However, there are lessons from international experience that allow a number of guiding principles for reforms which support progress towards UHC, to be specified. The combination of UHC goals and intermediate objectives can be used to set the direction of health financing reforms in any country, when contextualized into specific and measurable objectives for that country. The key search terms used included health financing, universal health coverage in low- and middle-income countries, equity in health, and national health insurance in Ghana. The general challenge for health policy is reflected in the arrow in the middle of Fig. , . When autocomplete results are available use up and down arrows to review and enter to select. Conceptual framework for analysing health financing systems and the effects of reforms. a cross-country review)16 or hypertension control (e.g. In the third phase, each article was appraised for quality with specific attention on the rigorousness of the methodological approach employed, clarity of the objective . 2010 . The first point can be illustrated most clearly in the case of voluntary health insurance. Since the publication of The Jakab M, Lundeen E, Akkazieva B. Dhillon RS. Today marks the successful conclusion of the High-Level Dialogue on Healthcare Financing for UHC in Kenya!Throughout this remarkable event, we engaged in insightful discussions, shared innovative ideas, and collaborated towards a common goal: achieving universal health coverage Show more . The evidence is strong that progress towards UHC would spur not just better health but also inclusive and sustainable economic growth, yet this report estimates that in 2030 there will be a UHC financing gap of $176 billion in the 54 poorest countries. Written by Jenny Berg. Available from: Global Health Check [Internet]. in Nepal);18 or a wide but still limited set of interventions (e.g. This means that the whole population of the country, including foreign nationals, refugees, asylum seekers and stateless persons can access medical attention or healthcare through the National Health Service (Sistema Nacional de Salud or "SNS") in specific . Inclusion in an NLM database does not imply endorsement of, or agreement with, In: Kutzin J, Cashin C, Jakab M, editors. When autocomplete results are available use up and down arrows to review and enter to select. These three dimensions connect closely to health financing policies related to UHC and to the monitoring of UHC. The appropriate unit of analysis when planning or analysing reforms is the entire population. This document aims to provide an overview of strategic purchasing of nutrition services within primary health care. Kutzin J, Ibraimova A, Jakab M, ODougherty S. Bismarck meets Beveridge on the Silk Road: coordinating funding sources to create a universal health financing system in Kyrgyzstan. (i) Financing the development and maintenance of public universities; (ii) Providing financial support to university students (exclusive to relevant target groups such students that require this support based on socio-economic criteria5 such as income level and patrimony, or students with disabilities). Madrid Region Health System (SERMAS) assures the adequate coverage of more than 6.5 million inhabitants of the region, including the capital, the third biggest city in the EU. people with hypertension, diabetes, human immunodeficiency virus infection, etc.). Prakongsai P, Limwattananon S, Tangcharoensathien V. The equity impact of the universal coverage policy: lessons from Thailand. The interests of the scheme(s) are in conflict with UHC objectives at the level of the entire system. UHC is one of three strategic priorities of World Health Organization's (WHO) general program of work for 2019-2023, and it is then a global health priority. Gotsadze G, Gal P. Coverage decisions: benefit entitlements and patient cost sharing. The sixth section contains a discussion of the unit of analysis for UHC and of the practical importance of understanding the distinction between schemes and systems. In one study, for example, smoking and obesity were associated with a lack of ability to obtain voluntary coverage and smoking was associated with the loss of voluntary coverage.37 Thus, for those who can afford it, a voluntary insurance scheme can offer good benefits, particularly if it systematically excludes people known to have high health risks (e.g. , , , , , , , . Universal health insurance in Rwanda: major challenges and solutions Universal health coverage (UHC) aims at providing quality health services for all people in a society without suffering financial hardship. It covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care across the life course. Universal health coverage means that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship. Individual modules can also be used as part of a programme of blended capacity building. Learn more about a Summary of Benefits and Coverage, also commonly referred to as an SBC. . El presente documento ampla la definicin de financiacin de la salud para una cobertura universal, tal y como se utiliza en el Informe sobre la salud en el mundo 2010 de la Organizacin Mundial de la Salud, a fin de mostrar cmo la cobertura sanitaria universal abarca los objetivos concretos e intermedios relacionados con los