Family-Based Health Insurance for Informal Sector Workers in Vietnam: Why Does Enrolment Remain Low?

2018 ◽  
Vol 30 (8) ◽  
pp. 699-707 ◽  
Author(s):  
Nguyen Thi Thuy Nga ◽  
Gerard FitzGerald ◽  
Michael Dunne

Providing financial protection to the whole population is a top health policy priority of many countries. However, expanding social health insurance coverage to the “informal sector worker” is a challenge in many developing countries. This study analyzed the reasons for the limited coverage of health insurance for informal sector workers. Direct interviews were carried out with 391 uninsured households in Vietnam, followed by in-depth interviews with 11 key stakeholders. The study offers several possible explanations for the low enrollment in family-based health insurance scheme at both the demand and supply sides, such as inability to pay the premium, lack of information, perceived poor quality of primary health care services, and complicated enrollment procedures. The study suggests that a partial government subsidy and improvement in the quality of primary health care are crucial strategies for health insurance expansion for the informal sector workers and their families.

Curationis ◽  
2005 ◽  
Vol 28 (2) ◽  
Author(s):  
T-AB Mashego ◽  
K Peltzer

The aim of the study was to survey perceptions of quality of (primary) health care services provided in rural communities in the Limpopo province. Ten focus groups discussions were held with community members chosen by convenience from public places from four villages in the central region of the Limpopo Province. The sample included 42 women and 34 men (76 participants). Results indicated perceived quality discussed within the following categories: (1) conduct of staff (reception, communication, discrimination, care and compassion, respect for privacy), (2) technical care (examination, explanation of treatment, responsiveness, treatment outcomes), (3) health care facility, (4) health care organisation, (5) drugs (availability, explanation, effectiveness, payment), and (6) waiting time. The findings suggest some satisfaction with free basic and preventive health care and social services provided but there is a need to look closely into the interpersonal dimension of the services provided, provision of medication with adequate explanation to patients on the medication given, and on structural aspects, there is need for the government to give support to the clinics to provide adequate services. Improving drug availability, interpersonal skills (including attitudes towards patients) and technical care have been identified as the three main priorities for enhancing perceived quality of primary health care and health policy action.


2019 ◽  
pp. 9-52
Author(s):  
Krystyna WojtczaK

In 2019, twenty-five years have passed since the implementation of the first legisla-tive act introducing for the first time family doctors (primary health care physicians) into the Polish model of basic health care. The beginning of changes in this area, falling in the nineties of the last century, was not easy and has not yet been complete but will continue until the end of 2024. Over the years, not only the conditions for the education and professional development of primary health care physicians, in-cluding family doctors, have undergone changes. Also the organisational and legal forms of providing basic health services by this group of doctors were changing, as well as the conditions allowing patients, the recipients of medical services, to choose their doctor from among those with whom health insurance institutions (health insurance funds, or the National Health Fund) concluded agreements on the provision of basic health care services, or those employed by a medical entity with whom the National Health Fund signed relevant agreements.The scope of changes introduced at that time was wide, and when it started at the beginning of the 1990s it was almost impossible to achieve the goals without the support of the World Bank and the PHARE programme, alongside the efforts of the Ministry of Health and Social Welfare and three regional health care consortia (unions). Their work and contribution of each of them and their activities were sig-nificant and together constituted a solid basis for further work on the improvement of the model of a universal primary health care after 1998.The Act on primary health care of 2017 has completed the process of changes in this respect. For the first time, the objectives of the basic, or primary health care have been clearly defined. Although the implementation of each of these objectives is to serve the patient who is the recipient of the services, the value of the services pro-vided by primary care physicians varies. Family doctors (general practitioners) are to provide the patient and the patient’s family with health care services, coordinating at the same time all the stages of the process of their provision. However, the social mission of their profession is to ensure the implementation of broader tasks, such as health promotion adapted to the needs of various groups of society, education of the medical services recipients in the field of responsibility for their own health, as well as shaping pro-health awareness, setting health priorities of the population covered by care and implementation of preventive actions.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Manuel Leonard F. Albis ◽  
Subrata K. Bhadra ◽  
Brian Chin

