scholarly journals The Nature and Changing Aspects of Thailand’s Public Health Care Institutions: A Comparison before and after the Establishment of Thaksin’s Universal Health Coverage Scheme

2012 ◽  
Vol 22 (1) ◽  
pp. 177-205
Author(s):  
송경아
2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  

Abstract Oral health is a central element of general health with significant impact in terms of pain, suffering, impairment of function and reduced quality of life. Although most oral disease can be prevented by health promotion strategies and routine access to primary oral health care, the GBD study 2017 estimated that oral diseases affect over 3.5 billion people worldwide (Watt et al, 2019). Given the importance of oral health and its potential contribution to achieving universal health coverage (UHC), it has received increased attention in public health debates in recent years. However, little is known about the large variations across countries in terms of service delivery, coverage and financing of oral health. There is a lack of international comparison and understanding of who delivers oral health services, how much is devoted to oral health care and who funds the costs for which type of treatment (Eaton et al., 2019). Yet, these aspects are central for understanding the scope for improvement regarding financial protection against costs of dental care and equal access to services in each country. This workshop aims to present the comparative research on dental care coverage in Europe, North America and Australia led by the European Observatory on Health Systems and Policies. Three presentations will look at dental care coverage using different methods and approaches. They will compare how well the population is covered for dental care especially within Europe and North America considering the health systems design and expenditure level on dental care, using the WHO coverage cube as analytical framework. The first presentation shows results of a cross-country Health Systems in Transition (HiT) review on dental care. It provides a comparative review and analysis of financing, coverage and access in 31 European countries, describing the main trends also in the provision of dental care. The second presentation compares dental care coverage in eight jurisdictions (Australia (New South Wales), Canada (Alberta), England, France, Germany, Italy, Sweden, and the United States) with a particular focus on older adults. The third presentation uses a vignette approach to map the extent of coverage of dental services offered by statutory systems (social insurance, compulsory insurance, NHS) in selected countries in Europe and North America. This workshop provides the opportunity of a focussed discussion on coverage of dental care, which is often neglected in the discussion on access to health services and universal health coverage. The objectives of the workshop are to discuss the oral health systems in an international comparative setting and to draw lessons on best practices and coverage design. The World Conference on Public Health is hence a good opportunity for this workshop that contributes to frame the discussion on oral health systems in a global perspective. Key messages There is large degree of variation in the extent to which the costs of dental care are covered by the statutory systems worldwide with implications for oral health outcomes and financial protection. There is a need for a more systematic collection of oral health indicators to make analysis of reliable and comparable oral health data possible.


Author(s):  
Sarit K. Rout ◽  
Upasona Ghosh ◽  
Amrita Parhi ◽  
Sudhashree Chandrashekhar ◽  
Shridhar M. Kadam

Background: Odisha, a developing state of India, has introduced an innovative scheme known as Biju Swasthya Kalyan Yojana (BSKY), which aims at providing free health care to all the people. This paper examines the scope, key features, challenges and potentiality of BSKY to achieve universal health coverage (UHC) in Odisha.Methods: We reviewed policy documents and conducted qualitative interviews with key state government officials and other stakeholders to understand implement processes and constraints.Results: The scheme intends to provide free health care to all people in public health care institutions and additionally, 71 lakh poor households can avail health care services from the empanelled private hospitals with financial coverage up to 5 lakhs per family and women members up to 10 lakhs annually. This is implemented in assurance mode by merging state-run schemes- Rashtriya Swasthya Bima Yojana (RSBY), Biju Krushak Kalyan Yojana (BKKY) and Odisha State treatment fund (OSTF). The implementing agency is introducing several measures to control unnecessary health care utilisation and cost. Gate keeping mechanism and reserved packages by public hospital are major initiatives in this direction. Further, efforts to settle claims on time and IT related challenges are teething problems of the scheme. The findings further suggest that public expenditure on health stands at 1.3% of GSDP and inadequate human resources and health infrastructure are affecting service delivery.Conclusions: Achieving UHC with such a low public spending on health and different service delivery constraints looks ambitious. Odisha may learn from other countries to implement UHC phase wise.


2021 ◽  
Vol 5 (2) ◽  
pp. 84-100
Author(s):  
Marinah Syovinya Muteti

The County Governments in Kenya are faced with poor service delivery especially in the provision of maternal health care services. Maternal health care services in public hospitals are not meeting up to the quality standard as outlined by the Ministry of Health in Kenya. The paper sought to determine the influence of leadership and universal health coverage on public health maternal health care in Kitui County. This study was guided by Transformational Leadership Theory and Theory X & Y. The study focused on 11 public hospitals providing maternity services in Kitui County. The target population of the study was 203 health officers that include 26 doctors, 10 specialists, 41 clinical officers and 126 nurses across the 13 level 4 hospitals providing maternity services in Kitui County. Data was collected by use of structured closed ended questionnaire. Data analysis was conducted using SPSS Version 25.0 Software. Pearson Correlation showed that leadership and universal health coverage have a positive correlation with public health maternal health care service delivery. Model summary results indicated that leadership and universal health coverage explain 52.1 percent of public health maternal health care service delivery. Coefficient regression revealed that coefficient of leadership has appositive and significant influence (β=.203, p=.001<0.05) on and public health maternal health care service delivery. It was also found that coefficient of Universal Health Coverage and public health maternal health care service delivery have a positive and significant relationship (β=.662, p=.000<0.05). The study concludes that leadership is one of the key health systems factors affecting the performance of maternal health services at facility level. Conclusion can be made further that universal health coverage improves public health maternal health care service delivery. The study recommends for the need of maternal health care providers to review their leadership guidelines and styles with aim of enhancing quality of leadership in the management of hospitals. Though universal health coverage is on trial, the study recommends for the need to adequately support the implementation of universal health coverage.


