The Politics of Promoting Social Protection in Uganda

2019 ◽  
pp. 202-224
Author(s):  
Badru Bukenya ◽  
Sam Hickey
Keyword(s):  
Health Insurance ◽  
Social Protection ◽  
Social Health Insurance ◽  
Cash Transfers ◽  
Process Tracing ◽  
Social Health ◽  
Holding Power ◽  
The Poor ◽  
External Actors ◽  
Political Settlement

The success of efforts to promote social protection in Uganda since the early 2000s has varied considerably, with cash transfers progressing much further than social health insurance. Using original primary research and a process-tracing methodology, we show that external actors were able to form a coherent policy coalition around cast transfers and promote them in ways that became aligned with the dominant ideas and incentives of powerful actors within Uganda’s political settlement. In contrast, proponents of health insurance struggled to mobilize a coalition capable of overcoming actors with greater holding power, particularly the President and private sector actors. Whereas ‘just giving money to the poor’ fits with Uganda’s increasingly personalized-populist political settlement, the hard work of building a credible health system, and formally requiring citizens to contribute to their own healthcare, requires a commitment and capacity to promoting a new social contract that seems to be lacking in Uganda.

scholarly journals Social health insurance for the poor: lessons from a health insurance programme in Karnataka, India

2018 ◽  
Vol 3 (1) ◽  
pp. e000582 ◽  
Author(s):  
Neeraj Sood ◽  
Zachary Wagner
Keyword(s):  
Health Insurance ◽  
Financial Burden ◽  
Tertiary Care ◽  
Substantial Reduction ◽  
Unmet Need ◽  
Social Health Insurance ◽  
Well Being ◽  
Poverty Line ◽  
Social Health ◽  
The Poor

Life-saving technology used to treat catastrophic illnesses such as heart disease and cancer is often out of reach for the poor. As life expectancy increases in poor countries and the burden from chronic illnesses continues to rise, so will the unmet need for expensive tertiary care. Understanding how best to increase access to and reduce the financial burden of expensive tertiary care is a crucial task for the global health community in the coming decades. In 2010, Karnataka, a state in India, rolled out the Vajpayee Arogyashree scheme (VAS), a social health insurance scheme focused on increasing access to tertiary care for households below the poverty line. VAS was rolled out in a way that allowed for robust evaluation of its causal effects and several studies have examined various impacts of the scheme on poor households. In this analysis article, we summarise the key findings and assess how these findings can be used to inform other social health insurance schemes. First, the evidence suggests that VAS led to a substantial reduction in mortality driven by increased tertiary care utilisation as well as use of better quality facilities and earlier diagnosis. Second, VAS significantly reduced the financial burden of receiving tertiary care. Third, these benefits of social health insurance were achieved at a reasonable cost to society and taxpayers. Several unique features of VAS led to its success at improving health and financial well-being including effective outreach via health camps, targeting expensive conditions with high disease burden, easy enrolment process, cashless treatment, bundled payment for hospital services, participation of both public and private hospitals and prior authorisation to improve appropriateness of care.

scholarly journals Governance and Purchasing Function under Social Health Insurance in Nepal: Looking Back and Moving Forward

2017 ◽  
Vol 15 (1) ◽  
pp. 85-87
Author(s):  
Vishnu Prasad Sapkota ◽  
Umesh Prasad Bhusal
Keyword(s):  
Health Insurance ◽  
Social Protection ◽  
Service Providers ◽  
Social Health Insurance ◽  
Social Health ◽  
Health Coverage ◽  
Health Security ◽  
The Social ◽  
Development Committee ◽  
Health Services Needs

Nepal is pursuing Social Health Insurance as a way of mobilizing revenues to achieve Universal Health Coverage. The Social Health Insurance governance encourages service providers to maintain quality and efficiency in services provision by practicing strategic purchasing. Social Health Security Programme is a social protection program which aspires to achieve the goals of Social Health Insurance. Social Health Security Development Committee needs to consider following experiences to function as a strategic purchaser. The Social Health Security Development Committee need to be an independent body instead of falling under Ministry of Health. Similarly, purchasing of health services needs to be made strategic, i.e., Social Health Security Development Committee should use its financial power to guide the provider behavior that will eventually contribute to achieving the goals of quality and efficiency in service provision. The other social health security funds should be merged with Social Health Security Development Committee and develop a single national fund. Finally, the state has to regulate and monitor the performance of the SHI agency.

