Forgone healthcare and financial burden due to out-of-pocket payments in Bangladesh: a multilevel analysis

Background Ensuring access to health services for all is the main goal of universal health coverage (UHC) plan. Out-of-pocket (OOP) payment still remains the main source of funding for healthcare in Bangladesh. The association between barriers to accessing healthcare and over-reliance on OOP payments has not been explored in Bangladesh using nationally representative household survey data. This study is a novel attempt to examine the burden of OOP payment and forgone healthcare in Bangladesh, and further explores the inequalities in catastrophic health expenditures (CHE) and forgone healthcare at the national and sub-national levels. Methods This study used data from the most recent nationally representative cross-sectional survey, Bangladesh Household Income and Expenditure Survey, conducted in 2016–17 (N = 39,124). In order to identify potential determinants of CHE and forgone healthcare, multilevel Poisson regression was used. Inequalities in CHE and forgone healthcare were measured using the slope index of inequality. Results Around 25% of individuals incurred CHE and 14% of the population had forgone healthcare for any reasons. The most common reasons for forgone healthcare were treatment cost (17%), followed by none to accompany or need for permission (5%), and distance to health facility (3%). Multilevel analysis indicated that financial burden and forgone care was higher among households with older populations or chronic illness, and those who utilize either public or private health facilities. Household consumption quintile had a linear negative association with forgone care and positive association with CHE. Conclusion This study calls for incorporation of social safety net in health financing system, increase health facility, and gives priority to the disadvantaged population to ensure access to health services for all.

Italian cultural policy: conclusions for Russia

The article analyses current public management and funding practices of cultural organisations in Italy by using comparative and statistical analysis. The structure of the sector’s governing bodies and approaches to budgeting for culture at national level have been explored. Trends in decreasing funding from provincial, regional and local budgets have been identified. The status, legislative and institutional conditions for the emergence of Italy’s unique multichannel cultural financing system have been described. An analysis of the Italian museum system’s reform has been presented. The activities of private opera foundations have been discussed in detail. The main similarities between Russian and Italian cultural policies have been described. These are the drive to expand the boundaries and activities associated with the cultural sector, the significant burden on local and regional authorities in the field of cultural heritage preservation, the “quantitative approach” and the application of financial performance indicators to assess cultural organisations performance.The article’s scientific novelty lies in the complex approach to the study of Italian cultural policy using the criteria proposed by D. Montias and A. I. Glagolev, and in the study of the activities of Italian opera foundations and museums, which had not previously been sufficiently covered in the Russian and foreign literature. The prospect of the topic, the practical significance and relevance of the research are due to the need to implement regulations in Russia which set a course for the creation of a multi-channel system of funding and a broad understanding of the cultural sector, and ensuring inter-agency and inter-regional cooperation between the authorities in the implementation of cultural policy.The article analyses a wide range of financial support mechanisms for culture, most of which are named in the “Strategy of State Cultural Policy of Russia as Targets by 2030”, while Italy has accumulated considerable experience in this area for several decades.

Public Procurement Concept as A Path Dependence Result

The rationale and conditions for transformation of a coordination mechanism in public procurement in Russia from market to redistribution, based on the quasi-market technology, are outlined. The authors view modernization of the economic framework of public procurement as an outcome of institutionalizing the rational conduct principles under the influence of such factors as public production conditions and path dependence. The paper describes transformation of the main elements of the machinery for financing public procurement associated with changing the institutional management structure towards support for the “best quality at an affordable price” principle. Alternatives of transaction managements in the financing system of supplying products for public needs are reviewed: from centralized planning in the USSR to the mixed economy in the today’s Russia. A comparative analysis based on the typical features of the market mechanism for transaction coordination justifies the quail-market nature of public procurement technologies in the Russian Federation. Arguments are given for procurement technology dynamics as returning to redistributive transaction coordination that facilitates transformation of public procurement from an economic-structure neutral into a proactive mechanism geared to form new economic orders. A sequence of tasks is given in order to execute the procurement concept in terms of institutional methodology as well as the prospects for developing a system of public procurement as a mechanism of proactive budgeting policy under bilateral economic sanctions that means de-liberalization of international economic relations. Public contractual system is a factor that is gradually restoring an ability to play a stabilizing and stimulating role in order to support the growth of national production and innovations by employing the taxpayer’s money to attain the national strategic development goals

