The implementation of national health insurance reforms designed to move towards universal health coverage by 9 low-income and lower-middle-income countries in Africa and Asia is reported. Five countries at intermediate stages of reform (Ghana, Indonesia, the Philippines, Rwanda, and Vietnam) and four at earlier stages (India, Kenya, Mali, and Nigeria) are considered. These countries’ approaches to raising prepaid revenues, pooling risk, and purchasing services are described using the functions-of-health-systems framework. Their progress across three dimensions of coverage: who, what services, and what proportion of health costs is assessed using the coverage-box framework. Patterns in the structure of these countries’ reforms including use of tax revenues to subsidise target populations and steps towards broader risk pools are identified. Trends in progress towards universal coverage, including increasing enrolment in government health insurance and a movement towards expanded benefits packages are reported. Common, comparable indicators of progress towards universal coverage are needed.
This book is the result of the Evaluating Capacity Development (ECD) Project, begun by ISNAR in January 2000, which aimed to improve capacity development efforts in research and development organizations through the use of evaluation. It explains how the project used an action-learning approach, bringing together people from various countries and different types of organisations. Six evaluation studies were conducted over the course of three years: exploring capacity development in a rural development NGO in Bangladesh; towards strategic management in a Cuban agricultural research institute; understanding capacity development in a plant genetic resources centre in Ghana; assessing organisational change in an agricultural faculty in Nicaragua; strengthening participatory research capacities in a Philippines root crops research centre; and expanding capacities in a rural development institute in Vietnam. Chapter 1 provides background reading on the ECD project that gave rise to the book. Chapter 2 discusses basic concepts of organisational capacity, capacity development and evaluation. Chapter 3 addresses two fundamental issues: why managers should be concerned with organisational capacity development and why they should evaluate capacity development efforts. Chapter 4 discusses issues related to the 'how' of capacity development. Chapter 5 discusses partnerships for capacity development while 6 outlines approaches and methods for evaluating organisational capacity development. Chapter 7 discusses how to utilize evaluation processes and results to advance capacity development and performance in an organisation
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