Implementation of Universal Health Coverage Program in Kisumu County, Kenya: Importance of Social Marketing Strategies

Universal Health Coverage is where communities have access to all needed health services without financial hardship. In Kenya, Universal Health Coverage (UHC) program was launched in December 2018, through a presidential decree. This study aimed to understand population needs, acceptability, and perceptions about UHC implementation. The study was undertaken in four pilot counties of Kisumu, Machakos, Nyeri and Isiolo between February and March 2019, using exploratory qualitative data collection techniques. However, this paper focuses on the County of Kisumu which was selected due to its high prevalence of infectious diseases. Respondents included women of reproductive age, men, youth, and elderly persons. In-depth interviews were conducted among health care providers and managers. Scientific and ethical approval was obtained from the Kenya Medical Research Institute’s Scientific and Ethical Review Unit (SERU). Consenting to participate was individualized. Analysis was done thematically. Findings suggest that UHC was understood variously by different groupings. Sensitization about the UHC programme was done through electronic media, by CHVs, education sessions, political class and outreaches. Planning for the programme was done by holding meetings, trainings for community registration and developing budgets. However there was a lot os misunderstanding, confussion and misconcepts about the UHC concept as it was seen as a means to seek for votes by politicians. Barriers for successful implementation included critically understaffed facilities.

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Sustaining the National Health Insurance Scheme in Ghana: Perceptions and Experiences of Health Care Providers and Subscribers

International Journal of Social Science Research ◽

10.5296/ijssr.v6i1.11633 ◽

2017 ◽

Vol 6 (1) ◽

pp. 29

Author(s):

Amangbey Emmanuel ◽

Gandiibu A. Julius ◽

Gbaran Gbolo

Keyword(s):

Health Care ◽

Health Insurance ◽

Health Care Providers ◽

National Health Insurance ◽

Universal Health Coverage ◽

National Health Insurance Scheme ◽

Health Coverage ◽

Care Providers ◽

Insurance Scheme ◽

Universal Health

The establishment of the National Health Insurance Scheme was as a consequence of government effort at adopting a sustainable health care financing system with the aim of achieving universal health coverage. This study therefore explored the perceptions and experiences of health care providers and subscribers regarding the sustenance of the NHIS in Ghana. The study employed a mixed method design using survey questionnaires and in-depth face-to-face interviews. The study revealed that NHIS had contributed to the revenue base of service providers and increased healthcare utilisation at provider centres. The inability of health care providers to provide essential medicines and perceived poor quality of health care were identified as challenges to subscribers. The study concludes that the NHIS has the potential of ensuring universal health coverage provided stakeholders make deliberate efforts at addressing the obvious sustainable threats identified.

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Universal Health Coverage: A burning need for developing countries

Journal of Medical Research and Innovation ◽

10.15419/jmri.41 ◽

2017 ◽

Vol 1 (1) ◽

pp. 18-20 ◽

Cited By ~ 7

Author(s):

Sojib Bin Zaman ◽

Naznin Hossain

Keyword(s):

Health Care ◽

Developing Countries ◽

Health Care Providers ◽

Universal Health Coverage ◽

Good Governance ◽

Poor People ◽

Health Coverage ◽

Care Providers ◽

Financing System ◽

Universal Health

The term of universal health coverage (UHC) are getting popularity among the countries who have not yet attained it. Majority of the developing countries are planning to implement the UHC to protect the vulnerable citizen who cannot afford to buy the health services. Poor people living in developing countries, where there is no UHC, are bereft of getting equal health care. They have to bear a significant amount of health cost in buying different services which often causes catastrophic expenditures for an individual and a family. If a country can provide UHC, it will be possible to bring all the citizens under provision of equal and quality care. However, implementation of a UHC is not an easy phenomenon, rather it needs proper design of a good health insurance system by integrating both the public and private health care providers. The influence of good governance and a sustainable health financing system is fundamental to establish UHC in the developing countries.