FEATURES OF LAND VALUATION IN PROJECT FINANCING USING ESCROW ACCOUNTS

Проведен анализ текущей ситуации на первичном рынке жилой недвижимости в рамках перехода на новые условия финансирования жилищного строительства. Выявлены преимущества внедрения проектного финансирования, а также проблемы, ограничивающие его эффективность на основе основных тенденций и направлений применения проектного финансирования в России в строительстве, при реализации инфраструктурных проектов и в деятельности институтов развития по привлечению в систему проектного финансирования частных инвестиций. Показаны принципы построения схемы для строительного проекта, реализующейся с проектным финансированием по заранее составленной модели, где применены эскроу-счета. Предложен метод оценки земельного участка при проектном финансировании с использованием эскроу-счетов. Для оценки инвестиционной стоимости земли, то есть стоимости, при которой доход от приобретения земельного участка соответствует норме интереса, установленной инвестором, или стоимости, удовлетворяющей требования инвестора к доходности конкретного проекта, рекомендовано использовать три денежных потока, а именно денежный поток от инвестиционной деятельности, финансовой деятельности и поток на собственный капитал проекта. Проведен анализ опыта иностранных государств в вопросе формирования стоимости земли в черте города и влияющих на неё факторов. Показаны преимущества оценки земельного участка при проектном финансировании с использованием эскроу-счетов: удобство, гарантии; прозрачность и поддержка. We carried out the analysis of the current situation in the primary residential real estate market as part of the transition to new conditions for financing housing construction. We identified the advantages of introducing project financing, as well as problems limiting its effectiveness on the basis of the identified main trends and areas of application of project financing in Russia in construction, when implementing infrastructure projects and in the activities of development institutions to attract private investment into the project financing system. We show the principles of constructing a scheme for a construction project, implemented with project financing according to a pre-compiled model, where escrow accounts are used. A method for assessing a land plot for project financing using escrow accounts of the intended use is proposed. To assess the investment value of land, that is the value at which the income from the acquisition of a land plot corresponds to the rate of interest set by the investor, or the value that meets the investor's requirements for the profitability of a particular project, it is recommended to use three cash flows, namely, cash flow from investment activities, financial activities and the flow on equity capital of the project. We analyzed the development of foreign countries in the context of cost formation of land within the city and relevant factors influencing this cost. The advantages of assessing a land plot with project financing using escrow accounts have also been revealed: convenience, guarantees, transparency and support.