2020 ◽  
Author(s):  
Yibeltal Assefa ◽  
Peter S Hill ◽  
Wim Van Damme ◽  
Judith Dean ◽  
Charles F Gilks

Abstract Background: The third Sustainable Development Goal (SDG-3) aims to ensure healthy lives and promote well-being for all at all ages. SDG-3 has a specific target on universal health coverage (UHC), which emphasizes the importance of all people and communities having access to quality health services without risking financial hardship. The objective of this study is to review progress towards UHC using antiretroviral treatment (ART) as a case study. Methods: We used a mixed-methods design including qualitative and quantitative approaches. We reviewed and synthesised the evidence on the evolution of the WHO HIV treatment guidelines between 2002 and 2019. We calculated ART coverage over time by gender, age group, and location. We also estimated ART coverage differences and ratios. Findings: ART guidelines have evolved from “treating the sickest” to “treating all”. ART coverage increased globally from under 7% in 2005 to 62% in 2018. There have been successes in increasing ART coverage in all populations and locations. However, progress varies by population and location in many regions. There is inequity in ART coverage: women (68%) versus men (55%), and adults (62%) versus children (54%). This inequity has widened over time, and with expanded ART eligibility criteria. On the other hand, data from at least one high-burden country (Ethiopia) shows that inequity among regions has narrowed over time due to the improvements in the primary health care systems and implementation of the public health approach in the country. Conclusion: ART coverage has increased at global, regional and national levels to all population groups. However, the gains have not been equitable among locations and populations. Policies towards universality may widen the inequity in resource-limited settings unless countries take precautions and “put the last first”. We argue that primary health care and public health approaches, with multi-sectoral actions and community engagement, are vital to minimize inequity, achieve UHC and leave no one behind.


2021 ◽  
Vol 7 (4) ◽  
pp. 166-171
Author(s):  
Sarah Mauren Michaela ◽  
Mieke Nurmalasari ◽  
Hosizah Hosizah

Every country needs to develop Universal Health Coverage (UHC) to promote optimal levels of public health. But in realizing UHC, there must be some problems, one of which is fraud. Based on the Corruption Eradication Commission (KPK) data, potential fraud is detected from 175,774 claims of Advanced Referral Health Facilities (FKRTL) or worth Rp. 440 billion until June 2015. This review article describes the incidence of fraud in health care facilities. Out of a total of 12,736 cases of fraud, readmission occupies the most cases of fraud, which is 4,827 cases or 37.9%.


2019 ◽  
Author(s):  
Yibeltal Assefa ◽  
Peter S Hill ◽  
Wim Van Damme ◽  
Judith Dean ◽  
Charles F Gilks

Abstract Background The third Sustainable Development Goal (SDG-3) aims to ensure healthy lives and promote well-being for all at all ages. SDG-3 has a specific target on universal health coverage (UHC), which emphasizes the importance of all people and communities having access to quality health services without risking financial hardship. The objective of this study is to review progress towards UHC using antiretroviral treatment (ART) as a case study.Methods We used a mixed-methods design including qualitative and quantitative approaches. We reviewed and synthesised the evidence on the evolution of the WHO HIV treatment guidelines between 2002 and 2019. We calculated ART coverage over time by gender, age group, and location. We also estimated ART coverage differences and ratios.Findings ART guidelines have evolved from “treating the sickest” to “treating all”. ART coverage increased globally from under 7% in 2005 to 62% in 2018. There have been successes in increasing ART coverage in all populations and locations. However, progress varies by population and location in many regions. There is inequity in ART coverage: women (68%) versus men (55%), and adults (62%) versus children (54%). This inequity has widened over time, and with expanded ART eligibility criteria. On the other hand, data from at least one high-burden country (Ethiopia) shows that inequity among regions has narrowed over time due to the improvements in the primary health care systems and implementation of the public health approach in the country.Conclusion ART coverage has increased at global, regional and national levels to all population groups. However, the gains have not been equitable among locations and populations. Policies towards universality may widen the inequity in resource-limited settings. We argue that primary health care and public health approaches, with multi-sectoral actions, are vital to minimize inequity and achieve UHC.


Author(s):  
Joia S. Mukherjee

This chapter explores the seminal topic of Universal Health Coverage (UHC), an objective within the Sustainable Development goals. It reviews the theory and definitions that shape the current conversation on UHC. The movement from selective primary health care to UHC demonstrates a global commitment to the progressive realization of the right to health. However, access to UHC is limited by barriers to care, inadequate provision of care, and poor-quality services. To deliver UHC, it is critical to align inputs in the health system with the burden of disease. Quality of care must also be improved. Steady, sufficient financing is needed to achieve the laudable goal of UHC.This chapter highlights some important steps taken by countries to expand access to quality health care. Finally, the chapter investigates the theory and practice behind a morbidity-based approach to strengthening health systems and achieving UHC.


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