Catastrophic health expenditure and universal health coverage: Analysis in the National Health System of Paraguay

Tujuan penelitian ini untuk mengetahui urgensi dan relevansi kebijakan Pemerintah dalam memperbaiki ekosistem penyelenggaraan kesehatan masyarakat dengan penguatan JKN sebagai skema asuransi kesehatan sosial yang bersifat wajib sebagai akibat adanya kesejangan antara iuran dengan manfaat yang komprehensif di masa wabah pandemi global Covid-19. Hasil penelitian menunjukkan bahwa: 1) kebijakan skema Jaminan Kesehatan Semesta (Universal Health Coverage, UHC) dalam SJSN-KIS mempunyai urgensi sebagai pemenuhan penyelenggaraan jaminan kesehatan yang terjangkau oleh seluruh lapisan masyarakat secara adil dan merata sesuai amanat konstitusi; 2) Skema sistem Jaminan Kesehatan Semesta (Universal Health Coverage, UHC) Sistem UHC telah dimodifikasi oleh Pemerintah untuk diselaraskan dengan kondisi dan tujuan penyelenggaraaan kesehatan nasional yang profesional, efisien dan efektif, dan menjangkai seluruh lapisan masyarakat;3) Skema Jaminan Kesehatan Semesta (Universal Health Coverage, UHC) yang terintegrasi antara Sistem Jaminan Sosial Nasional (SJSN) dan Sistem Kesehatan Nasional (SKN) sangat relevan bagi penyelenggaraan kesehatan masyarakat berdasarkan kerjasama, solidaritas dan empati semua warga di masa pandemi global Covid-19. Kata kunci: Universal Health Coverage, penyelenggaraan kesehatan masyarakatAbstract The purpose of this study is to study the urgency and relevance of Government policies in improving the public health ecosystem by strengthening JKN as a health insurance needed to improve the compatibility between contributions and useful benefits in the future of the global pandemic outbreak Covid-19. The results of the study show that: 1) the policy on universal health insurance requirements (Universal Health Coverage, UHC) in the SJSN-KIS has urgency as fulfilling the implementation of health insurance that is affordable to the whole community and in accordance with the mandate of the constitution; 2) Scheme of the Universal Health Insurance System (Universal Health Coverage, UHC) The UHC system is supported by the Government to be aligned with the requirements and objectives of national health care that are professional, efficient and effective, and reaches all communities; 3) The Universal Health Coverage Scheme (Universal Health Coverage, UHC) which is integrated between the National Social Security System (SJSN) and the National Health System (SKN) is very relevant for the implementation of public health through cooperation, solidarity, and empathy for all citizens in the global pandemic -19. Keywords: universal health coverage, public health administration

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Universal Health Coverage Development in Thailand: How Global Ideas and a National Medical Professional Movement Made a Difference

10.21203/rs.3.rs-674771/v1 ◽

2021 ◽

Author(s):

Rangsan Sukhampha

Keyword(s):

Developing Countries ◽

Global Health ◽

Health System ◽

National Health ◽

Universal Health Coverage ◽

Medical Professional ◽

System Reform ◽

Health Coverage ◽

Health System Reform ◽

Universal Health

Abstract Background: Universal health coverage is endorsed as the global development agenda in the 2015 SDGs for global achievement by 2030 and is expected to build national policymaking agendas. Common research often focuses on national processes in the first place. For example, accounts of Thailand's health system development mostly emphasise domestic factors and influences rather than the linkage of external/global health ideas. The paper questions how external/global health ideas influence national health policymaking and the linkage between them in achieving Thailand's universal health coverage policy.Methods: A qualitative method was employed to capture complex and historical narratives of the national medical professional movement for Thailand's health system reform through the lens of a global social policy approach for exploring external and global health ideas transfer. Moreover, the actor- and policy entrepreneur approaches would be employed to investigate national health policymaking and examine how ideas from the external and global levels have improved national equity in health. Results: The research locates the narratives on global ideas and practices that influence a national health system reform. This highlights the impact/role of global ideas on national professional movements, i.e. the rural doctor movement in Thailand mobilising the health system reform for all. The study found that national equity in health could not be achieved without external/global health ideas transfer. Such a case of national universal health coverage achievement in Thailand happened with the effort of the rural doctor movement and individual agency as policy entrepreneurs in translating external/global ideas and practices for their movement and mobilisation. The case contributed to a better understanding of the global process regarding ideas and practices that can be transferred directly and indirectly to the national level. Conclusions: Global ideas transfer can also happen in different aspects such as it can be seen the ideas transfer from developed to developed countries; from developed to developing countries. Besides, the author witnessed that the IOs ideas can also be transferred to developing countries or reverse, and again, between developing countries themselves.