Phenomenon of Causal Fraud Health Insurance in Hospitals: Theory of gear fraud

Objective: To describe and explore the experiences of hospital employees with the causes of fraud in the health insurance program at the hospitals. Design And Setting: This research was carried out at government hospitals in the Southeast Sulawesi Province in collaboration with BPJS Health, namely the Bahteramas Regional General Hospital and the Kendari City Regional General Hospital. Triangulation was carried out at BPJS Health, the Center for Health Insurance Financing at the Ministry of Health and the Center for Health Policy and Management at Gadjah Mada University, Yogyakarta. This research was conducted for one year, namely January 2020 to February 2021qualitative method with a phenomenological approach. Data collection methods were carried out through in-depth interviews, focus group discussions, and document studies. The number of participants in this study was 44 people consisting of doctors in charge of services, nurses, midwives, and case-mix team including coders who met the inclusion criteria. Data analysis used the Moustakas method. Result: The causes of health insurance fraud in hospitals financial motives (the desire to get money or material or economic or welfare benefits, get high service services and low employee salaries), behavioral motives (low integrity, lifestyle and employee habits of committing fraud0, and social motives (kinship, humanitarian factors, avoiding conflict, social position, and the existence of pressure), internal controls (a weak monitoring system, poorly enforced regulations, unclear regulations and limited hospitals providing services, no monitoring and evaluation, and there are no sanctions for fraud perpetrators), revenue targets (hospitals income and increasing the number of claims), leadership (leadership style or weak leadership in the hospitals and the absence of transparency), incentive systems (poor distribution of incentives and the absence of transparency of services from hospitals management), National Health Insurance (NHI) regulations (dynamic regulations and the availability of the National Guidelines for Medical Services has not been fulfilled and there is no standard for readmission and fragmentation), the NHI financing system (inconvenience of the financing system and the adequacy of the INA-CBGs tariff calculation), and the BPJS Health system (inconvenience of the BPJS Health system and the BPJS Health system which makes it difficult). Conclusions: The causes of health insurance fraud in hospitals can be explained by the gear fraud theory that Internal factors are the main cause and external factors predispose to health insurance fraud in hospitals. These internal and external factors interact with each other like the working mechanism of a gear. Understanding the theory of gear fraud will help formulate fraud prevention efforts in health insurance programs in hospitals that are more comprehensive and focus on eliminating the causes of fraud.

Fintech, Regtech and Suptech: Three Dimensional Approaches to Digital Finance

Every institution is now doing business transactions through digital financing system. Digital financing solutions offer great potential to overcome challenges and contribute toward achieving universal access to financial services. However, it is noticed that insufficiency of technological up-gradation and various issues created by hackers that might include fraudulent online transactions as an example, hampers people who are not aware of the other side of technology. There are three stages in the implementation of digital finance viz., Fintech, Regtech and Suptech. ‘Fintech’ is an application of Technology for financial services that include; digital payments and e-money, international remittances, personal and business loans, peer-topeer lending platforms, crowd funding platforms, Robo-advisors, Crypto currencies like Bitcoin, Altcoin, etc. ‘Regtech’ is a contraction of the terms ‘regulatory’ and ‘technology’ and it describes the context of regulatory monitoring, reporting, and compliance. ‘Suptech’ is derived from ‘Supervision’ and ‘Technology’, which monitors ‘Fintech’ and ‘Regtech’. The rise of Fintech will undermine the widespread assumption that the primary source of systemic risk in the financial sector is the domination of large, “systemically important” banks and other financial institutions. On this backdrop, this paper aimed to explore the importance of Fintech, Regtech, and Suptech as three stage approach to digital finance. This paper makes a focus as the special dynamics regarding how Fintech, Regtech, and Suptech as three stage approach to digital finance work and will become the better substitute of banks and other financial systems. Based on review of secondary sources, this paper highlights: 1. the problems and obstacles faced by corporate entities in digital finance and 2. the interdependency of three dimensions of technology viz., Fintech, Regtech and Suptech. Keywords: Digital finance, Financial literacy, Fintech, Regtech and Suptech.

Analisis Sistem Pembiayaan Akad Qardhul Hasan Di BMT Al-Amanah Cabang Subang

The Qardhul Hasan financing at BMT Al-Amanah Subang was not surveyed again, because the Qardhul Hasan survey had been carried out at the beginning of the members doing previous financing such as Mudharabah, Murabahah, Musyarakah, and Rahn financing, because Qarhdul Hasan financing is a conversion from the previous contract. Qardhul Hasan financing has certain categories for financing the needs of members such as education costs, medical expenses, and so on. The purpose of this study was to determine the terms and conditions of financing Qardhul Hasan at BMT Al-Amanah Subang Branch; To find out the Qardhul Hasan contract financing system at BMT Al-Amanah Subang Branch; and To find out the benefits of the Qardhul Hasan Agreement for members and managers of BMT Al-Amanah Subang Branch. The results of this study 1). The terms and conditions of Qardhul Hasan financing at BMT Al-Amanah Subang Branch do not use collateral on the condition that they must become members of BMT Al-Amanah, and members are no longer able to pay installments of previous contract financing that have matured; 2. Qardhul Hasan Financing System at BMT Al-Amanah Subang Branch, namely: a). For members of BMT Al-Amanah who are active members by having principal and mandatory savings, b). For members who already have financing, which is past due, but have difficulty paying the financing installments, BMT Al-Amanah converts the contract into Qardhul Hasan; 3). The benefits of Qardhul hasan for members and managers are: a). For members, it is very helpful for members who are having difficulty paying installments and as a source of non-commercial loans / bailout funds, b). For managers, namely because Qardhul Hasan financing is social and please help it will give a good image for BMT Al-Amanah Subang Branch.

