Tanzania Health Financing Policy Notes

Equity is one of the basic principles of health systems and features explicitly in the Nigerian health financing policy. Despiteacclaimed commitment to the implementation of this policy through various pro-poor health programmes and interventions,the level of inequity in health status and access to basic health care interventions remain high. This paper examines theequity of health care expenditure by individuals in Nigeria. The paper evaluated equity in out-of-pocket spending (OOP) forthe country and separately for the six geopolitical zones of the country. The methodological framework rests on KakwaniProgressivity Indices (KPIs), Reynold-Smolensky indices and concentration indices (CIs) using data from the 2004 Nigerian National Living Standard Survey (NLSS) collected by the National Bureau of Statistic. The results reveal that health financing is regressive with the incidence disproportionately resting on poor households with about 70% of the total expenditure on health being financed through out-of-pocket payments by households. Poor households are prone to bear most of the expenses in the event of any health shock. The catastrophic consequences thus push some into poverty, and aggravate the poverty of others. The paper therefore suggests that the country’s health financing systems must be such that allows people to access services when they are needed, but must also protect household, from financial catastrophe, by reducing OOP spending through risk pooling and prepayment schemes within the health system.

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Financial Protection Against Medical Expense

Oxford Research Encyclopedia of Economics and Finance ◽

10.1093/acrefore/9780190625979.013.27 ◽

2019 ◽

Cited By ~ 2

Author(s):

Owen O'Donnell

Keyword(s):

Risk Premium ◽

Health Financing ◽

Financial Protection ◽

Medical Expense ◽

Financing Policy ◽

Medical Expenses ◽

Catastrophic Payments ◽

The Cost ◽

The Impact ◽

Important Objective

Financial protection is claimed to be an important objective of health policy. Yet there is a lack of clarity about what it is and no consensus on how to measure it. This impedes the design of efficient and equitable health financing. Arguably, the objective of financial protection is to shield nonmedical consumption from the cost of healthcare. The instruments are formal health insurance and public finances, as well as informal and self-insurance mechanisms that do not impair earnings potential. There are four main approaches to the measurement of financial protection: the extent of consumption smoothing over health shocks, the risk premium (willingness to pay in excess of a fair premium) to cover uninsured medical expenses, catastrophic healthcare payments, and impoverishing healthcare payments. The first of these does not restrict attention to medical expenses, which limits its relevance to health financing policy. The second rests on assumptions about risk preferences. No measure treats medical expenses that are financed through informal insurance and self-insurance instruments in an entirely satisfactory way. By ignoring these sources of imperfect insurance, the catastrophic payments measure overstates the impact of out-of-pocket medical expenses on living standards, while the impoverishment measure does not credibly identify poverty caused by them. It is better thought of as a correction to the measurement of poverty.

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Study on the Factors Influencing Total Health Cost Based on Multiple Regression Model

Modern Economics & Management Forum ◽

10.32629/memf.v2i6.596 ◽

2021 ◽

Vol 2 (6) ◽

Author(s):

Xiaoduo Zu ◽

Jun Fang

Keyword(s):

Regression Model ◽

Structural Adjustment ◽

Social Economy ◽

Health Financing ◽

Multiple Regression Model ◽

Institutional Transformation ◽

Medical Expenditure ◽

Coordinated Development ◽

Financing Policy ◽

Using Data

In recent years, China's social economy and income level of residents have increased rapidly, the total cost of health has increased rapidly, and the level of medical expenditure of residents has been increasing. This paper establishes a multivariate linear regression model using data from 1996 to 2020, and analyzes several important influencing factors that affect overall health expenditure. The aim is to formulate a health financing policy suitable for the coordinated development of China's social economy, and to provide a basis for adapting to the needs of economic development, structural adjustment and institutional transformation.

