Suchergebnisse

The health sector of Papua New Guinea (PNG) has seen significant positive developments in recent years. Key indicators of health access and quality have, however, barely improved or have even declined (for example, maternal and child health) from 2006 to 2015. In 2016, PNG entered the accelerated transition phase from the vaccine alliance (Gavi) support. During this time, the government will be expected to increase its share of co-financing for vaccines, while Gavi gradually decreases their contribution. The government is simultaneously moving towards universal health coverage (UHC), along with many other developing countries, and has recently established fee free primary health care and subsidized secondary care. Given this backdrop, the health financing system assessment (HFSA), which evaluates the financing system and institutional sustainability, comes at an opportune time. The report begins by providing a comprehensive background, including an overview of PNG's economic situation, health demographics, health financing, human resources for health and the health system. It then analyses two areas critical to sustainable health financing: (i) PNG expenditure, with a focus on levels and sources of health expenditure, as well as resource allocation; and (ii) PNG reliance on donor resources, in particular, the global fund to fight aids, tuberculosis, and malaria (GFATM) and Gavi.

Provides an overview of Social impact bonds and describes related state and federal legislative efforts

Provides an overview of social impact bonds and describes state and federal legislative efforts. ; Office for State, Tribal, Local and Territorial Support Centers for Disease Control and Prevention

Abstract Background National health accounts provide useful information to understand the functioning of a health financing system. This article attempts to present a profile of the health system financing in Malawi using data from NHA. It specifically attempts to document the health financing situation in the country and proposes recommendations relevant for developing a comprehensive health financing policy and strategic plan. Methods Data from three rounds of national health accounts covering the Financial Years 1998/1999 to 2005/2006 was used to describe the flow of funds and their uses in the health system. Analysis was performed in line with the various NHA entities and health system financing functions. Results The total health expenditure per capita increased from US$ 12 in 1998/1999 to US$25 in 2005/2006. In 2005/2006 public, external and private contributions to the total health expenditure were 21.6%, 60.7% and 18.2% respectively. The country had not met the Abuja of allocating at least 15% of national budget on health. The percentage of total health expenditure from households' direct out-of-pocket payments decreased from 26% in 1998/99 to 12.1% in 2005/2006. Conclusion There is a need to increase government contribution to the total health expenditure to at least the levels of the Abuja Declaration of 15% of the national budget. In addition, the country urgently needs to develop and implement a prepaid health financing system within a comprehensive health financing policy and strategy with a view to assuring universal access to essential health services for all citizens.

We describe and compare the current status of mental health financing in Bulgaria, the Czech Republic, the Republic of Moldova, Poland, Romania, and Slovakia. In all six Eastern European countries, the state financed and state organized health system was transformed into a public health insurance scheme, though the implementation thereof differs from country to country. The country-specific information was obtained from a health policy questionnaire that includes both qualitative and quantitative information and covers health financing, purchasing, and provision of services. The compulsory health insurance secures that population has access to mental health services irrespective of their ability to pay. It seems that there is a problem to achieve such universal access in Bulgaria and the Republic of Moldova. The countries spend lower shares of GDP on total health expenditure and from this amount they spent lower shares of total health expenditure on mental health services than Western European countries. The political, social and economic transition in the 1990s initiated the process of mental health policy formulation, adoption of mental health legislation stressing human rights of patients, and a call for a pragmatic balance of community and hospital services. However, not all of this has been successfully realized. Mental health services are underfinanced. Insufficient financing of mental health services leads to absence of financial resources for mental health system development. There were poor investments in mental health services in the past, which led to the situation with a need of renovation of inpatient facilities, and need of improvement of the living conditions in the existing institutions. On the other hand, the national mental health systems need resources for strengthening weak community services. But such additional resources are not available.