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Title of Manuscript: Health System Performance Towards Universal Health Coverage in Iran: A Comparative Panel Data Analysis

10.21203/rs.2.23048/v1 ◽

2020 ◽

Author(s):

Haniye Sadat Sajadi ◽

Zahra Goudarzi ◽

Amirhossein Takian ◽

Efat Mohamadi ◽

Alireza Olyaeemanesh ◽

...

Keyword(s):

Panel Data ◽

Health System ◽

Universal Health Coverage ◽

Health Expenditure ◽

Malmquist Productivity Index ◽

Productivity Index ◽

Health Coverage ◽

System Efficiency ◽

Per Capita ◽

Universal Health

Abstract Background Building upon decades of continuous reforms, since 2014 under the banner of health transformation plan (HTP), Iran has been implementing various initiatives to strengthen its health system. Improving efficiency of the health system is fundamental to achieve better performance and reach universal health coverage (UHC). This article aimed to measure the efficiency and productivity changes in the Iranian health system during 2010-2015 in comparison with 36 selected other upper-middle income countries. Methods We used panel data to measure the variations in technical efficiency (TE) and total factor productivity (TFP) through an extended data envelopment analysis (EDEA) and Malmquist productivity index, respectively. General Government Health Expenditure (GGHE) per capita (International dollar) was selected as input variable. Service coverage of diphtheria, tetanus and pertussis; family planning; antiretroviral therapy; skilled attendants at birth; Tuberculosis treatment success rate; and GGHE as % of Total Health Expenditure (THE) were considered as output variables. The data for each indicator were taken from Global Health Observatory data repository and World Development Indicator database, for a period of six years (2010-2015). Results The TE scores of Iran’s health system were 0.75, 0.77, 0.74, 0.74, 0.97 and 0.84 in the period 2010-2015, respectively. TFP improved in 2011 (1.02), 2013 (1.01), and 2014 (1.30, generally). The overall efficiency and TFP increased in 2014. Changes made in CCHE per capita and GGHE/THE attributed to the increase of efficiency. ConclusionThere is a growing demand for efficiency improvements in the health systems to achieve UHC. While there are no defined set of indicators or precise methods to measure heath system efficiency, EDEA helped us to draw the picture of health system efficiency in Iran. Our findings also highlighted the essential need for targeted and sustained interventions, i.e. allocation of enough proportion of public funds to the health sector, to improve universal financial coverage against health costs aiming to enhance the future performance of Iran’s health system, ultimately. Such tailored interventions may be also useful for settings with similar context to speed up their movement towards improving efficiency, which in turn might lead to more resources to reach UHC.

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A review of the incidence and determinants of catastrophic health expenditure in Nigeria: Implications for universal health coverage

The International Journal of Health Planning and Management ◽

10.1002/hpm.2847 ◽

2019 ◽

Vol 34 (4) ◽

Cited By ~ 1

Author(s):

Ijeoma Nkem Okedo‐Alex ◽

Ifeyinwa Chizoba Akamike ◽

Obumneme Benaiah Ezeanosike ◽

Chigozie Jesse Uneke

Keyword(s):

Universal Health Coverage ◽

Health Expenditure ◽

Catastrophic Health Expenditure ◽

Health Coverage ◽

Universal Health

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Assessing the Efficiency of Iran Health System in Making Progress Towards Universal Health Coverage: A Comparative Panel Data Analysis

10.21203/rs.2.23048/v2 ◽

2020 ◽

Author(s):

Haniye Sadat Sajadi ◽

Zahra Goodarzi ◽

Amirhossein Takian ◽

Efat Mohamadi ◽

Alireza Olyaeemanesh ◽

...