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Analysis of Health Sector Budget of Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.2757 ◽

1970 ◽

Vol 52 (194) ◽

pp. 811-821 ◽

Cited By ~ 1

Author(s):

Ram Krishna Dulal ◽

Angel Magar ◽

Shreejana Dulal Karki ◽

Dipendra Khatiwada ◽

Pawan Kumar Hamal

Keyword(s):

Public Health ◽

Health Care ◽

Fiscal Federalism ◽

Health Care Services ◽

Central Government ◽

Health Sector ◽

Health Financing ◽

Political Commitment ◽

Financing Policy ◽

Health Budget

Introduction: Primarily, health sector connects two segments - medicine and public health, where medicine deals with individual patients and public health with the population health. Budget enables both the disciplines to function effectively. The Interim Constitution of Nepal, 2007 has adapted the inspiration of federalism and declared the provision of basic health care services free of cost as a fundamental right, which needs strengthening under foreseen federalism. Methods: An observational retrospective cohort study, aiming at examining the health sector budget allocation and outcome, was done. Authors gathered health budget figures (2001 to 2013) and facts published from authentic sources. Googling was done for further information. The keywords for search used were: fiscal federalism, health care, public health, health budget, health financing, external development partner, bilateral and multilateral partners and healthcare accessibility. The search was limited to English and Nepali-language report, articles and news published. Results: Budget required to meet the population's need is still limited in Nepal. The health sector budget could not achieve even gainful results due to mismatch in policy and policy implementation despite of political commitment. Conclusions: Since Nepal is transforming towards federalism, an increased complexity under federated system is foreseeable, particularly in the face of changed political scenario and its players. It should have clear goals, financing policy and strict implementation plans for budget execution, task performance and achieving results as per planning. Additionally, collection of revenue, risk pooling and purchasing of services should be better integrated between central government and federated states to horn effectiveness and efficiency. Keywords: health care; budget; financing; unitary system; federalism.

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How to do (or not to do) … Assessing the impact of a policy change with routine longitudinal data

Health Policy and Planning ◽

10.1093/heapol/czr004 ◽

2011 ◽

Vol 27 (1) ◽

pp. 76-83 ◽

Cited By ~ 140

Author(s):

Mylene Lagarde

Keyword(s):

Longitudinal Data ◽

Health Financing ◽

Data Series ◽

Simple Method ◽

Financing Policy ◽

Middle Income ◽

Middle Income Countries ◽

Before And After ◽

Quasi Experimental ◽

The Impact

Abstract A lack of good quality evidence on the effect of alternative social policies in low- and middle-income countries has been recently underlined and the value of randomized trials increasingly advocated. However, it is also acknowledged that randomization is not always feasible or politically acceptable. Analyses using longitudinal data series before and after an intervention can also deliver robust results and such data are often reasonably easy to access. Using the example of evaluating the impact on utilization of a change in health financing policy, this article explains how studies in the literature have often failed to address the possible biases that can arise in a simple analysis of routine longitudinal data. It then describes two possible statistical approaches to estimate impact in a more reliable manner and illustrates in detail the more simple method. Advantages and limitations of this quasi-experimental approach to evaluating the impact of health policies are discussed.

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Health Financing Functions in Community Based Health Insurance Schemes and Health Equity in Kenya

Global Journal of Health Science ◽

10.5539/gjhs.v10n1p147 ◽

2017 ◽

Vol 10 (1) ◽

pp. 147

Author(s):

Jane Gitahi ◽

Timothy C Okech

Keyword(s):

Health Equity ◽

Health Financing ◽

Multivariate Regression Analysis ◽

Healthcare Services ◽

Community Based ◽

Financing Policy ◽

Quality Healthcare ◽

Strategic Purchasing ◽

Research Designs ◽

The Government

The aim of this study was to establish how the healthcare financing functions are modeled within CBHIs and how they have impacted on realization of health equity with government stewardship being treated as the moderating factor. The study adopted descriptive and explanatory research designs to collect data from four members each management team of all registered CBHIs in Kenya. Descriptive statistics, factor analysis, path analysis and multivariate regression analysis in terms of structural modeling equation (SEM) were conducted to determine the hypothesized relationships between the health financing functions and their impact on health equity in Kenya. The study shows that enrolment and strategic purchasing in CBHIs accounted for variation in health equity in terms of increasing access to quality healthcare services. With the introduction of government stewardship as the moderating factor, the variation of health equity accounted for by enrolment and strategic purchasing increased. It was therefore inferred that the government should define the place of CBHIs within the context of the national health financing policy for realization of health equity by instituting the necessary legal and regulatory framework.

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