scholarly journals The Legislative Role of Universal Health Coverage Achievement in Kolaka Regency

2020 ◽  
Vol 8 (T2) ◽  
pp. 41-46
Author(s):  
Rahmat Anzari ◽  
Sukri Palutturi ◽  
Aminuddin Syam
Keyword(s):  
Universal Health Coverage ◽  
Health Sector ◽  
Health Coverage ◽  
Data Validity ◽  
District Government ◽  
Document Review ◽  
Fully Functioning ◽  
Depth Interviews ◽  
Universal Health

BACKGROUND: The legislative role intended in accordance with the mandate of law number 17 of 2014 concerning the MPR, DPR, DPD, and DPRD in article 365 mentions three functions of the DPRD, namely, legislation, budgeting, and supervision. AIM: This study aimed to determine the legislative role in the achievement of Universal Health Coverage (UHC) in Kolaka Regency. METOHDS: This research method uses a qualitative with four informants selected by accidental sampling. Data obtained through in-depth interviews, observation, and document review. Data triangulation analysis is used to obtain data validity. RESULTS: The results showed that the role of the legislature in the legislative function had not been carried out properly because there were no regional regulations issued by the district government of Kolaka who supports the achievement of UHC and will only conduct academic studies related to JKN, the budgeting function has been carried out well because of Commission III of the District Parliament of Kolaka has provided full support regarding budgeting in the health sector and the oversight function is also well implemented. Parliamentary budget oversight in Kolaka is carried out 3 times a year/per quarter by the DPRD in collaboration with the inspectorate, BPK and APIP by comparing planning with reality on the ground. It was concluded that the legislative role in the achievement of UHC in Kolaka was not fully functioning properly. CONCLUSION: It is expected to immediately formulate and issue regional regulations that support the implementation of the JKN program as a manifestation of the achievement of UHC in Kolaka and involve academic experts in UHC/JKN in formulating the regional regulation.

scholarly journals Financing Healthcare in Central and Eastern European Countries: How Far Are We from Universal Health Coverage?

2021 ◽  
Vol 18 (4) ◽  
pp. 1382
Author(s):  
Marzena Tambor ◽  
Jacek Klich ◽  
Alicja Domagała
Keyword(s):  
Universal Health Coverage ◽  
European Countries ◽  
Eastern European ◽  
Health Coverage ◽  
Benefit Package ◽  
Significant Downward Trend ◽  
Out Of Pocket Payments ◽  
Eastern European Countries ◽  
Universal Health

After the fall of communism, the healthcare systems of Central and Eastern European countries underwent enormous transformation, resulting in departure from publicly financed healthcare. This had significant adverse effects on equity in healthcare, which are still evident. In this paper, we analyzed the role of government and households in financing healthcare in eight countries (EU-8): Czechia, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia, and Slovenia. A desk research method was applied to collect quantitative data on healthcare expenditures and qualitative data on gaps in universal health coverage. A linear regression analysis was used to analyze a trend in health expenditure over the years 2000–2018. Our results indicate that a high reliance on out-of-pocket payments persists in many EU-8 countries, and only a few countries have shown a significant downward trend over time. The gaps in universal coverage in the EU-8 countries are due to explicit rationing (a limited benefit package, patient cost sharing) and implicit mechanisms (wait times). There is need to increase the role of public financing in CEE countries through budget prioritization, reducing patient co-payments for medical products and medicines, and extending the benefit package for these goods, as well as improving the quality of care.

scholarly journals People’s Voice and Civil Society Participation as a Core Element of Universal Health Coverage Reforms: Review of Experiences in Iran

2021 ◽  
Author(s):  
Dheepa Rajan ◽  
Mohammad Hadi Ayazi ◽  
Maziar Moradi-Lakeh ◽  
Narges Rostamigooran ◽  
Maryam Rahbari ◽  
...  
Keyword(s):  
Civil Society ◽  
International Development ◽  
Universal Health Coverage ◽  
Health Sector ◽  
Civil Society Organizations ◽  
Health Coverage ◽  
Health Governance ◽  
Core Element ◽  
Governance Challenges ◽  
Universal Health

Health governance challenges can make or break universal health coverage (UHC) reforms. One of the biggest health governance challenges is ensuring meaningful participation and adequately reflecting people’s voice in health policies and implementation. Recognizing this, Iran’s Health Transformation Plan (HTP) lays out the country’s blueprint for UHC with an explicit emphasis on the ‘socialization of health.’ ‘Socialization’ is seen as a key means to contribute to HTP objectives, meaning the systematic and targeted engagement of the population, communities, and civil society in health sector activities. Given its specific cultural and historical context, we sought to discern what notions such as ‘civil society,’ ‘non-governmental organization,’ etc mean in practice in Iran, with the aim of offering policy options for strengthening and institutionalizing public participation in health within the context of the HTP. For this, we reviewed the literature and analysed primary qualitative data. We found that it may be more useful to understand Iranian civil society through its actions, ie, defined by its motivation and activities rather than the prevailing international development understanding of civil society as a structure which is completely independent of the state. We highlight the blurry boundaries between the different types of civil society organizations (CSOs) and government institutions and initiatives, as well as high levels of overlaps and fragmentation. Reducing fragmentation as a policy goal could help channel resources more efficiently towards common HTP objectives. The National Health Assembly (NHA) model which was first launched in 2017 offers a unique platform for this coordination role, and could be leveraged accordingly.

