Historically, a greater focus upon technology has suppressed the discourse of access (Candi 2007).
In health care projects, service design has benefited the client, often a publicly owned organization (Cottam and Leadbeater 2004).
Extending such a paradigm of practice, producer-side thinking, into disadvantaged communities often leads to unintended consequences such as the exploitation of rural-poor communities. (Goodman 1968; Whitehead, Dahlgren et al. 2001; Wagstaff 2002).
Models: push model, pull model
Oppositions: Centralized funding versus User Pays model, entitlement versus consumption