Abstract Background The Urban Primary Health Care Project (UPHCP) was implemented by the Government of Bangladesh in response to rapid urbanization and growing inequalities in access to and quality of primary health care. The goal of the project was to improve health status of the urban poor living in city corporations and municipalities through the provision of health care services by NGOs that are contracted through public-private partnership. The first phase of the project started in 1998 and the project is currently in its fourth phase covering more urban areas than the first three phases. This study evaluates the impact of the second phase project (UPHCP-II) on health outcomes, mainly child diarrhea, acute respiratory infection, antenatal and postnatal care, skilled birth attendance, breastfeeding prevalence, contraceptive prevalence, sexually transmitted infections, and HIV/AIDS awareness. Methods The effect of the project was estimated through propensity score matching between project and non-project areas comparing baseline and endline surveys over a six-year period from 2006 to 2012. An innovation of this study is the recalibration of the sampling weights that allows the use of these two independent surveys in impact evaluation. Results Over the six-year period, UPHCP-II improved the health status of the population in project areas compared to non-project areas. The study found significant improvement in health outcomes in terms of reduced diarrhea and acute respiratory infection in children, which explains the downward trend in child mortality rate. Moreover, the project also improved antenatal care and skilled birth attendance. Contraceptive prevalence and HIV/AIDS awareness and avoidance increased, and sexually transmitted infections decreased. Conclusions UPHCP-II was effective in achieving its health outcome targets, while previous studies show that it was efficient in the delivery of health care and clients were highly satisfied because health facilities were in close proximity, and doctors and staff were perceived as responsive in delivering high quality of care. The results of this study could help inform future design and implementation of urban health interventions that involve contracting primary health care service delivery in Bangladesh and other similar settings.


2020 ◽  
Vol 19 (3) ◽  
pp. 433-443
Author(s):  
Md Mizanur Rahman ◽  
Sharmin Mizan ◽  
Razitasham binti Safii ◽  
Sk Akhtar Ahmad

Background and Objective: With the growing concern over treatment cost in health care and the desire to improve the effectiveness and equality of healthcare financing and the quality of the care, policy-makers have turned their attention to health insurance, especially, for the poor. This study attempted to determine the willingness to pay for health insurance among the mothers who utilized the urban primary health care clinic (UPHCC) for maternal and child health. Methods: This cross-sectional study was carried out in the working areas of UPHC Project in Bangladesh following two-stage cluster sampling technique to select the participants. Data were collected from 3949 women aged 15-49 years having at least one child aged two years or less. The data on willingness to pay for health insurance was collected using the contingent valuation method with bidding style. Data analysis was done by SPSS 22.0 version. Two generalized linear models with binary logit link function and normal identity link function were developed to identify the potential predictors for willingness to pay for monthly health insurance. Results: Three-fifths (67.5%) of the respondents agreed to pay for monthly health insurance. The median monthly premium for health insurance was BDT 15.5. Multivariate analysis revealed that utilization of UPHC clinic, quality of life, family size, age, wealth index, level of education, husband and respondent’s occupation, ownership status of the house, religion and family income appeared to be potential predictors for health insurance (p<0.05). However, utilization of UPHC clinic and quality of life appeared to be important predictors across all the models. Conclusion: A large proportion of the community agreed to pay premium for health insurance. Based on the finding of the current study the policy makers might consider introducing a scheme for health insurance especially among the urban poor. Bangladesh Journal of Medical Science Vol.19(3) 2020 p.433-443


2015 ◽  
Vol 69 (2) ◽  
pp. 123
Author(s):  
Neritan Kellici ◽  
Arvin Dibra ◽  
Joana Mihani ◽  
Suela Kellici ◽  
Genc Burazeri

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