scholarly journals Methods for assessing the need for health financing: international experience (analytical review)

2021 ◽  
Vol 65 (3) ◽  
pp. 261-268
Author(s):  
Elena G. Potapchik
Keyword(s):  
Health System ◽  
Health Spending ◽  
Demographic Factors ◽  
Health Financing ◽  
Developed Countries ◽  
International Experience ◽  
World Health ◽  
Free Text ◽  
Spending Growth ◽  
The Government

There has been an active discussion on estimating the need for public funding of the domestic health system. An analysis of international experience can be helpful to determine methodological approaches to estimate the market for government spending on the Russian health system. Aim. To systemize and summarize approaches and methods used in international practice to estimate the need for health financing; to highlight the most important factors dictating the need for additional funding. Material and methods. A systematic search with the developed protocol for publications, a comprehensive analysis and systematization of the obtained information. The protocol included databases of peer-reviewed publications, search terms, and search restrictions. The search for publications was carried out in the databases of Embase, Pubmed, Medline, Global Health, etc., on the websites of international organizations (World Health Organization (WHO), Organization for Economic Cooperation and Development (OECD), etc.). The search strategy included a combination of the terms “free text” and “Medical subject heading”, which refer to the definition of the need for health financing. The main limitations of the search were the language of publications (English and Russian) and the date of publication (not earlier than 2000). Results. Of the two used in international practice approaches to estimate the need for health financing, a system based on the use of the current level of funding and its forecasting under several factors is used in developed countries. Forecasting health expenditures is one of the most effective tools to identify critical factors affecting needs for sector financing. Despite the variety of indicators and methods used, most studies agree that non-demographic factors, such as GDP growth and technology development, influence health spending growth to the greatest extent. Demographic factors per se, including population ageing, affect health spending growth to a lesser extent. Conclusion. Conducting scenario forecasts contributes to a better understanding of what can happen in the future if the government does not act. This also contributes to a more clear determining of the main spheres for government interventions in the health sector.

scholarly journals Strategies for reducing out of pocket payments in the health system: a scoping review

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Faride Sadat Jalali ◽  
Parisa Bikineh ◽  
Sajad Delavari
Keyword(s):  
Health System ◽  
Health Systems ◽  
Scoping Review ◽  
Health Financing ◽  
Developed Countries ◽  
Vulnerable Groups ◽  
System A ◽  
Out Of Pocket Payments ◽  
Review Study ◽  
Developing And Developed Countries

Abstract Background Direct out-of-pocket payments (OOP) are among the most important financing mechanisms in many health systems, especially in developing countries, adversely affecting equality and leading vulnerable groups to poverty. Therefore, this scoping review study was conducted to identify the strategies involving OOP reduction in health systems. Methods Articles published in English on strategies related to out-of-pocket payments were Searched and retrieved in the Web of Science, Scopus, PubMed, and Embase databases between January 2000 and November 2020, following PRISMA guidelines. As a result, 3710 papers were retrieved initially, and 40 were selected for full-text assessment. Results Out of 40 papers included, 22 (55%) and 18 (45%) of the study were conducted in developing and developed countries, respectively. The strategies were divided into four categories based on health system functions: health system stewardship, creating resources, health financing mechanisms, and delivering health services.As well, developing and developed countries applied different types of strategies to reduce OOP. Conclusion The present review identified some strategies that affect the OOP payments According to the health system functions framework. Considering the importance of stewardship, creating resources, the health financing mechanisms, and delivering health services in reducing OOP, this study could help policymakers make better decisions for reducing OOP expenditures.

scholarly journals Health system gaps in cardiovascular disease prevention and management in Nepal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Archana Shrestha ◽  
Rashmi Maharjan ◽  
Biraj Man Karmacharya ◽  
Swornim Bajracharya ◽  
Niharika Jha ◽  
...  
Keyword(s):  
Human Resources ◽  
Health System ◽  
Health Systems ◽  
National Health ◽  
Task Force ◽  
Health Spending ◽  
Building Blocks ◽  
Critical System ◽  
Government Organizations ◽  
The Government

Abstract Background Cardiovascular diseases (CVDs) are the leading cause of deaths and disability in Nepal. Health systems can improve CVD health outcomes even in resource-limited settings by directing efforts to meet critical system gaps. This study aimed to identify Nepal’s health systems gaps to prevent and manage CVDs. Methods We formed a task force composed of the government and non-government representatives and assessed health system performance across six building blocks: governance, service delivery, human resources, medical products, information system, and financing in terms of equity, access, coverage, efficiency, quality, safety and sustainability. We reviewed 125 national health policies, plans, strategies, guidelines, reports and websites and conducted 52 key informant interviews. We grouped notes from desk review and transcripts’ codes into equity, access, coverage, efficiency, quality, safety and sustainability of the health system. Results National health insurance covers less than 10% of the population; and more than 50% of the health spending is out of pocket. The efficiency of CVDs prevention and management programs in Nepal is affected by the shortage of human resources, weak monitoring and supervision, and inadequate engagement of stakeholders. There are policies and strategies in place to ensure quality of care, however their implementation and supervision is weak. The total budget on health has been increasing over the past five years. However, the funding on CVDs is negligible. Conclusion Governments at the federal, provincial and local levels should prioritize CVDs care and partner with non-government organizations to improve preventive and curative CVDs services.