Keyword(s):

Panel Data ◽

Health System ◽

Universal Health Coverage ◽

Health Expenditure ◽

Malmquist Productivity Index ◽

Health Coverage ◽

System Efficiency ◽

Per Capita ◽

Health System Efficiency ◽

Universal Health

Abstract Background: Building upon decades of continuous reforms, Iran has been implementing various initiatives to reach universal health coverage (UHC). Improving efficiency is a crucial intermediate policy objective for UHC. Therefore, this article aimed to measure the efficiency and productivity changes of the Iranian health system in making progress towards UHC during 2010-2015 in comparison with 36 selected other upper-middle-income countries.Methods: We used panel data to measure the variations in technical efficiency (TE) and total factor productivity (TFP) through an extended data envelopment analysis (EDEA) and Malmquist productivity index, respectively. General Government Health Expenditure (GGHE) per capita (International dollar) was selected as the input variable. Service coverage of diphtheria, tetanus and pertussis; family planning; antiretroviral therapy; skilled attendants at birth; Tuberculosis treatment success rate; and GGHE as % of Total Health Expenditure (THE) were considered as output variables. The data for each indicator were taken from the Global Health Observatory data repository and World Development Indicator database, for six years (2010-2015). Results: The TE scores of Iran’s health system were 0.75, 0.77, 0.74, 0.74, 0.97, and 0.84 in the period 2010-2015, respectively. TFP improved in 2011 (1.02), 2013 (1.01), and 2014 (1.30, generally). The overall efficiency and TFP increased in 2014. Changes made in CCHE per capita and GGHE/THE attributed to the increase of efficiency. Conclusion: There is a growing demand for efficiency improvements in the health systems to achieve UHC. While there are no defined set of indicators or precise methods to measure health system efficiency, EDEA helped us to draw the picture of health system efficiency in Iran. Our findings highlighted the essential need for targeted and sustained interventions, i.e., allocation of enough proportion of public funds to the health sector, to improve universal financial coverage against health costs aiming to enhance the future performance of Iran’s health system, ultimately. Such tailored interventions may also be useful for settings with similar context to speed up their movement towards improving efficiency, which in turn might lead to more resources to reach UHC. Trial registration: NA

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Achieving SDG 3.8.2: Financial Protection Against Catastrophic Health Expenditure in Malaysia

10.21203/rs.3.rs-54824/v1 ◽

2020 ◽

Author(s):

Surianti Sukeri ◽

Muaz Sayuti

Keyword(s):

At Risk ◽

Universal Health Coverage ◽

Health Expenditure ◽

Health Spending ◽

Safety Net ◽

Catastrophic Health Expenditure ◽

P Value ◽

Financial Protection ◽

Health Coverage ◽

Universal Health

Abstract Background: The Sustainable Development Goal (SDG) 3.8.2 is one of the two indicators to monitor a country's progress towards universal health coverage. It concerns the financial protection against catastrophic spending on health based on the budget share approach. The purpose of this study is twofold: 1) to measure SDG 3.8.2 on the proportion of households with catastrophic health expenditure (CHE), and 2) to determine households at risk of CHEMethods: A cross-sectional study was conducted using secondary data from the 2015/2016 Household Expenditure Survey. The inclusion criterion was Malaysian households with some health spending in the past 12 months before the date of the survey. The World Health Organization method of calculating CHE was applied in the calculation, and a threshold of 10% out-of-pocket health spending from total household expenditures was used to determine CHE. Data were analysed descriptively, and multiple logistic regression was used to determine factors associated with CHE.Results: A total of 13015 households were involved in the study. The proportion of CHE was 2.8%. Four associated factors that were statistically significant were female-headed household (Adjusted OR 1.6; CI 1.25, 2.03; p-value <0.001), household that lived in rural area (Adjusted OR 1.29; 95% CI 1.04, 1.61; p-value =0.022), small household size (Adjusted OR 2.4; 95% CI 1.81, 3.18; p-value <0.001) and head of household aged below 60 years old (Adjusted OR2.34; 95% CI 1.81, 3.18; p-value <0.001).Conclusions: The low proportion of CHE revealed that Malaysia is on the right track towards achieving SDG 3.8 on universal health coverage status by 2030. However there is an increasing trend in the proportion of CHE. Households at risk of CHE require financial protection to afford healthcare and safety net measures to prevent from spiralling further into the vicious cycle of illness and poverty.

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