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A. It has to be based on different sources of
data which have to be linked together;
B. There are many sources of uncertainty about
the numerical information used in evaluation
(Morris et al., 2007, pp. 326-327).
from the lack of specialized intermediaries to lack
of regulatory systems (Khanna, Palepu & Sinha,
2005). Although this concern seems to apply
more to multinational than health care projects,
the need for creating a viable and sustainable
business model for the HTC initiative justifies
the need to look into the characteristics of devel-
oping countries as well as the characteristics of
their health care systems. Mapping institutional
context in terms of political and social systems,
openness, product market and labor market (for
an extensive analysis even capital market can be
added) can prove very helpful. For instance, the
decentralization of health care services in emerg-
ing countries is a decision making process that
is highly charged politically (Smith, 1997). This
is where political, social and openness analysis
come intro play. At the same time, innovations
in the delivery of health care offer insights on
how to tackle the rising costs, which is a matter
of product and labor markets.
The keyword used in addressing health care
needs in developing countries is innovation. De-
velopment of new ideas, concepts or just a new
way of presenting the old ones plays a critical
role in global health needs. As the costs for health
increase, only an increase in the development of
effective, affordable innovation and diffusion
in the market will help. Emerging markets play
an important part, as they are an expansive and
growing source of consumers (about 80% of
global population). Growing health care needs
and a steady raise in income levels create new
opportunities for business growth in these markets
(“Opportunities In Ageing Populations,” 2007).
Innovation has to deal with long standing pri-
orities such as communicable, chronic diseases.
Although innovation is becoming more and more
important, an analysis of strengths and weak-
nesses is critical. Go and Batra (2009) created a
proof-of-concept study to benchmark emerging
markets based on each country's ability to promote
innovation. They describe three objectives:
Program budgeting and marginal analysis
(PBMA) is a pragmatic approach internationally
used in order to resource allocation. It is a plan-
ning tool for rationing resources in the context
of the public sector or humanitarian work in the
absence of a market. Therefore, it is applicable
to our endeavors. Program budgeting (PB) is the
first component of this approach and is a form of
output-based budgeting (Craig, Parkin & Gerard,
1995). Costs are connected to the production of
health outputs and not to the purchase of health
inputs. It can be used in micro or macro levels. If
economic evaluation of health service provision
is considered as means of extracting maximum
gains from the budget allocated, it takes PB to
the level of marginal analysis (MA). Marginal
analysis establishes if the current expenditure
pattern is appropriate and how it can be changed
to increase health gain. It is basically a marginal
evaluation of different ways of using resources
and it can be used within or between programs
(Morris et al., 2007, p. 364).
All these theoretical frameworks need to be
taken into consideration along with the following
details on developing countries. Although these
evaluation are done during or even at the end of a
program, they need to be taken into consideration
when suggesting a model for an incipient project.
8.2. Health Care in
Developing Countries
It is often considered that fast-growing economies
provide poor soil for profits. This is why strategies
for emerging markets are so popular in the late
years. The cause for most of the preconceptions
regarding developing countries is the so-called
institutional void. It can be defined as anything
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