“Air pollution arrested not imprisoned”: The impact of laws invoked on Covid-19 city lockdowns

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Emmanuel Mensah Aboagye ◽  
◽  
Nana Osei Owusu ◽  
Keyword(s):  
Air Pollution ◽  
Environmental Problem ◽  
World Health Organisation ◽  
Developed Countries ◽  
World Health ◽  
Economic Activities ◽  
Global Pandemic ◽  
Depth Study ◽  
The Government ◽  
The Impact

Air pollution continues to be an environmental problem that poses a lot of health risks to the young and aged. Developed countries have invested heavily to curb this environmental problem, causing severe threats to human lives, yet the results do not look convincing. In developing countries, the situation is difficult than they can imagine, resulting in governments borrowing to fight what looks like a lost battle [1-3]. The in-depth study of this environmental menace - air pollution, suggests that the government enacts stringent measures to help fight this battle. This is because air pollution has natural (volcanic eruption) and anthropogenic (human activities) causes. In December 2019, the deadly Coronavirus (Covid-19) outbreak was soon declared as a global pandemic by the World Health Organisation (WHO) [4]. Majority of countries have had their share of the impact of this outbreak. Many countries resorted to city lockdown to strictly control the movement of people and economic activities as recommended by WHO.

scholarly journals Indirect costs associated with deaths of children aged 0–14 years from measles in a weak health system and conflict and fragile zone: the case of Somalia

2019 ◽  
Vol 147 ◽  
Author(s):  
Omar B. Da'ar
Keyword(s):  
Health System ◽  
Indirect Cost ◽  
Indirect Costs ◽  
Developed Countries ◽  
World Health ◽  
Sensitivity Analyses ◽  
Years Of Life Lost ◽  
Security Measures ◽  
Least Developed Countries ◽  
The Future

Abstract This study recognises periodic outbreaks of measles continue to affect conflict and fragile zones in the least developed countries. This study set out to provide evidence for the indirect costs or economic loss associated with measles-related deaths among children aged 0–14 years in Somalia. Using epidemiologic and economic data, the indirect cost was calculated based on the framework of the World Health Organisation guide of identifying the economic consequences of disease and injury. The baseline indirect cost was computed as the product of discounted future productive years of life lost (PYLL), non-health gross domestic product per capita (NHGDPPC) and the estimated total measles deaths (ETMD). The model was adjusted for conflict and fragility conditions and further extension considered a finite and stable upper limit growth of the instability-adjusted NHGDPPC. To discount future costs, a rate of 3% was applied. Using a ±20% variability assumption of the epidemiologic and economic factor inputs, a sensitivity analysis was conducted to account for uncertainty. In 2015 values, the ETMD of 3723 measles deaths of children aged 0–14 years could decrease non-health GDP of the country by $23.46 million, a potential loss of $6303 per death over the discounted PYLL. The loss would increase by 5.3% when adjusted for conflict and fragility conditions. Assuming growth, the future adjusted loss is expected to be $35.91 million in 2015 values. Girl-child deaths accounted for 51.2% of the burden. Results are robust to the variations in the model inputs, although sensitivity analyses suggest the proportion of total measles deaths and the discount rate accounted for greater uncertainty of the loss than do the proportion of growth and instability assumption. Conflict and fragility accounted for the least uncertainty, perhaps confirming their relative perpetuity in Somalia. Results show significant indirect cost related to measles deaths of children, exacerbated by conflict and fragility. This is an economic burden, but one which the health system, policy-makers, government and other stakeholders should be prepared to colossally discount by collectively taking measles surveillance and security measures now to reduce further deaths in the future.

scholarly journals The Contribution of Public Health Investments to the Economic Growth of Cameroon

2017 ◽  
Vol 4 (1) ◽  
pp. 12-21 ◽  
Author(s):  
Ismaila Amadu ◽  
Ngoe Fritz Eseokwea ◽  
Marcel Ngambi
Keyword(s):  
Public Health ◽  
Economic Growth ◽  
Health Care ◽  
Health Care Services ◽  
Health Spending ◽  
World Health ◽  
Quality Health Care ◽  
Health Investments ◽  
The World ◽  
The Government

