services; including non-linear relationships, continuums of time and skills needed in care provision, the role of communities in mediating member's access, and the dynamic interaction between patients and providers. We suggest an approach to conceptualizing access taking uncertainty and complexity into account - addressing the continuous nature of treatment, the diversity of barriers at each stage, and the dynamic provider-patient interaction in context.
Health Systems Development Programme working paper, 14/06, 37 pp.