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1
Health Care Financing in Nepal
recommended
Value in Health Regional Issues 4 C (2014) 37-40
Guidelines for the Implementation of the SHA 2011 Framework for Accounting Health Care Financing
Organisation for Economic Co-operation and Development (OECD) and World Health Organization (WHO)
Organisation for Economic Co-operation and Development (OECD) and World Health Organization (WHO)
(2014)
CC
The accounting framework for health care financing is a key component of A System of Health Acco
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unts 2011, published by OECD, Eurostat and WHO in October 2011.1 The framework makes health accounts more adaptable to rapidly evolving health financing systems, further enhances crosscountry comparability of health expenditures and financing data, and ultimately improves the information base for the analytical use of national health accounts (NHAs). It is hoped that SHA 2011 – including its financing framework – will make health accounts a more useful assessment and monitoring tool for health systems and health expenditure in the economy as a whole.
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A corruption event in 2009 led to changes in how donors supported the Zambian health system. Donor funding was withdrawn from the district basket mechanism, originally designed to pool donor and government
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financing for primary care. The withdrawal of these funds from the pooled financing mechanism raised questions from Government and donors regarding the impact on primary care financing during this period of aid volatility.
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Background and aims: Current coverage of mental health care in low- and middle-income countries is limited, not only in terms of access to services but also in terms of financial protection of perso
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ns in need of care and treatment. This is especially pertinent considering the established relationship between mental illness and poverty and the need to ensure the financial risk protection of persons with mental disorders and their families as part of country's efforts to attain universal health coverage. This study set out to review the health and socio-economic contexts of Nigeria as well as to generate strategies for sustainable mental health financing that will be feasible, within the specific context of the country.
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The Millennium Development Goals (MDGs) showed
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This comprehensive HPFM report thoroughly explores Kenya’s health financing landscape. It provides an in-depth analysis of the current state of affairs and sheds light on required strategic change
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s in health financing. The report points out the need to improve public financial management within the health sector, for more efficient financial systems. It focuses on better resourceraising and utilization mechanisms. The matrix highlights the need for consolidation of fragmented health financing arrangements, for a more efficient health system. It also emphasizes the need for enhancing strategic purchasing of health services, to improve the overall efficiency and quality of care. Additionally, the report stresses the critical
role of leveraging data and information systems for more evidence-based informed decision-making. These recommendations are crucial for advancing Kenya’s health financing system and moving closer to the UHC goal.
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It focuses on nine major priority areas, namely: Leadership and Governance for Health; Health Service Delivery; Human Resources for Health;
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Health Financing; Health Information Systems; Health Technologies; Community Ownership and Participation; Partnerships for Health Development; and Research for Health.
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Measures to strengthen primary health-care systems in low- and middle-income countries
Etienne V Langlois, Andrew Mc Kenzie, Helen Schneider & Jeffrey W Mecaskey
World Health Organization
(2020)
C_WHO
Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary
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health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primary health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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This thematic brief accompanies the Working for Health 2022–2030 Action Plan, providing a rationale for the related actions of the Working for Health progression model (see Annex). This brief ai
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ms to inform Member States, non-state actors and other stakeholders vested in implementing the Action Plan to consider the context of planning and financing for the health and care workforce, including the relevant policy landscape, key challenges and future directions.
In doing so, it provides an expanded exploration of the themes beyond what is provided in the Action Plan Itself, and reflects the topical issues and considerations that shaped its design, including those issues identified in the World Health Assembly Resolution WHA74.14 to protect, safeguard and invest in the health and care workforce. The importance of these themes was again emphasized at the Seventy-fifth WHA, when Resolution WHA75.17: Human resources for health, was co-sponsored by over 100 Member States, calling for the adoption and implementation of the Working for Health 2022–2030 Action Plan and utilization of the related Global Health and Care Worker Compact.
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Following the 2014 Euromaidan Revolution, Ukraine embarked on a national reform program to reduce widespread corruption within government. In the health sector, the government introduced several complementary reforms that aimed to improve the
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health outcomes of Ukrainian citizens, but designed in such a way that they would also reduce corruption. The reforms included reconfiguring primary care financing and essential medicines reimbursement under the newly formed National Health Service of Ukraine; raising the remuneration of health professionals; introducing a transparent, merit-based, process for medical university admissions; and initiating development of an eHealth digital records system.
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A two-week mission was conducted by WASH and quality UHC technical experts from WHO headquarters and supported by the WHO Ethiopia Country Office (WASH and health systems teams) in July 2016, to understand how change in WASH services and quality imp
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rovements have been implemented in Ethiopia at national, sub-national and facility levels; to document existing activities; and through the “joint lens” of quality UHC and WASH, to identify and seek to address key bottlenecks in specific areas including leadership, policy/financing, monitoring and evaluation, evidence application and facility improvements. Ethiopia has implemented a number of innovative and successful interventions.
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Background: The amount of resources, particularly prepaid resources, available for health can affect access to health care and
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health outcomes. Although health spending tends to increase with economic development, tremendous variation exists among health financing systems. Estimates of future spending can be beneficial for policy makers and planners, and can identify financing gaps. In this study, we estimate future gross domestic product (GDP), all-sector government spending, and health spending disaggregated by source, and we compare expected future spending to potential future spending. Methods: We extracted GDP, government spending in 184 countries from 1980–2015, and health spend data from 1995–2014. We used a series of ensemble models to estimate future GDP, all-sector government spending, development assistance for health, and government, out-of-pocket, and prepaid private health spending through 2040. We used frontier analyses to identify patterns exhibited by the countries that dedicate the most funding to health, and used these frontiers to estimate potential health spending for each low-income or middle-income country. All estimates are inflation and purchasing power adjusted.
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The biennium 2020–2021 has revealed more clearly than ever the need for a strong, credible and independent WHO on the world stage. The coronavirus disease (COVID-19) crisis has demonstrated the fundamental importance of the global detection, response and coordination roles that only WHO can play a
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cross all Member States. At the same time, the challenges to global health systems and the pressure to ensure equal access to quality health care and the best health possible for all have mounted. The triple billion targets of the Thirteenth General Programme of Work, 2019–2023 remain relevant. The work of WHO in all contexts has never been more critical. However, as several Member States have pointed out, the COVID-19 pandemic has highlighted the discrepancy between what the world expects of WHO and what it is able to deliver with the resources/capacity it has at its disposal. Sustainable financing is thus a key challenge for the Organization that must be addressed as part of the lessons learned from the current COVID-19 pandemic. Member States discussed this issue in detail during the Seventy-third World Health Assembly and their conclusions were reflected in resolution WHA73.1 (2020). The topic of adequate funding is not new. However, discussions on the matter have, to date, remained rather abstract. Building on previous discussions and taking account of lessons learned, the WHO Secretariat would like to initiate a process aimed at finding a concrete solution to the sustainable financing of WHO. This document proposes a process through which to arrive at such a decision, including the key stages and timeline.
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Ukrainian decentralization reform has increased and democratized local government responsibility for health care at the level of local government closest to communities and has increased regional an
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d local government responsibility for public health. Decentralization affects health system reform in three important areas: health financing, individual health services and public health.
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