The goal of this paper is to determine the contribution of public health investments to the economic growth of Cameroon. The study used the human capital model of Lucas (1988) within the framework of endogenous growth theories. The Vector Error Correction Model (VECM) was employed in the estimations procedure using the World Development Indicators (WDI, 2013) data from the World Bank over the period spanning from 1988 to 2013.The findings show that government health expenditures contribute to economic growth only in the long run. From our results, we recommend that: first, the government should increase health spending to 10 or 15 percent of its GDP as initially suggested by the African Union and the World Health Organization respectively; second, government should enhance the provision of health care services by the private sector by putting in place incitation measures; third, competitive awards should be granted to those health units that render quality health care services.Int. J. Soc. Sc. Manage. Vol. 4, Issue-1: 12-21

scholarly journals Fairness evaluation of health financing between 2007 to 2010 in China

2020 ◽  
Author(s):  
Guan Wang ◽  
Qing Shen
Keyword(s):  
Health Behavior ◽  
Health System ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Health Financing ◽  
The Elderly ◽  
Communicable Diseases ◽  
World Health ◽  
Health Conditions ◽  
Non Communicable Diseases

Abstract Background: Population aging and the increasing burden of non-communicable diseases (NCDs) are increasingly a strain on health systems. The World Health Organization (WHO) uses fairness of health financing as one of the criteria for assessing health system performance. The Chinese government has undertaken a series of health reforms to reduce the pace of disease transition towards non-communicable diseases, as well as protecting people from catastrophic health expenditures. The aim of this study was to assess the fairness of health financing among the elderly with different health conditions in China during the year of 2007 to 2010. Methods: The data source was the WHO Study on global AGEing and adult health (SAGE) Wave 1, a national weighted data collected from adults older than 50 years. In this study, 10099 respondents were included for analysis. Chi-square and partial proportional odds model test were applied to assess the distribution of socioeconomic and health behavior factors among different chronic conditions. Fairness of healthcare financing analysis was used to evaluate how the burden of health financing is distributed according to the household ability to pay (ATP). Dominance tests were applied for comparing different ways of health financing among health conditions. Results: More than half of the elderly had at least one chronic condition, and around 20% people suffered from multi-morbidity. Several socioeconomic as well as health behavior factors were found associated with developing NCDs. Out-of-pocket payment dominated other health finance sources in Non-NCD, single morbidity and multi-morbidity groups with a regressive pattern. Even though mandatory insurance had covered more than 70% of the elder population in China, due to the relative lower proportion reimbursement for chronic diseases, people still had to pay a lot for seeking healthcare between 2007 to 2010. Conclusion: When reimbursement for chronic diseases is relatively low, high mandatory insurance coverage does not ensure fairness of health financing. The Chinese health system should be developed further in order to meet the needs of elderly with different chronic conditions.

scholarly journals Governance in Public Purchasing of Tertiary-Level Health Care: Lessons From Madhya Pradesh, India

SAGE Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 215824402094248
Author(s):  
Raj Panda ◽  
Pradeep Guin ◽  
Kumar Gaurav
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Services ◽  
Health Financing ◽  
Madhya Pradesh ◽  
World Health ◽  
Organizational Assessment ◽  
The Status ◽  
Critical Components ◽  
Health Organization

The performance of a health system hinges upon effective and efficient allocation of resources. The nature of governance within the health system, including critical components such as purchasing mechanism of health care services, also determines the health status of program beneficiaries. This article investigates an existing purchasing mechanism of a state-funded health care scheme through the lens of governance. We applied framework method on an adapted version of a tool developed by the World Health Organization (WHO), Organizational Assessment for Improving and Strengthening Health Financing (OASIS), to draw four themes to study the status of purchasing mechanism in Madhya Pradesh (MP), India. We used purposive sampling to select subjects from the state, district, and block levels and conducted 32 in-depth interviews. Subjects from the district and block levels were drawn from a sample of three out of 51 districts in MP. We found that although the scheme is functional, it has immense scope for improvement, thereby bettering the health outcomes of its beneficiaries.

