Countries must invest at least 1% more of GDP on primary health care to eliminate glaring coverage gaps
At current rates of progress up to 5 billion people will miss out on health care in 2030
Countries must increase spending on primary healthcare by at least 1% of their gross domestic product (...GDP) if the world is to close glaring coverage gaps and meet health targets agreed in 2015, says this new report. They must also intensify efforts to expand services countrywide.
The world will need to double health coverage between now and 2030, according to the Universal Health Coverage Monitoring Report. It warns that if current trends continue, up to 5 billion people will still be unable to access health care in 2030 – the deadline world leaders have set for achieving universal health coverage. Most of those people are poor and already disadvantaged.
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In 2017, the World Bank and partners created the Global Investment Framework for Nutrition as a roadmap towards achieving the World Health Assembly (WHA) nutrition targets by 2025. The framework estimates that the world needs to mobilize an annual additional investment of $7 billion per year to scal...e-up nutrition-specific interventions at the level needed to achieve the global targets. However, the world is off-track to meet the global targets. And it is unclear whether additional resources will be mobilized for life-saving and cost-effective nutrition-specific interventions, or whether donor support will be enough to meet the annual resource need established by the framework.
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Despite the considerable improvement in global health, millions of people still lack access to quality health services, including access to effective antimicrobial medicines, or are impoverished as a result of health spending. At the same time, antimicrobial resistance – a consequence of overuse a...nd misuse of antimicrobials – is increasingly a barrier to accessing effective care. The declining effectiveness of antibiotics is driven by multiple factors, many of which can be addressed through well functioning primary health care. However, primary health care has not always had much attention in national health sector responses to
antimicrobial resistance, which often focus on tertiary care, laboratory detection and surveillance. The three pillars of primary health care (community engagement, front-line health services including primary care and essential public health, and multisectoral action on wider health determinants) are central not just to Universal Health Coverage and the Sustainable Development Goals, but also to an effective response to antimicrobial resistance.
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Hundreds of millions of people worldwide are required to stay at home to protect themselves and prevent the spread of the disease, including young people. Children have been out of school and as a result, many of them may be spending more time on screens to complete online activities as part of home...schooling, socializing with peers or playing video games given that outdoor activities may be restricted due to lockdowns. This infographic provides important information on what you need to know in regard to excessive screen use and gaming during the COVID-19 pandemic. It also stresses the importance of recognizing the signs of excessive screen use and taking action to ensure online safety for young people during this pandemic.
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Health sector reforms not only require attention to specific components but also a supportive environment. In low- and middle-income countries (LMICs), there is still much to be done on ensuring that people receive prioritized healthcare services. Despite LIMCs spending an average of 6% of their GDP... on health, there have been minimal impacts compared to high-income countries. Health sector reform is a gradual process with complex systems; hence, the need for a vision and long-term strategies to realize the desired goals. In this chapter, we present our proposal to advance universal health coverage (UHC) in LMICs. Overall, our main aim is to provide strategies for achieving actual UHC and not aspirational UHC in LMICs by strengthening health systems, improving health insurance coverage and financial protection, and reducing disparities in healthcare coverage especially on prioritized health problems, and enhancing a primary care-oriented healthcare system.
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Monitoring financial protection and utilization of health services in Mongolia 2009-2018 is based on national representative household socioeconomic surveys. The study finds that between 2009 and 2018, despite ambitious health reforms, the incidence of catastrophic health spending and impoverishing ...spending at the relative poverty line have increased. These increases were mainly driven by out-of-pocket spending on medicines and inpatient care. In the same period, inequity in access to and utilization of health services remained constant among population groups. Evidence suggests health financing policies need to be further strengthened to make progress towards universal health coverage. Continuous tracking of out-of-pocket payments and service utilization to inform policymaking is needed.
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Childhood immunisation is one of the most cost-effective health interventions. However, despite its known value, global access to vaccines remains far from complete. Although supply-side constraints lead to inadequate vaccine coverage in many health systems, there is no comprehensive analysis of the... funding for immunisation. We aimed to fill this gap by generating estimates of funding for immunisation disaggregated by the source of funding and the type of activities in order to highlight the funding landscape for immunisation and inform policy making.