This report identifies critical opportunities and constraints faced by the Kiribati health system as it makes progress towards Universal Health Coverage. Protecting the achievements that have been made over recent years, while continuing to improve a broader range of health outcomes, requires effective management of changes in financial and other institutional arrangements in the health sector. Despite notable improvements in recent decades, most population health outcomes in Kiribati do not compare well with other small countries in the Pacific. In many respects, this reflects the very difficult geographic, environmental and social determinants of health that the country faces. Strong collaboration across sectors is essential to implement the commitment to "health in all Government policies" agreed to in the Ambo Declaration in 2017. The Ministry of Health and Medical Services has taken impressive steps to improve its oversight of health sector performance. Continued attention to spending health dollars better is needed to achieve more efficient and quality outcomes from frontline service delivery, including for the outer islands.

Universal health coverage and healthy lives for all are now widely shared goals and central to the 2030 Agenda for Sustainable Development. Despite significant progress over the last decades, the world is still far from reaching these goals. Billions of people lack basic coverage of health services, live with unnecessary pain and disability, or have their lives cut short by avoidable or treatable conditions (Jamison et al., 2013; Murray et al., 2015; World Health Organization, World Bank, 2015). At the same time, millions are pushed into poverty simply because they need to use health services and must pay for them out-of-pocket. Fundamental to this situation is the way health interventions and the health system are financed. Numerous countries spend less than is required to ensure even the most essential health services, scarce funds are wasted, out-of-pocket payments remain high and disadvantaged groups get the least public resources despite having the greatest needs. It is clear that today's global and national arrangements for health financing need to change, and this is a multifaceted endeavour. It is about domestic financing of health systems, joint financing of global public goods and external financing of health systems. It is about resource mobilisation, pooling and effective use. And it is about economics, politics, public health, human rights, law and ethics. To get health financing right, these areas, functions and perspectives must all be integrated and aligned. ; publishedVersion

BACKGROUND: Achieving universal health coverage (UHC) requires health financing systems that provide prepaid pooled resources for key health services without placing undue financial stress on households. Understanding current and future trajectories of health financing is vital for progress towards UHC. We used historical health financing data for 188 countries from 1995 to 2015 to estimate future scenarios of health spending and pooled health spending through to 2040. METHODS: We extracted historical data on gross domestic product (GDP) and health spending for 188 countries from 1995 to 2015, and projected annual GDP, development assistance for health, and government, out-of-pocket, and prepaid private health spending from 2015 through to 2040 as a reference scenario. These estimates were generated using an ensemble of models that varied key demographic and socioeconomic determinants. We generated better and worse alternative future scenarios based on the global distribution of historic health spending growth rates. Last, we used stochastic frontier analysis to investigate the association between pooled health resources and UHC index, a measure of a country's UHC service coverage. Finally, we estimated future UHC performance and the number of people covered under the three future scenarios. FINDINGS: In the reference scenario, global health spending was projected to increase from US$10 trillion (95% uncertainty interval 10 trillion to 10 trillion) in 2015 to $20 trillion (18 trillion to 22 trillion) in 2040. Per capita health spending was projected to increase fastest in upper-middle-income countries, at 4·2% (3·4-5·1) per year, followed by lower-middle-income countries (4·0%, 3·6-4·5) and low-income countries (2·2%, 1·7-2·8). Despite global growth, per capita health spending was projected to range from only $40 (24-65) to $413 (263-668) in 2040 in low-income countries, and from $140 (90-200) to $1699 (711-3423) in lower-middle-income countries. Globally, the share of health spending covered by pooled resources ...

In 1948, the Communist Party finally defeated the Czechoslovak government over the next few years and adapted the Czechoslovak economy to the other countries of the USSR over the next few years. On the basis of this was also nationalized the health care, which passed to Semashko model of financing and organization of health care. Given that this model currently only works in Cuba, the aim of this article is to describe the Semashko model and its effect on the health of the population from historical data. At the same time, it is compared in several places with the current results of the Czech health service, which operates on the basis of the Bismarck model.

Vietnam's health system since Doi Moi -- Recent trends in Vietnam's health sector's performance -- Health insurance -- Reforming health insurance -- Service delivery -- Reforming service delivery -- Decentralization and government stewardship