Beyond MDG 6: HIV and chronic NCDs: Integrating health systems toward universal health coverage

2012 ◽  
2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
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Abstract Oral health is a central element of general health with significant impact in terms of pain, suffering, impairment of function and reduced quality of life. Although most oral disease can be prevented by health promotion strategies and routine access to primary oral health care, the GBD study 2017 estimated that oral diseases affect over 3.5 billion people worldwide (Watt et al, 2019). Given the importance of oral health and its potential contribution to achieving universal health coverage (UHC), it has received increased attention in public health debates in recent years. However, little is known about the large variations across countries in terms of service delivery, coverage and financing of oral health. There is a lack of international comparison and understanding of who delivers oral health services, how much is devoted to oral health care and who funds the costs for which type of treatment (Eaton et al., 2019). Yet, these aspects are central for understanding the scope for improvement regarding financial protection against costs of dental care and equal access to services in each country. This workshop aims to present the comparative research on dental care coverage in Europe, North America and Australia led by the European Observatory on Health Systems and Policies. Three presentations will look at dental care coverage using different methods and approaches. They will compare how well the population is covered for dental care especially within Europe and North America considering the health systems design and expenditure level on dental care, using the WHO coverage cube as analytical framework. The first presentation shows results of a cross-country Health Systems in Transition (HiT) review on dental care. It provides a comparative review and analysis of financing, coverage and access in 31 European countries, describing the main trends also in the provision of dental care. The second presentation compares dental care coverage in eight jurisdictions (Australia (New South Wales), Canada (Alberta), England, France, Germany, Italy, Sweden, and the United States) with a particular focus on older adults. The third presentation uses a vignette approach to map the extent of coverage of dental services offered by statutory systems (social insurance, compulsory insurance, NHS) in selected countries in Europe and North America. This workshop provides the opportunity of a focussed discussion on coverage of dental care, which is often neglected in the discussion on access to health services and universal health coverage. The objectives of the workshop are to discuss the oral health systems in an international comparative setting and to draw lessons on best practices and coverage design. The World Conference on Public Health is hence a good opportunity for this workshop that contributes to frame the discussion on oral health systems in a global perspective. Key messages There is large degree of variation in the extent to which the costs of dental care are covered by the statutory systems worldwide with implications for oral health outcomes and financial protection. There is a need for a more systematic collection of oral health indicators to make analysis of reliable and comparable oral health data possible.


2017 ◽  
Vol 95 (7) ◽  
pp. 537-539 ◽  
Author(s):  
Marie Paule Kieny ◽  
Henk Bekedam ◽  
Delanyo Dovlo ◽  
James Fitzgerald ◽  
Jarno Habicht ◽  
...  

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  

Abstract Since the publication of the World Health Report 2000, which aimed at assessing health systems performance globally, a number of health systems performance assessment (HSPA) frameworks and tools, designed for various purposes, have emerged. In 2017, the joint Universal Health Coverage 2030 Technical Working Group on Health Systems Assessment (TWG), consisting of health policy makers and global actors, such as the WHO, World Bank, USAID, Unicef, European Commission, OECD, etc., was formed with the aim to align the existing tools and develop a common approach to understanding and measuring health systems performance globally. As part of this work, the European Observatory on Health Systems and Policies (OBS) has developed a Health Systems Performance Assessment framework for Universal Health Coverage (HSPA Framework for UHC), that allows to evaluate health system performance, largely by drawing on the information available in the existing tools or through global data collection initiatives. Suggested approach is based on the detailed assessment of the four health system functions (governance, financing, resource generation and service delivery) and their sub-functions, the interaction of which jointly leads to the successes and failures in the achievement of health system goals. We propose distinct assessment areas for specific functions and sub-functions as a way to identify potential strengths and weaknesses, which can then be related to actions or responsibilities of specific actors within a health system, or linkages to other sectors. The objective of the workshop is to introduce the background, rationale, methods and process of developing of the HSPA framework for UHC; present a systematic approach to assessing various functions of health system and their interactions; relate the assessment areas of specific functions and sub-functions to the final health system goals; and, finally, to test the use of the framework in practice. The workshop is structured as follows: the workshop will start from the four 10-minute presentations (outlined below), followed by an interactive session with the audience to discuss the content of the framework and elaborate on its potential use for HSPA and applications globally. Key messages The HSPA framework for UHC is an approach that allows to bring together existing HSPA efforts and moves towards a more systematic and universally applicable health system performance assessment. The approach assesses performance through attribution of various health system outcomes to specific functions and sub-functions, allowing to identify strengths and weaknesses that affect performance.


2019 ◽  
Vol 24 (4) ◽  
pp. 279-287
Author(s):  
Si Ying Tan ◽  
GJ Melendez-Torres ◽  
Tikki Pang

Objective Launched to assist in achieving universal health coverage, provider payment reform (PPR) is one of the most important policy tools deployed to transform incentives within a health system that is plagued with allocative inefficiency and high out-of-pocket payments to one that is able to deliver basic services and be cost-efficient. However, the black box of such reform – that is, the contexts in which reform operates, the mechanisms by which it changes health systems and behaviour within health systems, and the outcome patterns that arise from – remains unexplored. This review aims to examine the implementation mechanisms underlying PPR in Asian developing countries. Methods A realist synthesis approach was employed to tease out the configurative elements of PPR in developing countries. A multimethod and retrospective search was conducted to locate the evidence. A programme theory and data extraction framework were developed. Data were analysed using thematic synthesis to inform an overarching realist synthesis, expressed as a set of synthesized context-mechanism-outcome configurations. Results This review found that the policy design of PPR, policy capacity, willingness of policy adoption at the local government level and provider autonomy are critical contextual factors that could trigger different policy mechanisms leading to either intended theoretical outcomes or perverse incentives. Conclusions Our findings, demonstrating the PPR implementation contexts and mechanisms that have worked in Asian countries, have implications in terms of policy learning for most developing countries that are contemplating rolling out similar reforms in the future.


2021 ◽  
Vol 29 (2) ◽  
pp. 78-80
Author(s):  
Sophie Hermanns ◽  
Jean-Olivier Schmidt

Abstract Maternal health is one of the 169 targets of the Sustainable Development Goals (SDGs). While the SDGs are less focused on maternal health than their predecessors, the Millennium Development Goals (MDGs), the SDGs’ commitments to multisectoral development, health systems, universal health coverage and equity could provide the foundations for sustainable advances in maternal health.


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