scholarly journals Early experience of universal health coverage in Turkey on access to health services for the poor: regression kink design analysis

2018 ◽  
Vol 8 (2) ◽  
Author(s):  
Abdullah Tirgil ◽  
Ipek Gurol-Urganci ◽  
Rifat Atun
Keyword(s):  
Health Services ◽  
Universal Health Coverage ◽  
Early Experience ◽  
Design Analysis ◽  
Health Coverage ◽  
Access To Health Services ◽  
The Poor ◽  
Access To Health ◽  
Regression Kink Design ◽  
Universal Health

scholarly journals Financial Barriers to Access to Health Services for Adult People with Disability in Iran: The Challenges for Universal Health Coverage

2019 ◽  
Author(s):  
Shahin SOLTANI ◽  
Amirhossein TAKIAN ◽  
Ali AKBARI SARI ◽  
Reza MAJDZADEH ◽  
Mohammad KAMALI
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Universal Health Coverage ◽  
Healthcare Services ◽  
Health Coverage ◽  
Access To Health Services ◽  
Financial Barriers ◽  
Access To Health ◽  
People With Disability ◽  
Universal Health

Background: Reducing inequities in access to healthcare is one of the most important goals for all health systems. Financial barriers play a fundamental role here. People with disability (PWD) experience further financial barriers in access to their needed healthcare services. This study aimed to explore the causes of barriers in access to health services for PWD in Tehran, Iran. Methods: In this qualitative study, we used semi-structured in-depth interviews to collect data and selected participants through purposeful sampling with maximum variation. We conducted 56 individual interviews with people with disability, healthcare providers and policymakers from Sep 2015 until May 2016, at different locations in Tehran, Iran. Results: We identified four categories and eight subcategories of financial barriers affecting access to healthcare services among PWD. Four categories were related to health insurance (i.e. lack of insurance coverage for services like dentistry, occupational therapy and speech therapy), affordability (low income for PWD and their family), financial supports (e.g. low levels of pensions for people with disabilities) and transportation costs (high cost of transportation to reach healthcare facilities for PWD). Conclusion: Financial problems can lead to poor access to health care services. To achieve universal health coverage, government should reduce health insurance barriers and increase job opportunities and sufficient financial support for PWD. 

scholarly journals In search of universal health coverage – highlighting the accessibility of health services for students with disabilities in Ghana: a qualitative study

2019 ◽  
Author(s):  
Eric Abodey ◽  
Irene Vanderpuye ◽  
Isaac Mensah ◽  
Eric Badu
Keyword(s):  
Health Services ◽  
Students With Disabilities ◽  
Universal Health Coverage ◽  
Health Workers ◽  
Policy Formulation ◽  
Health Coverage ◽  
Access To Health Services ◽  
Accessibility Of Health Services ◽  
The Government ◽  
Universal Health

Abstract Background: Accessibility to health services for students with disabilities is a global concern. This is no less important in Ghana, however, to date, no study has been undertaken regarding access to health services for students with disabilities. This study, therefore, aims to explore the accessibility of health services for students with disabilities, in the quest of achieving universal health coverage in Ghana. Methods: Qualitative methods, involving in-depth interviews were employed to collect data from 54 participants (29 students with disabilities, 17 health workers and 8 school mothers), selected through purposive sampling. Thematic analysis was used to analyze the data. Results : The study identified three themes – accessibility, adequacy, and affordability. The study findings highlighted that universal health coverage for students with disabilities has not been achieved due to barriers in accessing health services. The barriers faced by students with disabilities are unfriendly physical environments, structures, equipment, limited support services and poor health insurance policy to finance health services. Conclusion : The study concludes that the government should prioritize disability-related issues in health policy formulation, implementation and monitoring. The current provisions and requirements in the disability act should be prioritized, enforced and monitored to ensure adequate inclusion of disability issues in health services. Further, the current exemption policy under the NHIS scheme should be revised to adequately address the needs of people with disabilities.

scholarly journals Achieving universal health coverage in small island states: could importing health services provide a solution?