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Factors associated with high Cesarean deliveries in China and Brazil - A Call for reducing elective surgeries in moving towards Universal Health Coverage

Journal of Hospital Administration ◽

10.5430/jha.v3n5p67 ◽

2014 ◽

Vol 3 (5) ◽

pp. 67 ◽

Cited By ~ 5

Author(s):

Xiaohui Hou ◽

Noor Sabah Rakhshani ◽

Roberto Iunes

Keyword(s):

Quality Of Care ◽

Health Care Providers ◽

Universal Health Coverage ◽

Financial Burden ◽

Labor Pain ◽

Health Coverage ◽

Care Providers ◽

Cesarean Deliveries ◽

Universal Health

Background: Annually 6.2 million unnecessary Cesarean Deliveries (CD) are performed globally. Such high unnecessary CD rate is a concern not only due to the additional financial burden it places on the health system but also because the quality of care could be compromised. There is an even more imperative need to reduce elective surgeries in moving towards the Universal Health Coverage (UHC), to ensure the ever stretched resources are effectively channeled for the best health outcomes. Methods: The paper uses a case study method. China and Brazil were selected primarily due to their alarmingly high number and percentage of the CD rate. Systematic literature review was conducted and the analyses were structured based on the framework “Determinants of High Cesarean Delivery Rates”, developed by the authors. Results: In China and Brazil, cultural belief, fear of labor pain and patient’s perception regarding quality of care may play a role in the patient’s preference for CD but these perceptions are shaped by their health care providers as well. The principal-agent relation comes into play as the health professionals can modify perceived needs of their patients. Availability of health insurance to mothers, physicians’ preference for convenient working hours, and payment incentives for performing higher yielding Cesarean procedures are driving the high CD rate phenomena in China and Brazil. Understand the social determinants of CD and using various instruments to change women’s perceptions of birthing options and physicians’ behaviors are critical in managing the CD rate. Conclusion: In the context of the rapid movement towards UHC, the evidence presented in this paper supports the call for implementing complementary policy interventions and regulation to ensure minimal efficiency loss due to resources being diverted to unnecessary procedures or hospital stays.

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Regulating for-profit private health care providers in the context of universal health coverage: a case study from Mongolia

10.14264/uql.2018.549 ◽

2018 ◽

Author(s):

Uranchimeg Tsevelvaachig

Keyword(s):

Health Care ◽

Health Care Providers ◽

Universal Health Coverage ◽

Health Coverage ◽

Private Health Care ◽

Care Providers ◽

For Profit ◽

Universal Health

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The role of community pharmacists in increasing access and use of self-care interventions for sexual and reproductive health in the Eastern Mediterranean Region: examples from Egypt, Jordan, Lebanon and Somalia

Health Research Policy and Systems ◽

10.1186/s12961-021-00695-0 ◽

2021 ◽

Vol 19 (S1) ◽

Author(s):

Luna El Bizri ◽

Laila Ghazi Jarrar ◽

Wael K. Ali Ali ◽

Abdifatah H. Omar

Keyword(s):

Health Care ◽

Health Care Providers ◽

Eastern Mediterranean ◽

Self Care ◽

Eastern Mediterranean Region ◽

Community Pharmacists ◽

Health Coverage ◽

Care Providers ◽

Universal Health

Abstract Background Self-care interventions offer a solution to support the achievement of three goals of the World Health Organization (WHO): to improve universal health coverage, reach people in humanitarian situations, and improve health and well-being. In light of implementing WHO consolidated guidelines on self-care interventions to strengthen sexual and reproductive health (SRH) in the Eastern Mediterranean Region (EMR), especially during the COVID-19 pandemic, pharmacists from four different EMR countries discussed the current SRH situation, inequality gaps, barriers to SRH service access and the pharmacist’s crucial role as a first-line responder to patients before, during and after COVID-19. Case presentation Self-care interventions for SRH allow health care providers to serve a greater number of patients, improve progress toward universal health coverage, and reach people in humanitarian crises. In fact, these interventions can be significantly enhanced by utilizing community pharmacists as first-line health care providers. This review highlights the important role of community pharmacists in promoting self-care interventions and empowering individuals, families and communities. As a result, well-informed individuals will be authoritative in their health decisions. Exploring self-care interventions in the EMR was done through reviewing selected SRH services delivery through community pharmacists before and during the COVID-19 pandemic in Egypt, Jordan, Lebanon and Somalia. Before the COVID-19 pandemic, community pharmacists were found to be excluded from both governmental and nongovernmental SRH programmes. During the pandemic, community pharmacists managed to support patients with self-care interventions, whether voluntarily or through their pharmacy associations. This highlights the need for the health care decision-makers to involve and support community pharmacists in influencing policies and promoting self-care interventions. Conclusion Self-care interventions can increase individuals’ choice and autonomy over SRH. Supporting community pharmacists will definitely strengthen SRH in the EMR and may help make the health system more efficient and more targeted.