REPRESENTATION OF THE FINANCIAL NEEDS OF RURAL MALAGASY HOUSEHOLDS

Madagascar is committed to implementing local financial services to facilitate rural households' access to these various services and promote rural development. The objective of the study is to understand the realities of the financing system in rural areas and more particularly in the rural commune of Alakamisy Itenina in vohibato district, and this, through the experience of rural households that determine the different financial needs and their financial priority. Using the Schwartz formula, surveys of 81 households were statistically treated. The results show that rural households prioritize social needs by meeting the social obligations dictated by fihavanana. The first place of the social obligations is perceived through the attachment to the traditional practice by the proverb “atero k'alao” which means "one receives by giving". This is how behavioural logic has been observed in localities far from financial services. Changing this behavioral logic turns out to be the best option. Rural households should accept new forms of financial innovation.

Bekasi City Government Policy In Financing Stunting In Children

Currently, nutritional problems in Indonesia are still in the spotlight, one of which is the problem of stunting in toddlers. The government shows its commitment to tackling stunting by making regulations regarding the acceleration of stunting reduction as stated in Presidential Regulation No. 72 of 2021. The health financing system is an effort to fund the health sector to support the implementation of health with the aim of achieving the highest health status. This study aims to provide an overview of the Bekasi City government's policy in financing stunting prevention in Bekasi City. The research method used is normative juridical, with a statutory approach. The policies issued by the Bekasi City Government regarding the Prevention and Control of Stunting are contained in the Bekasi Mayor's Instruction No: 440/1914/Bappeda and the establishment of the Task Force for the Acceleration of Stunting Prevention and Control is contained in Decree Number: 440/Kep.277-Bappelitbangda/V/ 2020. The results of this study show that the participation of the Bekasi City government has been very good from issuing policies related to stunting reduction efforts, forming and implementing 8 integration actions by involving multi-sectoral roles in government which is an effort to prevent stunting. The financing used in the stunting prevention process is funded by the Bekasi City Government from the Regional Revenue and Expenditure Budget (APBD) and or other funds that can be utilized by the relevant government sector to be in charge of 8 integration actions.

Pendampingan Manajemen Dan Administrasi Keuangan Pada Koperasi Wanita Arwana Kota Bengkulu

The Women's Cooperative "Arwana" which is a legal entity No.: 99/BH/DK PPKM/KEP/IX.4/2008 is a savings and loan cooperative having its address at Jl. Wren Rt. 17/Rw.06 Cempaka Permai Village, Gading Cempaka District, Bengkulu City. This cooperative was established by notarial deed SK. Minister of Law and Human Rights of the Republic of Indonesia Number: C-226.HT.03.01. July 5, 2006 and started operating in 2008. In 2019 this cooperative began to turn into a sharia-based cooperative. This community service activity aims to provide understanding assistance to administrators and members in terms of management as an effort towards better management from conventional to Sharia. So it is hoped that later the management and members of the cooperative in carrying out their duties and responsibilities in accordance with the principles and rules of management can become a financing system in accordance with the sharia concept. This community service is carried out with lectures on the principles of cooperative management. The output of this community service activity is that the management and members of the cooperative, especially in the savings and loan business, are able to know and understand and implement financing business activities with a management system according to SAK ETAP as a step towards developing a financing business that is still using the conventional system to be more ready to use the system. Sharia. The output of this community service is in the form of a scientific journal that will be published.