2018 ◽  
Vol 3 (1) ◽  
pp. e000612 ◽  
Author(s):  
Mariyam Suzana ◽  
Helen Walls ◽  
Richard Smith ◽  
Johanna Hanefeld
Keyword(s):  
Health Services ◽  
Universal Health Coverage ◽  
Economies Of Scale ◽  
Health Workers ◽  
Health Indicators ◽  
Small Island ◽  
Health Coverage ◽  
Access To Health Services ◽  
Medical Travel ◽  
Universal Health

BackgroundUniversal health coverage (UHC) is difficult to achieve in settings short of medicines, health workers and health facilities. These characteristics define the majority of the small island developing states (SIDS), where population size negates the benefits of economies of scale. One option to alleviate this constraint is to import health services, rather than focus on domestic production. This paper provides empirical analysis of the potential impact of this option.MethodsAnalysis was based on publicly accessible data for 14 SIDS, covering health-related travel and health indicators for the period 2003–2013, together with in-depth review of medical travel schemes for the two highest importing SIDS—the Maldives and Tuvalu.FindingsMedical travel from SIDS is accelerating. The SIDS studied generally lacked health infrastructure and technologies, and the majority of them had lower than the recommended number of physicians in a country, which limits their capacity for achieving UHC. Tuvalu and the Maldives were the highest importers of healthcare and notably have public schemes that facilitate medical travel and help lower the out-of-pocket expenditure on medical travel. Although different in approach, design and performance, the medical travel schemes in Tuvalu and the Maldives are both examples of measures used to increase access to health services that cannot feasibly be provided in SIDS.InterpretationOur findings suggest that importing health services (through schemes to facilitate medical travel) is a potential mechanism to help achieve universal healthcare for SIDS but requires due diligence over cost, equity and quality control.

scholarly journals Workshop: Access to health services in health systems providing universal coverage

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Health Systems ◽  
Universal Health Coverage ◽  
Expert Panel ◽  
Health Coverage ◽  
Access To Health Services ◽  
Research Teams ◽  
Access To Health ◽  
Universal Health

Abstract Universal health coverage (UHC) is part of the global WHO strategy to improve health. UHC and equity in access to care fall within the shared principles and values of EU health systems. However, as reported in 2016 by the Expert panel on effective ways of investing in health (EXPH), significant amount of unmet needs persisted both between and within EU member states. Access to health services encompasses the dimensions of affordability, user experience and availability of services with potential barriers arising at individual, providers or health systems levels. Health needs are constantly evolving as a consequence of population ageing and of health care technology development. Consequently access to care does not simply mean availability of a single component of care, but rather to an array of pertinent, coordinated, cost-effective and timely primary and specialized health and social interventions. Measuring performance in that respect is beyond the ability of commonly used “national level” indicators of access. Available research suggests that achieving ubiquitous access to optimal care across territories and populations (eg socioeconomic groups) is hard to achieve. This applies to the whole spectrum of health interventions, from preventive care such as immunizations to multidisciplinary interventions required for the management of chronic diseases. In this context, the workshop proposes to present examples of policy initiatives and results from research projects focusing on access and use of health care conducted in a variety of settings. The aims are to share knowledge about methods used in measuring variations of access, to improve understanding of their determinants and to identify avenues for improving performance. The workshop is proposed by a multidisciplinary and international group of research teams. It will start with a short introduction from the chair (5 minutes, Olivier Grimaud) followed by five presentations (10 minutes) addressing the issues of variations in access and use of care from different research teams and in a variety of settings. The first presentation will report on an innovative policy aiming at improving UHC in India. The following presentations will illustrate the challenges of providing access in high income countries, including, Scotland, France and Australia. In the last part of the workshop (30 minutes) comments from Prof Helmut Brand (former expert panel member of the EXPH) will introduce a general discussion with the audience moderated by the chair. Key messages Even when the conditions for universal health coverage are in place, providing equitable access to quality care remains a challenge. Understanding variations in access to care would help improve performance and equity.

Smart Cards for All: Digitalisation of Universal Health Coverage in India

2020 ◽  
Vol 25 (3) ◽  
pp. 426-443
Author(s):  
Marine Al Dahdah ◽  
Rajiv K. Mishra
Keyword(s):  
Health Services ◽  
Smart Card ◽  
Universal Health Coverage ◽  
Poverty Line ◽  
Public Private Partnership ◽  
Health Coverage ◽  
Indian States ◽  
Private Partnership ◽  
Access To Health ◽  
Universal Health

In less than ten years, India has launched colossal biometric databases. One among them is related to the first ‘free’ health coverage scheme offered by the government of India: the Rashtriya Swasthya Bima Yojna (RSBY). Based on a public–private partnership between government and private companies, RSBY national scheme was launched in 2008, as a first step towards universal health coverage in a country where households endorse 70% of health expenses. The first phase of RSBY offers to cover ₹30,000 ($600) of inpatient expenses per year for five members of a below poverty line household and is now piloted in several Indian States to include outpatient expenses and above poverty line families too. RSBY relies exclusively on a centralised digital artefact to function, made visible by the ‘RSBY Smart Card’, a chip enabled plastic card containing personal data of individual and their family counting and conditioning the granting of health services to them; thus, no smart card means no health coverage. Till date 120 million Indians have been registered in the RSBY database. This article analyses how health accessibility is crafted under the RSBY scheme by questioning two central dimensions of this data-driven digital health scheme: the smart card technology and the public–private partnership, whereas RSBY scheme promises health coverage for all, its digital infrastructures may complicate access to health services, and reveal new patterns of exclusion of individuals. Thus, we will detail how smartcards technologies and private providers condition access to health care in India.