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Impact of Health Insurance on Health Care Utilisation and Out-of-Pocket Health Expenditure in Vietnam

BioMed Research International ◽

10.1155/2020/9065287 ◽

2020 ◽

Vol 2020 ◽

pp. 1-16

Author(s):

Nguyen Thi Thu Thuong ◽

Tran Quang Huy ◽

Do Anh Tai ◽

Tran Nhuan Kien

Keyword(s):

Health Care ◽

Health Insurance ◽

Health Care Providers ◽

Health Care Utilisation ◽

Health Coverage ◽

Care Providers ◽

Care Utilisation ◽

The Mean ◽

Number Of Visits ◽

Universal Health

Background. In recent years, health insurance (HI) has been chosen by many low- and middle-income countries to obtain an important health policy target—universal health coverage. Vietnam has recently introduced the Revised Health Insurance Law, and the effects of the voluntary health insurance (VHI) and heavily subsidised health insurance (HSHI) programmes have not yet been analysed. Therefore, this study is aimed at examining the impact of these HI programmes on the utilisation of health care services and out-of-pocket health expenditure (OOP) in general and across different health care providers in particular. Methods. Using the two waves of Vietnam Household Living Standard Surveys 2014 and 2016 and the difference-in-difference method, the impacts of VHI and HSHI on health care utilisation and OOP in Vietnam were estimated. Results. For both the VHI and HSHI groups, we found that HI increased the probability of seeking outpatient care, the mean number of outpatient visits, the total number of visits, and the mean number of visits at the district level of health care providers in the last 12 months. However, there was no evidence that the HSHI programmes increased the mean number of inpatient visits and the number of visits at the provincial hospital. We also found that while the VHI programme reduced OOP for both outpatient and inpatient care, the HSHI scheme did not result in a reduction in OOP for hospitalisation, although HI lowered the total OOP. Similarly, we found that for both groups, HI reduced OOP when the insured visited district and provincial hospitals. However, the statistically significant impact was not demonstrated when the enrolees of HSHI programmes visited provincial hospitals. Conclusion. The study offers evidence that the Vietnamese HI scheme increased health care service utilisation and decreased OOP for the participants of the VHI and HSHI programmes. Therefore, the government should continue to consider improving the HI system as a strategy to achieve universal health coverage.

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Regulation of Private Health Care Providers in India: Current Status, Future Directions

Indian Journal of Public Administration ◽

10.1177/0019556118780093 ◽

2018 ◽

Vol 64 (4) ◽

pp. 587-598 ◽

Cited By ~ 1

Author(s):

Indira Chakravarthi

Keyword(s):

Health Care ◽

Health Care Providers ◽

Current Status ◽

Health Coverage ◽

Private Health Care ◽

Care Providers ◽

Future Directions ◽

Current Context ◽

Universal Health ◽

Regulatory Challenges

In the current context of more expansive role for private sector in health systems, especially in universal health coverage (UHC), its regulation has gained importance in health policy discourse. This article provides an overview of the existing regulatory mechanisms and their implementation in India, the enormity of the regulatory challenges raised by the nature of the private health care sector here and the available alternatives.