scholarly journals Nurses’ perceptions of universal health coverage and its implications for the Kenyan health sector

2016 ◽  
Vol 27 (1) ◽  
pp. 28-38 ◽  
Author(s):  
Adam D. Koon ◽  
Lahra Smith ◽  
David Ndetei ◽  
Victoria Mutiso ◽  
Emily Mendenhall
Keyword(s):  
Universal Health Coverage ◽  
Health Sector ◽  
Health Coverage ◽  
Nurses Perceptions ◽  
Universal Health

scholarly journals A Narrative Synthesis Review of Out-of-Pocket Payments for Health Services Under Insurance Regimes: A Policy Implementation Gap Hindering Universal Health Coverage in Sub-Saharan Africa

2021 ◽  
Author(s):  
Abigail Nyarko Codjoe Derkyi-Kwarteng ◽  
Irene Akua Agyepong ◽  
Nana Enyimayew ◽  
Lucy Gilson
Keyword(s):  
Policy Implementation ◽  
Universal Health Coverage ◽  
Health Sector ◽  
Sub Saharan Africa ◽  
Narrative Synthesis ◽  
Health Coverage ◽  
Implementation Gap ◽  
Street Level ◽  
Sub Saharan ◽  
Universal Health

Background: "Achieve universal health coverage (UHC), including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines for all" is the Sustainable Development Goal (SDG) 3.8 target. Although most high-income countries have achieved or are very close to this target, low- and middle-income countries (LMICs) especially those in sub-Saharan Africa (SSA) are still struggling with its achievement. One of the observed challenges in SSA is that even where services are supposed to be "free" at point-of-use because they are covered by a health insurance scheme, out-of-pocket fees are sometimes being made by clients. This represents a policy implementation gap. This study sought to synthesise the known evidence from the published literature on the ‘what’ and ‘why’ of this policy implementation gap in SSA. Methods: The study drew on Lipsky’s street level bureaucracy (SLB) theory, the concept of practical norms, and Taryn Vian’s framework of corruption in the health sector to explore this policy implementation gap through a narrative synthesis review. The data from selected literature were extracted and synthesized iteratively using a thematic content analysis approach. Results: Insured clients paid out-of-pocket for a wide range of services covered by insurance policies. They made formal and informal cash and in-kind payments. The reasons for the payments were complex and multifactorial, potentially explained in many but not all instances, by coping strategies of street level bureaucrats to conflicting health sector policy objectives and resource constraints. In other instances, these payments appeared to be related to structural violence and the ‘corruption complex’ governed by practical norms. Conclusion: A continued top-down approach to health financing reforms and UHC policy is likely to face implementation gaps. It is important to explore bottom-up approaches – recognizing issues related to coping behaviour and practical norms in the face of unrealistic, conflicting policy dictates.

scholarly journals Local experience of using traditional medicine in northern Rwanda: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mengxin Tan ◽  
Yuko Otake ◽  
Teisi Tamming ◽  
Valerie Akuredusenge ◽  
Beatha Uwinama ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health Services ◽  
Traditional Medicine ◽  
Universal Health Coverage ◽  
Low Income ◽  
Traditional Healers ◽  
Health Coverage ◽  
Community Members ◽  
Depth Interviews ◽  
Universal Health

Abstract Background The popular use of traditional medicine in low-income settings has previously been attributed to poverty, lack of education, and insufficient accessibility to conventional health service. However, in many countries, including in Rwanda, the use of traditional medicine is still popular despite the good accessibility and availability of conventional health services. This study aims to explore why traditional medicine is popularly used in Rwanda where it has achieved universal health coverage. Methods The qualitative study, which included in-depth interviews and participant observations, investigated the experience of using traditional medicine as well as the perceived needs and reasons for its use in the Musanze district of northern Rwanda. We recruited 21 participants (15 community members and 6 traditional healers) for in-depth interviews. Thematic analysis was conducted to generate common themes and coding schemes. Results Our findings suggest that the characteristics of traditional medicine are responding to community members’ health, social and financial needs which are insufficiently met by the current conventional health services. Participants used traditional medicine particularly to deal with culture-specific illness – uburozi. To treat uburozi appropriately, referrals from hospitals to traditional healers took place spontaneously. Conclusions In Rwanda, conventional health services universally cover diseases that are diagnosed by the standard of conventional medicine. However, this universal health coverage may not sufficiently respond patients’ social and financial needs arising from the health needs. Given this, integrating traditional medicine into national health systems, with adequate regulatory framework for quality control, would be beneficial to meet patients’ needs.

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