scholarly journals Assessing catastrophic out-of-pocket payments in Ethiopia’s health system

2020 ◽  
Author(s):  
Amarech G. Obse ◽  
John E. Ataguba
Keyword(s):  
Health Services ◽  
Universal Health Coverage ◽  
Low Income ◽  
Household Expenditure ◽  
Financial Protection ◽  
Health Coverage ◽  
The Poor ◽  
Out Of Pocket Payments ◽  
Food Expenditure ◽  
Universal Health

Abstract Background: Providing adequate financial protection for all remains an essentialaspect of Universal Health Coverage (UHC). In Ethiopia, although the government has introduced reforms, out-of-pocket (OOP) spending accounts for 37% of current health expenditure in 2016. This is considered high enough to lead to financial catastrophe—a situation where a household spends more than a given fraction of its expenditure (or capacity to pay) OOP on health services. This study assessedfinancial catastrophe resulting from OOP health spending in Ethiopia. Methods: Data come fromthe Ethiopian Household Consumption Expenditure Survey (HCES) 2010/11 with about 28,000 households. The incidence and intensity of catastrophic spending were estimated using rank-dependent thresholds that are different depending on household income levels—the thresholds become lower for low-income households. Initial thresholds used ranged between 5% and 25% of total household expenditure, and between 20% and 40% of household non-food expenditure. Concentration indices are used to assess whether financial catastrophe is more prevalent among the poor or rich. Results: Atthe 10% initial threshold of total household expenditure, financial catastrophe was estimated at 4.08%, translating to over 668,000 households. At an initial threshold of 40% of total household non-food expenditure, about 0.82% or about 133,600 households incurred financial catastrophe, paying more thantheir rank-dependent thresholds. Financialcatastrophe was more prevalent among poorer and urban households, butthere was a mixed pattern across Ethiopia’s 11 regions. Conclusion: Financialcatastrophe resulting from paying OOP for health services exists in Ethiopia, affecting over 100,000 households. The low incidence compared to other studies may suggest that government’s initiatives like the fee-waiver and exemption systems have been successful, but the prevalence of financial catastrophe among the poor may signify that more is needed to achieve universal financial protection in Ethiopia. Keywords: Universal health coverage; financial catastrophe; Ethiopia

scholarly journals Advanced Practice Nursing: A Strategy for Achieving Universal Health Coverage and Universal Access to Health

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Denise Bryant-Lukosius ◽  
Ruta Valaitis ◽  
Ruth Martin-Misener ◽  
Faith Donald ◽  
Laura Morán Peña ◽  
...  
Keyword(s):  
Latin America ◽  
Universal Health Coverage ◽  
Universal Access ◽  
Advanced Practice Nursing ◽  
Advanced Practice ◽  
Health Coverage ◽  
Access To Health ◽  
The Caribbean ◽  
Universal Health ◽  
Role Implementation

ABSTRACT Objective: to examine advanced practice nursing (APN) roles internationally to inform role development in Latin America and the Caribbean to support universal health coverage and universal access to health. Method: we examined literature related to APN roles, their global deployment, and APN effectiveness in relation to universal health coverage and access to health. Results: given evidence of their effectiveness in many countries, APN roles are ideally suited as part of a primary health care workforce strategy in Latin America to enhance universal health coverage and access to health. Brazil, Chile, Colombia, and Mexico are well positioned to build this workforce. Role implementation barriers include lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong nursing leadership to align APN roles with policy priorities, and to work in partnership with primary care providers and policy makers is needed for successful role implementation. Conclusions: given the diversity of contexts across nations, it is important to systematically assess country and population health needs to introduce the most appropriate complement and mix of APN roles and inform implementation. Successful APN role introduction in Latin America and the Caribbean could provide a roadmap for similar roles in other low/middle income countries.

scholarly journals Progressive Pathway to Universal Health Coverage in Tanzania: A Call for Preferential Resource Allocation Targeting the Poor

2018 ◽  
Vol 4 (4) ◽  
pp. 279-283
Author(s):  
Huihui Wang ◽  
Mariam Ally Juma ◽  
Nicolas Rosemberg ◽  
Mpoki M. Ulisubisya
Keyword(s):  
Resource Allocation ◽  
Universal Health Coverage ◽  
Health Coverage ◽  
The Poor ◽  
Universal Health
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