High-Performance Health Financing for Universal Health Coverage

10.1596/31930 ◽  
2019 ◽  
Author(s):  
Keyword(s):  
Universal Health Coverage ◽  
High Performance ◽  
Health Financing ◽  
Health Coverage ◽  
Universal Health

scholarly journals Employment based health financing does not support gender equity in universal health coverage

BMJ ◽  
2020 ◽  
pp. m3384 ◽  
Author(s):  
Lavanya Vijayasingham ◽  
Veloshnee Govender ◽  
Sophie Witter ◽  
Michelle Remme
Keyword(s):  
Gender Equity ◽  
Universal Health Coverage ◽  
Health Financing ◽  
Health Coverage ◽  
Universal Health

scholarly journals Universal Health Coverage in Bangladesh: Activities, Challenges, and Suggestions

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Taufique Joarder ◽  
Tahrim Z. Chaudhury ◽  
Ishtiaq Mannan
Keyword(s):  
Health Insurance ◽  
Universal Health Coverage ◽  
Service Management ◽  
Service Providers ◽  
Health Financing ◽  
Community Empowerment ◽  
Health Coverage ◽  
Demand Side ◽  
Implementation Barriers ◽  
Universal Health

Catastrophic health expenditure forces 5.7 million Bangladeshis into poverty. Inequity is present in most of health indicators across social, economic, and demographic parameters. This study explores the existing health policy environment and current activities to further the progress towards Universal Health Coverage (UHC) and the challenges faced in these endeavors. This qualitative study involved document reviews (n=22) and key informant interviews (KII, n=15). Thematic analysis of texts (themes: activities around UHC, implementation barriers, suggestions) was done using the manual coding technique. We found that Bangladesh has a comprehensive set of policies for UHC, e.g., a health-financing strategy and staged recommendations for pooling of funds to create a national health insurance scheme and expand financial protection for health. Progress has been made in a number of areas including the roll out of the essential package of health services for all, expansion of access to primary health care services (support by donors), and the piloting of health insurance which has been piloted in three subdistricts. Political commitment for these areas is strong. However, there are barriers pertaining to the larger policy level which includes a rigid public financing structure dating from the colonial era. While others pertain to the health sector’s implementation shortfalls including issues of human resources, political interference, monitoring, and supervision, most key informants discussed demand-side barriers too, such as sociocultural disinclination, historical mistrust, and lack of empowerment. To overcome these, several policies have been recommended, e.g., redesigning the public finance structure, improving governance and regulatory mechanism, specifying code of conduct for service providers, introducing health-financing reform, and collaborating with different sectors. To address the implementation barriers, recommendations include improving service quality, strengthening overall health systems, improving health service management, and improving monitoring and supervision. Addressing demand-side barriers, such as patient education and community empowerment, is also needed. Research and advocacy are required to address crosscutting barriers such as the lack of common understanding of UHC.

scholarly journals Towards universal health coverage: governance and organisational change in ministries of health

2019 ◽  
Vol 4 (5) ◽  
pp. e001735 ◽  
Author(s):  
Peter Berman ◽  
Azrina Azhar ◽  
Elizabeth J Osborn
Keyword(s):  
Health System ◽  
Universal Health Coverage ◽  
Organisational Change ◽  
Health Financing ◽  
Comparative Case Study ◽  
Health Coverage ◽  
Political Commitment ◽  
Middle Income ◽  
High Level ◽  
Universal Health

Countries have implemented a range of reforms in health financing and provision to advance towards universal health coverage (UHC). These reforms often change the role of a ministry of health (MOH) in traditionally unitary national health service systems. An exploratory comparative case study of four upper middle-income and high-income countries provides insights into how these reforms in pursuit of UHC are likely to affect health governance and the organisational functioning of an MOH accustomed to controlling the financing and delivery of healthcare. These reforms often do not result in simple transfers of responsibility from MOH to other actors in the health system. The resulting configuration of responsibilities and organisational changes within a health system is specific to the capacities within the health system and the sociopolitical context. Formal prescriptions that accompany reform proposals often do not fully represent what actually takes place. An MOH may retain considerable influence in financing and delivery even when reforms appear to formally shift those powers to other organisational units. MOHs have limited ability to independently achieve fundamental system restructuring in health systems that are strongly subject to public sector rules and policies. Our comparative study shows that within these constraints, MOHs can drive organisational change through four mechanisms: establishing a high-level interministerial team to provide political commitment and reduce institutional barriers; establishing an MOH ‘change team’ to lead implementation of organisational change; securing key components of systemic change through legislation; and leveraging emerging political change windows of opportunity for the introduction of health reforms.

scholarly journals Pooling arrangements in health financing systems: a proposed classification

