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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.

Universal health coverage for inclusive and sustainable development. A synthesis of 11 country case studies.

MAEDA, Akiko
CASHIN, Cheryl
HARRIS, Joseph
REICH, Michael R.
et al

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Universal health coverage (UHC) for inclusive and sustainable development synthesises the experiences from 11 countries—Bangladesh, Brazil, Ethiopia, France, Ghana, Indonesia, Japan, Peru, Thailand, Turkey, and Vietnam—in implementing policies and strategies to achieve and sustain UHC. These countries represent diverse geographic and economic conditions, but all have committed to UHC as a key national aspiration and are approaching it in different ways. The UHC policies for each country are examined around three common themes: (1) the political economy and policy process for adopting, achieving, and sustaining UHC; (2) health financing policies to enhance health coverage; and (3) human resources for health policies for achieving UHC. The path to UHC is specific to each country, but countries can benefit from experiences of others and avoid potential risks

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.

Universal coverage of health services: tailoring its implementation

XU, Ke
EVANS, David

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In 2005, the Member States of WHO adopted a resolution encouraging countries to develop health financing systems capable of achieving and/or maintaining universal coverage of health services – where all people have access to needed health services without the risk of severe financial consequences. In doing this, a major challenge for many countries will be to move away from out-of-pocket payments, which are often used as an important source of fund collection. Prepayment methods will need to be developed or expanded but, in addition to questions of revenue collection, specific attention will also have to be paid to pooling funds to spread risks and to enable their efficient and equitable use. Developing prepayment mechanisms may take time, depending on countries’ economic, social and political contexts. Specific rules for health financing policy will need to be developed and implementing organizations will need to be tailored to the level that countries can support and sustain. In this paper we propose a comprehensive framework focusing on health financing rules and organizations that can be used to support countries in developing their health financing systems in the search for universal coverage.

Community-based health financing and child health

et al

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This brief reports on the effects that membership in community-based health financing schemes has on the use of health services when a member is ill or injured and, specifically, on priority child health services (immunisations, vitamin A supplementation, treatment of diarrhoeal disease, and prevention and treatment of malaria). The results come from household surveys performed by the Partners for Health Reformplus project (PHRplus) in the three West African countries of Ghana, Mali, and Senegal in 2004

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

South African health review 2002

Health Systems Trust (HST)

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This is a comprehensive, authoritative and independent review of the South African health system. It is published annually and the theme of this year's edition is the restructuring of the health care system: progress to date. It is made up of 21 chapters grouped into four themes: framework for transformation, human resources, priority programmes and support systems. The review acts as a barometer for assessing the transformation processes and their impact on provision of equitable health care to all in South Africa

South African health review 2001

March 2002

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This is a comprehensive, authoritative and independent review of the South African health system. It is published annually and this year's edition is is made up of 17 chapters grouped into four themes: listening to voices, equity, information for health, accountability and transformation. The review acts as a barometer for assessing the transformation processes and their impact on provision of equitable health care to all in South Africa

Current issues in sector-wide approaches for health development : Uganda case study

BROWN, Adrienne

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This brief document reports on the broad achievements and constraints faced in the health sector in Uganda. Poverty-reduction funds are being channelled into primary care, and improved management of public funds is helping the situation. However, capacity beyond the Ministry of Health is limited, and decentralization, with unclear policy links in the regions, is a challenge. There is some evidence of success in using funding strategies to reorient services to primary care and prevention


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