sistemas sanitarios y, en sentido amplio, cmo pueden influir en los mismos las reformas de financiacin sanitaria. Why Is Strategic Purchasing Critical for Universal Health Coverage in The first e-learning course on health financing policy for universal health coverage. This paper unpacks the definition of health financing for universal coverage as used in the World Health Organizations World health report 2010 to show how UHC embodies specific health system goals and intermediate objectives and, broadly, how health financing reforms can influence these. Ex ante, the cube portrays policies on benefit design, reflecting decisions on who is entitled to what services and how much they are obligated to pay for those services at the time of use. , , . Moving towards universal health coverage for mental disorders in Ethiopia. Health financing is a core function of health systems that can enable progress towards universal health coverage by improving effective service coverage and financial protection. transparency in terms of peoples understanding of their entitlements (rights) and their obligations with regard to health service use, as well as the extent to which these are realized in practice; and. Kutzin J. Universal means universal. Aterido R, Hallward-Driemeier M, Pags C. Shengelia B, Tandon A, Adams OBR, Murray CJL. Si nicamente concierne a proyectos concretos, ser incompatible con un enfoque universal e incluso podra minar la cobertura sanitaria universal, particularmente en lo que respecta a la igualdad. extent of corruption, public reporting on performance). Universal health coverage (UHC) - World Health Organization (WHO) the contents by NLM or the National Institutes of Health. Glassman A. High-Performance Health-Financing for Universal Health Coverage Health system effectiveness in hypertension control in Kyrgyzstan. Par consquent, la survie de la CMU reste pertinente pour tous les pays. This article provides an overview of health financing reforms across countries in the Western Pacific Region as progress is made toward universal health coverage (UHC). Por el contrario, si un plan se enfoca por completo hacia los objetivos y las metas a nivel del sistema, se puede continuar avanzando hacia la cobertura sanitaria universal. G20, World Bank Explore Financing for Universal Health Coverage 3. The first aspect of UHC defined above (use of needed services of good quality) corresponds closely to the concept of effective coverage, i.e. employment-linked voluntary health insurance that typically services upper-income persons). Bishkek: Center for Health System; 2007 (Policy Research Paper No. Gal P, Jakab M, Shishkin S. Strategies to address informal payments for health care. Investing in primary healthcare, implementing health financing reforms . The final section of the paper summarizes the core messages arising from this conceptual approach. All countries seek to improve equity in the use of health services, service quality and financial protection for their populations. aHealth Systems Financing, World Health Organization, 20 avenue Appia, 1211 Geneva 27, Switzerland. a countrys income, education levels, political factors, etc.). The https:// ensures that you are connecting to the 2, health financing influences the final goals and intermediate objectives of health systems. In: Kutzin J, Cashin C, Jakab M, editors. Health Financing and the Pandemic Response, Implementing health financing reforms in fragile and conflict-affected settings, Addressing the political economy of health financing reform, Providing guidance to countries on institutionalizing Health Technology Assessment, Improving efficiency across health programmes, Pooling revenues and reducing fragmentation, Leveraging public financial management for better health, Fostering fiscal dialogue between finance and health, Assessing country progress in health financing for UHC. The evidence is strong that progress towards UHC would spur not just better health but also inclusive and sustainable economic growth, yet this report estimates that in 2030 there will be a UHC financing gap of $176 billion in the 54 poorest countries. Universal Health Coverage | SpringerLink . This article focuses on pooling: the accumulation and management of prepaid financial resources. It can be used to graphically depict how many people received various needed health services of sufficient quality and how much they had to pay. Health financing, one of the seven building blocks of a well-functioning health system, can be a key policy instrument to improve health and reduce health inequalities if aimed at removing financial barriers to accessing health care and preventing financial hardship. , 2010 , , , , . . In some countries, such as Germany and Japan, insurance schemes are the instruments used to ensure financial access and financial protection for the entire population. In the third phase, each article was appraised for quality with specific attention on the rigorousness of the methodological approach employed, clarity of the objective . Given the definition of UHC and its specification here, however, fully achieving UHC is impossible for any country. Central and West Asia Health Sector Approach 2025 The World Bank Blog [Internet]. Certainly from a health policy perspective, the aim is to increase attainment from a given