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Inke Mathauer ◽  
Priyanka Saksena ◽  
Joe Kutzin
Keyword(s):  
Health Insurance ◽  
Universal Health Coverage ◽  
Grey Literature ◽  
Health Spending ◽  
Health Financing ◽  
Policy Instrument ◽  
Health Coverage ◽  
Voluntary Health Insurance ◽  
Financing Policies ◽  
Universal Health

Abstract Objectives The function of pooling and the ways that countries organize this is critical for countries’ progress towards universal health coverage, but its potential as a policy instrument has not received much attention. We provide a simple classification of country pooling arrangements and discuss the specific ways that fragmentation manifests in each and the typical challenges with respect to universal health coverage objectives associated. This can help countries assess their pooling setup and contribute to identifying policy options to address fragmentation or mitigate its consequences. Methods The paper is based on a review of published and grey literature in PubMed, Google and Google Scholar and our information gathered from our professional work in countries on health financing policies. We examined the nature and structure of pooling in more than 100 countries across all income groups to develop the classification. Findings We propose eight broad types of pooling arrangements: (1.) a single pool; (2.) territorially distinct pools; (3.) territorially overlapping pools in terms of service and population coverage; (4.) different pools for different socio-economic groups with population segmentation; (5.) different pools for different population groups, with explicit coverage for all; (6.) multiple competing pools with risk adjustment across the pools; and in combination with types (1.)-(6.), (7.) fragmented systems with voluntary health insurance, duplicating publicly financed coverage; and (8.) complementary or supplementary voluntary health insurance. However, we recognize that any classification is a simplification of reality and does not substitute for a country-specific analysis of pooling arrangements. Conclusion Pooling arrangements set the potential for redistributive health spending. The extent to which the potential redistributive and efficiency gains established by a particular pooling arrangement are realized in practice depends on its interaction and alignment with the other health financing functions of revenue raising and purchasing, including the links between pools and the service benefits and populations they cover.

Transforming Health Financing Systems in the Arab World Toward Universal Health Coverage

2021 ◽  
pp. 1-50
Author(s):  
Awad Mataria ◽  
Sameh El-Saharty ◽  
Mariam M. Hamza ◽  
Hoda K. Hassan
Keyword(s):  
Universal Health Coverage ◽  
Arab World ◽  
Health Financing ◽  
Health Coverage ◽  
Universal Health

scholarly journals Health financing lessons from Thailand for South Africa on the path towards universal health coverage

2016 ◽  
Vol 106 (6) ◽  
pp. 533 ◽  
Author(s):  
Mark Blecher ◽  
Anban Pillay ◽  
Walaiporn Patcharanarumol ◽  
Warisa Panichkriangkrai ◽  
Viroj Tangcharoensathien ◽  
...  
Keyword(s):  
South Africa ◽  
Universal Health Coverage ◽  
Health Financing ◽  
Health Coverage ◽  
Universal Health

scholarly journals Progress in the face of cuts: a qualitative Nigerian case study of maintaining progress towards universal health coverage after losing donor assistance

2021 ◽  
Author(s):  
Uche Shalom Obi ◽  
Osondu Ogbuoji ◽  
Wenhui Mao ◽  
Minahil Shahid ◽  
Obinna Onwujekwe ◽  
...  
Keyword(s):  
Health System ◽  
Universal Health Coverage ◽  
Health Financing ◽  
Health Coverage ◽  
Middle Income ◽  
Hiv Services ◽  
Country Ownership ◽  
Road Map ◽  
External Funds ◽  
Universal Health

Abstract In the coming years, about a dozen middle-income countries are excepted to transition out of development assistance for health (DAH) based on their economic growth. This anticipated loss of external funds at a time when there is a need for accelerated progress towards universal health coverage (UHC) is a source of concern. Evaluating country readiness for transition towards country ownership of health programmes is a crucial step in making progress towards UHC. We used in-depth interviews to explore: (1) the preparedness of the Nigerian health system to transition out of DAH, (2) transition policies and strategies that are in place in Nigeria, (3) the road map for the implementation of these policies and (4) challenges and recommendations for making progress on such policies. We applied Vogus and Graff’s expanded transition readiness framework within the Nigerian context to synthesize preparedness plans, gaps, challenges and stakeholders’ recommendations for sustaining the gains of donor-funded programmes and reaching UHC. Some steps have been taken to integrate and institutionalize service delivery processes toward sustainable immunization and responsive primary healthcare in line with UHC. There are ongoing discussions on integrating human immunodeficiency virus (HIV) services with other services and the possibility of covering HIV services under the National Health Insurance Scheme (NHIS). We identified more transition preparedness plans within immunization programme compared with HIV programme. However, we identified gaps in all the nine components of the framework that must be filled to be able to sustain gains and make significant progress towards country ownership and UHC. Nigeria needs to focus on building the overall health system by identifying systematic gaps instead of continuing to invest in parallel programmes. Programmes need to be consolidated within the overall health system, health financing priorities and policies. A comprehensive and functional structure will provide continuity even in the event of decreasing external funds or donor exits.

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