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This important research emphasises that many governments are not meeting spending goals, and in many countries the financing gaps are so great that, even if they met the spending goals, expenditure would still fall short of what is needed (expenditure would cover only 64% of estimated future funding... requirements, leaving a gap of around a third of the total US$7·9 billion needed). Quantification of the gaps in domestic spending encourages us to consider whether the amount of funding is appropriate and how much more could and should be done to fight HIV/AIDS. The important question of how governments make allocation choices also comes to the forefront. The aim of this Comment is to draw attention to the many dimensions that contribute to the complexity of these decisions on health resource allocation.
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The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed,
especially during public health emergencies. Development assistance is an important source of health financing in
many low-income countries, yet little is known about how much of this funding was di...sbursed for COVID-19. We
aimed to put development assistance for health for COVID-19 in the context of broader trends in global health
financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020.
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The majority of developing countries will fail to achieve their targets for Universal Health Coverage (UHC)1 and the health- and poverty-related Sustainable Development Goals (SDGs) unless they take urgent steps to strengthen their health financing. Just over a decade out from the SDG deadline of 20...30, 3.6 billion people do not receive the most essential health services they need, and 100 million are pushed into poverty from paying out-of-pocket for health services. The evidence is strong that progress towards UHC, core to SDG 3, will spur inclusive and sustainable economic growth, yet this will not happen unless countries achieve high-performance health financing, defined here as funding levels that are adequate and sustainable; pooling that is sufficient to spread the financial risks of ill-health; and spending that is efficient and equitable to assure desired levels of health service coverage, quality, and financial protection for all people— with resilience and sustainability.
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The 2021 Global monitoring report on financial protection in health shows that before the COVID-19 pandemic, the world was off-track to reduce financial hardship due to health expenditures because trends in catastrophic health spending were going in the wrong direction and the number of people incur...ring impoverishing health spending remained unacceptably high (Chapter 1). Chapter 2 summarizes emerging evidence on the consequence of the pandemic and the related macroeconomic and fiscal crisis that points to the likely worsening of financial protection for households, particularly as a result of declining income and consumption, along with rising poverty and inequality
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Member States of the Region have initiated processes to strengthen leadership and governance for mental health. Several countries have developed and implemented mental health plans, strategies and legislations. Direct spending on mental health needs to be increased throughout the Region through the ...health sector as well as other relevant sectors.
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The world is off track to make significant progress towards universal health coverage (UHC) (SDG target 3.8) by 2030 as improvements to health services coverage have stagnated since 2015, and the proportion of the population that faced catastrophic levels of out-of-pocket (OOP) health spending has i...ncreased.
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Donor financing to low- and middle-income countries for reproductive, maternal, newborn, and child health increased substantially from 2008 to 2013. However, increased spending by donors might not improve outcomes, if funds are delivered in ways that undermine countries’ public financial managemen...t systems and incur high transaction costs for project implementation
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Member States of the Region have initiated processes to strengthen leadership and governance for mental health. Several countries have developed and implemented mental health plans, strategies and legislations. Direct spending on mental health needs to be increased throughout the Region through the ...health sector as well as other relevant sectors.
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Introduction
In 2017, development assistance for health (DAH) comprised 5.3% of total health spending in lowincome countries. Despite the key role DAH plays in global health-spending, little is known about the characteristics of assistance that may be associated with committed assistance that is a...ctually disbursed. In this analysis, we examine associations between these characteristics and disbursement of committed assistance.
Methods
We extracted data from the Creditor Reporting System of the Organization for Economic Co-operation and Development, Institute for Health Metrics and Evaluation, and the WHO National Health Accounts database. Factors examined were off-budget assistance, administrative assistance, publicly sourced assistance and assistance to health systems strengthening. Recipient-country characteristics examined were perceived level of corruption, civil fragility and gross domestic product per capita (GDPpc). We used linear regression methods for panel of data to assess the proportion of committed aid that was disbursed for a given country-year, for each data source.
Results
Factors that were associated with a higher disbursement rates include off-budget aid (p<0.001), lower administrative expenses (p<0.01), lower perceived corruption in recipient country (p<0.001), lower fragility in recipient country (p<0.05) and higher GDPpc (p<0.05).
Conclusion
Substantial gaps remain between commitments and disbursements. Characteristics of assistance (administrative, publicly sourced) and indicators of government transparency and fragility are also important drivers associated with disbursement of DAH. There remains a continued need for better aid flow reporting standards and clarity around aid types for better measurement of DAH.
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Tracking development assistance for health for low- and middle-income countries gives policy makers information about spending patterns and potential improvements in resource allocation. We tracked the flows of development assistance and explored the relationship between national income, disease bur...den, and assistance
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