level of funding rather than to reduce funding to achieve the same level of attainment. Thus, strictly speaking, no country in the world has achieved universal coverage. Tous les pays cherchent amliorer l'quit dans l'utilisation des services de sant, dans la qualit des services et dans la protection financire des populations. Lessler J, Metcalf CJE, Grais RF, Luquero FJ, Cummings DAT, Grenfell BT. Center for Global Development Blog [Internet]. In: Kutzin J, Cashin C, Jakab M, editors. Nonetheless, the following examples illustrate the kinds of actions that can promote progress towards UHC: These are merely examples intended to illustrate some ways in which financing reforms actions taken to alter arrangements for revenue collection, pooling, purchasing and benefit design can support progress towards UHC. Adopting localised health financing models for universal health . Accessibility Contribute to international policy debates on financing for universal health coverage; and; Share educational resources and materials among IHEA members and more broadly. Many countries have identified Universal Health Coverage (UHC) as the goal for their health systems, and health financing reforms are at the core of strategies to move in this direction. We've discussed the importance of revitalizing Kenya's health system for universal health coverage. Independent Oversight and Advisory Committee, Health Financing Progress Matrix Background Indicators, Click here to access health financing trainings, Developing a national health financing strategy: a reference guide, A system-wide approach to analyzing efficiency across health programmes, Health financing country diagnostic: a foundation for national strategy development, Governance for strategic purchasing: An analytical framework to guide a country assessment, Analytical guide to assess a mixed provider payment system, Process guide for identifying issues and fostering dialogue in public financial management, Diagnosis-related groups (DRG): A Q&A guide on case-based classification and payment systems, Synthesis of evidence and policy recommendations: Health financing policy and implementation in fragile and conflict-affected settings, Guidance paper - Assessing country health financing systems: the health financing progress matrix, WHA resolution: Sustainable health financing structures and universal coverage (2011) - WHA64.9, WHA resolution: Sustainable health financing, universal coverage and social health insurance (2005) WHA58.33, Regional Office for Africa: Health financing: a strategy for the African region (AFR/RC56/R5), Regional Office for Africa: Luanda commitment to universal health coverage: From concept to action, 2014, Regional Office for the Eastern Mediterranean: The impact of health expenditure on households and options for alternative financing (EM/RC51/4), Regional Office for Europe: Ministerial Conference on Health Systems - The Tallin Charter: health systems for health and wealth, Regional Office for Europe: Priorities for health systems strengthening in the WHO European Region 20152020: walking the talk on people centredness (EUR/RC65/13), Regional Office for the Americas: Strategy for universal access to health and universal health coverage (CD53.R14), Regional Office for South-East Asia: Strategy for universal health coverage (SEA/RC65/R6 ), Regional Office for the Western Pacific: Universal Health Coverage: Moving Towards Better Health. . Download Full report and Executive summary, Global data and statistics, research and publications, and topics in poverty and development, Press Release: World Bank: People Spend Half a Trillion Dollars Out-Of-Pocket on Health in Developing Countries Annually, Infographic: Financing universal health coverage drives inclusive economic growth, The World Banks digital platform for live-streaming, Environmental and Social Policies for Projects, International Development Association (IDA). Universal health coverage (UHC) means that all people can access health services of good quality without experiencing . Sustainable health: Stakeholder call for Strengthening of health financing Beattie A, Yates R, Noble DJ. Abstract. This article provides an overview of health financing reforms across countries in the Western Pacific Region as progress is made toward universal health coverage (UHC). Strictly interpreted, UHC is a utopian ideal that no country can fully achieve. Taking action for universal health coverage - UHC2030 In: Chernichovsky D, Hanson K, editors. What matters is not how a particular financing scheme affects its individual members, but rather, how it influences progress towards UHC at the population level. The concentration of resources on behalf of the insured has a spillover effect on those without this form of coverage: the existence of a pool of funds that is such a large share of total health care funds inevitably impacts on the distribution of health care professionals between the public and private health sectors, and hence contributes to a skewed distribution of service benefits.32. ( , ) . Financing arrangements contribute to a health system favouring the rich, with total expenditure for the insured population being from 4.5 to 6 times higher than for people who only use publicly-funded health services, a distribution pattern very unlikely to reflect need.