Health care in South Africa

2020 ◽  
pp. 70-75
Author(s):  
Elena Frolova
Keyword(s):  
South Africa ◽  
Health Care ◽  
Organ Transplant ◽  
Developed Countries ◽  
World Health ◽  
Malignant Neoplasms ◽  
The Rich ◽  
The Republic ◽  
The Government ◽  
Health Organization

Every person who is at least somewhat familiar with the history of medicine knows the name of Christiaan Barnard, cardiac surgeon who performed the first successful heart transplant. This happened on December 3, 1967 at a hospital in Cape Town, South Africa. A man suffering from an incurable heart disease had a healthy organ transplant from a 25-yearold girl who died in a car accident. The patient lived for two weeks and died from complicated bilateral pneumonia, however, this case marked the beginning of a new era in transplantology giving hope of saving hundreds of patients. What do we know about health care of the Republic of South Africa, one of the most developed countries on the African continent? How much does the present situation allow the government to be classified as a world leader in healthcare? Unfortunately, according to the World Health Organization newsletter, South Africa at the present stage tops the sad ranking of countries by the number of HIV-infected and AIDS patients — about 7 million out of the 58 million people are infected with a dangerous virus. Unlike developed countries, where the main cause of death is pathology of the cardiovascular system, strokes and malignant neoplasms, three quarters of patients in the Republic of South Africa die due to infectious processes. Speaking about the heterogeneity of medicine, we were almost for the first time confronted with the fact that health services can be divided not only into health care for the «rich and poor», but also for the «white and black».

The relationship between development assistance for health and public health financing in 134 countries between 2000 and 2015

2021 ◽  
Author(s):  
Bryan N Patenaude
Keyword(s):  
Public Health ◽  
Health Outcomes ◽  
Development Assistance ◽  
Health Sector ◽  
Health Spending ◽  
Health Financing ◽  
World Health ◽  
Public Financing ◽  
Development Assistance For Health ◽  
The Relationship

Abstract This paper utilizes causal time-series and panel techniques to examine the relationship between development assistance for health (DAH) and domestic health spending, both public and private, in 134 countries between 2000 and 2015. Data on 237 656 donor transactions from the Institute for Health Metrics and Evaluation’s DAH and Health Expenditure datasets are merged with economic, demographic and health data from the World Bank Databank and World Health Organization’s Global Health Observatory. Arellano–Bond system GMM estimation is used to assess the effect of changes in DAH on domestic health spending and health outcomes. Analyses are conducted for the entire health sector and separately for HIV, TB and malaria financing. Results show that DAH had no significant impact on overall domestic public health investment. For HIV-specific investments, a $1 increase in on-budget DAH was associated with a $0.12 increase in government spending for HIV. For the private sector, $1 in DAH is associated with a $0.60 and $0.03 increase in prepaid private spending overall and for malaria, with no significant impact on HIV spending. Results demonstrate that a 1% increase in public financing reduced under-5 mortality by 0.025%, while a 1% increase in DAH had no significant effect on reducing under-5 mortality. The relationships between DAH and public health financing suggest that malaria and HIV-specific crowding-in effects are offset by crowding-out effects in other unobserved health sectors. The results also suggest policies that crowd-in public financing will likely have larger impacts on health outcomes than DAH investments that do not crowd-in public spending.

scholarly journals Strengthening health system building blocks: configuring post-COVID-19 scenario in Pakistan

2021 ◽  
Vol 22 ◽  
Author(s):  
Babar Tasneem Shaikh
Keyword(s):  
Public Health ◽  
Developing Countries ◽  
Health System ◽  
Emergency Preparedness ◽  
Virus Disease ◽  
Building Blocks ◽  
Research Capacity ◽  
Control Measures ◽  
World Health ◽  
The Government

Abstract Aim: To gauge the level of preparedness of health system of Pakistan in the wake of Corona Virus Disease 2019 (COVID-19) pandemic. Background: The global COVID-19 outbreak and its subsequent repercussions and implications, after being declared as a pandemic by the World Health Organization (WHO), exposed all the inherent, lingering, and acute shortcomings of the health systems in many developing countries and Pakistan was no exception. Methods: A detailed literature review was done which included peer-reviewed articles on COVID-19 and health system, published in local and international journals, WHO and World Bank’s publications, and the documents and official reports of the government. Focus was to glean and cite strategies adopted by the developing countries in response to COVID-19 and to see the applicability of those which are feasible for Pakistan. Findings: Level of preparedness was minimal and the response to manage the outbreak was weak. Based on toll of the cases and number of deaths, this public health threat turned out to be a catastrophe beyond the controlling authority and capacity of the health system, and hence other sectors and agencies had to be engaged for devising a concerted and integrated response to deal with the emergency. Governance was disorderly, financing was inadequate, human resources were not trained, supplies and logistic were not stocked, information system was patchy, and research capacity was limited, and most of all the service delivery was in a biggest chaos of times. COVID-19 demanded to re-configure the health system of Pakistan. Conclusion: Improving the emergency preparedness of the hospitals is the foremost and an urgent need. A strong national public health system in Pakistan is needed to rapidly investigate and analyze the reports, assess the magnitude of the public health risk, share real-time information, and implement public health control measures in a concerted and systematic demeanor.

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