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PEMANFAATAN JAMINAN KESEHATAN DALAM PELAYANAN KESEHATAN IBU DI TUJUH KABUPATEN/KOTA DI INDONESIA

Jurnal Ekologi Kesehatan ◽

10.22435/jek.18.2.2160.111-121 ◽

2019 ◽

Vol 18 (2) ◽

pp. 111-121

Author(s):

Heny Lestary ◽

Sugiharti Sugiharti ◽

Suparmi Suparmi

Keyword(s):

Health Insurance ◽

Maternal Health ◽

Antenatal Care ◽

Universal Health Coverage ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Reproductive Age ◽

Health Coverage ◽

Delivery Services ◽

Universal Health

ABSTRACT Since 2014, Indonesia has been implementing universal health coverage to increase health insurance coverage. However, health insurance utilization by the community for maternal health is still low. This research aimed to determine factors related to the use of health insurance for antenatal care and delivery services among pregnant and childbirth women. The research conducted in 7 districts/cities, namely Kota Bandar Lampung, Kota Palembang, Kabupaten Lebak, Kabupaten Karawang, Kota Semarang, Kota Surabaya, dan Kota Makasar. A total of 517 respondents has been interviewed. The results showed that most respondents aged 21-34 years (68.5%), unemployed (74.7%) and graduated from high school or higher (58.4%). Around 11% of the respondent had health insurance. 73.0% of respondents who had health insurance used it for antenatal care and 88.3% used it for delivery. Multivariate analysis shows that the level of income is related to the use of health insurance for antenatal care and delivery, whereas mothers who have income level higher than Rp 2,000,000 had lower odds to utilize health insurance for antenatal care (OR=0,56; 95%CI:0,35 - 0,91) and delivery (OR=0,52; 95%CI:0,27 - 1,02). Therefore, there is a need for broader socialization of health insurance utilization for antenatal and delivery, especially for couples at reproductive age. Keywords: Health insurance, health services, maternal health ABSTRAK Pada tahun 2014, Indonesia mulai melaksanakan Universal Health Coverage untuk meningkatkan cakupan jaminan kesehatan. Namun, pemanfaatan jaminan kesehatan oleh masyarakat untuk kesehatan ibu masih rendah. Penelitian ini bertujuan untuk mengetahui faktor yang berhubungan dengan pemanfaatan jaminan kesehatan untuk pemeriksaan kehamilan dan pelayanan persalinan pada ibu hamil dan bersalin. Penelitian dilaksanakan di 7 (tujuh) kabupaten/kota, yaitu Kota Bandar Lampung, Kota Palembang, Kabupaten Lebak, Kabupaten Karawang, Kota Semarang, Kota Surabaya, dan Kota Makasar. Sebesar 517 responden yang berhasil diwawancarai. Hasil analisis menunjukkan bahwa sebagian besar responden berumur 21 – 34 tahun (68,5%), tidak bekerja (74,7%) dan berpendidikan tamat SMA+ (58,4%). Sekitar 11,0% responden tidak memiliki jaminan kesehatan. Dari responden yang memiliki jaminan kesehatan, hanya 73,0% di antaranya yang memanfaatkan untuk pemeriksaan kehamilan dan 88,3% memanfaatkan untuk persalinan. Analisis multivariat menunjukkan bahwa tingkat pendapatan berhubungan dengan pemanfaatan jaminan kesehatan untuk pemeriksaan kehamilan, dan persalinan, dimana ibu yang memiliki tingkat pendapatan ≥Rp 2.000.000,- memiliki kemungkinan lebih rendah untuk memanfaatkan jaminan kesehatan untuk pemeriksaan kehamilan (OR=0,56; 95%CI:0,35 - 0,91) maupun persalinan (OR=0,52; 95%CI:0,27 - 1,02). Oleh sebab itu, perlu sosialisasi lebih luas agar memanfaatkan jaminan kesehatan untuk pemeriksaan kehamilan dan persalinan, terutama pada Pasangan Usia Subur (PUS). Kata kunci: Jaminan kesehatan, pelayanan kesehatan, kesehatan ibu

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