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Health financing country diagnostic: a foundation for national strategy development

KUTZIN, Joseph

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Health systems’ analysis is not an exact science in the sense that it is not a case of calculating an indicator and comparing that to a target that is set in stone. Instead, the analysis rests on describing elements of the existing system and critically assessing this on the basis of a clear understanding of health financing policy, the objectives associated with UHC, and relevant comparisons with and lessons from other countries. The paper attempts to provide guidance on how this can be done by highlighting the key issues that should be considered and some of the specific questions that should be addressed. It is not intended to provide a strict chapter-bychapter outline for a system assessment, but instead to foster and guide a systematic approach to the analysis of the health financing system. The health financing country diagnostic is written for Ministries of Health, advisors and others actors responsible for developing and implementing health financing policies, and provides step-by-step guidance on how to undertake a situation analysis of a country’s health financing system. Topics considered include: key contextual factors that influence health financing policy and attainment of policy goals; overview of health expenditure patterns; review of health financing arrangements; analysis UHC goals and intermediate objectives; and overall assessment - priorities for health financing reform.

Moving towards universal health coverage: health insurance reforms in nine developing countries in Africa and Asia

Lagomarsion G.
Garabrant A.
Adyas A.
Otoo N.
Muga R.
et al
September 2012

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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.

Guidelines: Incentives for health professionals

WELLER, Bridget

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Staff costs dominate health services expenditure and ongoing shortages in the availability of health professionals present a real and direct threat to the continued delivery and development of health care services. Incentives, both financial and non-financial, provide one tool that governments and other employer bodies can use to develop and sustain a workforce with the skills and experience to deliver the required care. Financial incentives (wages and conditions, performance-linked payments and others) and nonfinancial incentives (career and professional development, workload management, flexible working arrangements, positive working arrangements and access to benefits and supports) are both discussed. The characteristics of an effective incentive scheme and the development of an incentive package are described. 

Improving the health of the world's poorest people [whole issue]

CARR, Dara

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This bulletin examines the facets of the rich-poor health divide, factors that play a role in in health disaparities, and approaches for improving the health of the poor (socio-economic health service and health financing). It also provides indicators for monitoring progress to diminishing the disparities. In recent years a great deal of research has become available on health inequalities within low-income countries. This report provides the latest data on how the world's poorest people are faring on key indicators of reproductive and child health


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