scholarly journals Social health insurance schemes in Africa leave out the poor

2018 ◽  
Vol 10 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Ama Pokuaa Fenny ◽  
Robert Yates ◽  
Rachel Thompson
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Social Health ◽  
The Poor

scholarly journals WOMEN MIGRANT WORKERS AND SOCIAL PROTECTION SYSTEMS IN THE PHILIPPINES

2017 ◽  
Vol 3 (1) ◽  
pp. 23
Author(s):  
Purwo Purwowi Wibowo
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care System ◽  
Migrant Workers ◽  
Social Protection ◽  
Social Health Insurance ◽  
The Philippines ◽  
Social Health ◽  
Protection Systems ◽  
Social Protection Systems

Women migrant workers often face a variety of problems in the workplace, for example violence, sexual abuse, rape, extortion, and so on. Social protection systems for women migrant workers in other countries are very important. In the Philippines, there are two social protection systems to improve social welfare for vulnerable populations. Two models of social protection called the health care system and social health insurance. Both social protection systems can be managed, as based on: (1) culture value, (2) to be funded by the financial institutions, (3) implemented freely, (4) the scheme is combined with the national health insurance system, (5) able to create a high quality service. The conditions of women migrant workers are more vulnerable than male workers. So, the social protection for women migrant workers is urgent and need policies to protect them. The Government of the Philippines emphasizes the problems related to the obligation of women migrant workers to have right information and guidance before they leave the country in order to minimize social problems. Finally, social protection, not only in the Philippines, but also cooperation among countries to ptotect women migrant workers by making policy of social protection from local, national, regional, and international level.   Keywords: Migrant Worker, Social Protection in Philippines, Health Care System, Social Health Insurance

Social Protection under Authoritarianism

2020 ◽  
Author(s):  
Xian Huang
Keyword(s):  
Health Insurance ◽  
Social Welfare ◽  
Social Protection ◽  
Social Health Insurance ◽  
Multilevel Governance ◽  
Social Health ◽  
Social Constraints ◽  
Welfare Provision ◽  
Trade Off ◽  
The Masses

Why would authoritarian leaders expand social welfare provision in the absence of democratization? What are the distributive features and implications of social welfare expansion in an authoritarian country? How do authoritarian leaders design and enforce social welfare expansion in a decentralized multilevel governance setting? This book identifies the trade-off authoritarian leaders face in social welfare provision: effectively balancing coverage and benefits between elites and masses in order to maximize the regime’s survival prospects. Using government documents, field interviews, survey data, and government statistics about Chinese social health insurance, this book reveals that the Chinese authoritarian leaders attempt to manage the distributive trade-off by a “stratified expansion” strategy, establishing an expansive yet stratified social health insurance system to perpetuate a particularly privileged program for the elites while building an essentially modest health provision for the masses. In China’s decentralized multilevel governance setting, the stratified expansion of social health insurance is implemented by local leaders who confront various fiscal and social constraints in vastly different local circumstances. As a result, there is great regional variation in the expansion of social health insurance, in addition to the benefit stratification across social strata. The dynamics of central-local interaction in enforcing the stratified expansion of social health insurance stands at the core of the politics of health reform in China during the first decade of the 2000s. This book demonstrates that the strategic balance between elites and masses in benefit distribution is delicate in authoritarian and decentralized multilevel governance settings.

THE EFFECTS OF SOCIAL HEALTH INSURANCE ON WOMEN’S HEALTHCARE USE: EVIDENCE FROM INDONESIA

2020 ◽  
pp. 1-24
Author(s):  
SHANIKA SAMARAKOON ◽  
RASYAD A. PARINDURI
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Healthcare Services ◽  
Social Health ◽  
Public Healthcare ◽  
Delivery Care ◽  
Healthcare Use ◽  
Healthcare Facilities ◽  
The Poor ◽  
The Government

To increase the use of healthcare services in Indonesia, the government of Indonesia introduced Askeskin, a subsidized social health insurance for the poor, in 2005. We examine the effects of this social health insurance on women’s healthcare use. Using propensity score matching, we find Askeskin induces women to use public healthcare facilities for birth delivery and antenatal checkup, discourages them from getting help from midwives for birth delivery, and makes them more likely to use contraceptives. The insurance seems to increase delivery care expenditure, however. We do not find evidence that it increases women’s preventive and curative healthcare use.

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