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Sustainability And Risk Of Community Based Health Insurance In Ethiopia
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Book Synopsis Health Insurance Handbook by : Hong Wang
Download or read book Health Insurance Handbook written by Hong Wang and published by World Bank Publications. This book was released on 2012-01-18 with total page 141 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many countries that subscribe to the Millennium Development Goals (MDGs) have committed to ensuring access to basic health services for their citizens. Health insurance has been considered and promoted as the major financing mechanism to improve access to health services, as well to provide financial risk protection.
Book Synopsis The Road to Universal Health Coverage by : Jeffrey L. Sturchio
Download or read book The Road to Universal Health Coverage written by Jeffrey L. Sturchio and published by JHU Press. This book was released on 2019-01-15 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt: Srinath Reddy, Yasmine Rouai, Jeffrey L. Sturchio, Cicely Thomas, Tana Wuliji, Snow Yang, Pascal Zurn
Book Synopsis Paying for Health Care by : Adam Wagstaff
Download or read book Paying for Health Care written by Adam Wagstaff and published by World Bank Publications. This book was released on with total page 56 pages. Available in PDF, EPUB and Kindle. Book excerpt: Egalitarian concepts of fairness in health care payments (requiring that payments be linked to ability to pay) are compared with minimum standards approaches (requiring that payments not exceed a prescribed share of prepayment income or not drive households into poverty). The arguments and methods are illustrated using data and out-of-pocket health spending in Vietnam in 1993 and 1998.
Book Synopsis Ghana National Health Insurance Scheme by : Huihui Wang
Download or read book Ghana National Health Insurance Scheme written by Huihui Wang and published by World Bank Publications. This book was released on 2017-08-14 with total page 101 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ghana National Health Insurance Scheme (NHIS) was established in 2003 as a major vehicle to achieve the country’s commitment of Universal Health Coverage. The government has earmarked value-added tax to finance NHIS in addition to deduction from Social Security Trust (SSNIT) and premium payment. However, the scheme has been running under deficit since 2009 due to expansion of coverage, increase in service use, and surge in expenditure. Consequently, Ghana National Health Insurance Authority (NHIA) had to reduce investment fund, borrow loans and delay claims reimbursement to providers in order to fill the gap. This study aimed to provide policy recommendations on how to improve efficiency and financial sustainability of NHIS based on health sector expenditure and NHIS claims expenditure review. The analysis started with an overall health sector expenditure review, zoomed into NHIS claims expenditure in Volta region as a miniature for the scheme, and followed by identifictation of factors affecting level and efficiency of expenditure. This study is the first attempt to undertake systematic in-depth analysis of NHIS claims expenditure. Based on the study findings, it is recommended that NHIS establish a stronger expenditure control system in place for long-term sustainability. The majority of NHIS claims expenditure is for outpatient consultations, district hospitals and above, certain member groups (e.g., informal group, members with more than five visits in a year). These distribution patterns are closely related to NHIS design features that encourages expenditure surge. For example, year-round open registration boosted adverse selection during enrollment, essentially fee-for-service provider mechanisms incentivized oversupply but not better quality and cost-effectiveness, and zero patient cost-sharing by patients reduced prudence in seeking care and caused overuse. Moreover, NHIA is not equipped to control expenditure or monitor effect of cost-containment policies. The claims processing system is mostly manual and does not collect information on service delivery and results. No mechanisms exist to monitor and correct providers’ abonormal behaviors, as well as engage NHIS members for and engaging members for information verification, case management and prevention.
Book Synopsis Universal Health Coverage for Inclusive and Sustainable Development by : Akiko Maeda
Download or read book Universal Health Coverage for Inclusive and Sustainable Development written by Akiko Maeda and published by World Bank Publications. This book was released on 2014-07-10 with total page 75 pages. Available in PDF, EPUB and Kindle. Book excerpt: The book synthesizes the experiences from Bangladesh, Brazil, France, Ethiopia, Ghana, Indonesia, Japan, Peru, Thailand, Turkey and Vietnam in implementing policies to achieve and sustain Universal Health Coverage. The study focuses on three aspects of UHC reforms: political economy, health financing, and human resources for health.
Author :National Academies of Sciences, Engineering, and Medicine Publisher :National Academies Press ISBN 13 :0309477891 Total Pages :399 pages Book Rating :4.3/5 (94 download)
Book Synopsis Crossing the Global Quality Chasm by : National Academies of Sciences, Engineering, and Medicine
Download or read book Crossing the Global Quality Chasm written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2019-01-27 with total page 399 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.
Book Synopsis Social Reinsurance by : David M. Dror
Download or read book Social Reinsurance written by David M. Dror and published by World Bank Publications. This book was released on 2002-01-01 with total page 548 pages. Available in PDF, EPUB and Kindle. Book excerpt: Annotation This volume views community-based microinsurance as an incremental first step to improved financial protection and better access to health services for the poor. While community-based financing can be structured in various ways, this volume focuses on reinsurance as a mechanism for improving micro-level health insurance units. It outlines strategies and policies that can be applied by countries and donors to improve access to health care services.
Book Synopsis Health Microinsurance Schemes, 1 by : International Labour Office
Download or read book Health Microinsurance Schemes, 1 written by International Labour Office and published by . This book was released on 2007 with total page 164 pages. Available in PDF, EPUB and Kindle. Book excerpt: This two-volume guide provides assitance for a process of monitoring and evaluating the microinsurance schemes. It provides managers a assisting tool during such process for their microinsurance schemes. It also allows stakeholders - both technical and financial - to evaluate the vialability and performance of such schemes.
Book Synopsis Health Financing Revisited by : Pablo Enrique Gottret
Download or read book Health Financing Revisited written by Pablo Enrique Gottret and published by World Bank Publications. This book was released on 2006-01-01 with total page 340 pages. Available in PDF, EPUB and Kindle. Book excerpt: This overview of health financing tools, policies and trends--with a particular focus on challenges facing developing countries--provides the basis for effective policy-making. Analyzing the current global environment, the book discusses health financing goals in the context of both the underlying health, demographic, social, economic, political and demographic analytics as well as the institutional realities faced by developing countries, and assesses policy options in the context of global evidence, the international aid architecture, cross-sectoral interactions, and countries' macroeconomic frameworks and overall development plans.
Book Synopsis Government-Sponsored Health Insurance in India by : Gerard La Forgia
Download or read book Government-Sponsored Health Insurance in India written by Gerard La Forgia and published by World Bank Publications. This book was released on 2012-09-14 with total page 446 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book presents the first comprehensive review of all major government-supported health insurance schemes in India and their potential for contributing to the achievement of universal coverage in India are discussed.
Book Synopsis Disease Control Priorities, Third Edition (Volume 2) by : Robert Black
Download or read book Disease Control Priorities, Third Edition (Volume 2) written by Robert Black and published by World Bank Publications. This book was released on 2016-04-11 with total page 419 pages. Available in PDF, EPUB and Kindle. Book excerpt: The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.
Book Synopsis Financing Micro Health Insurance: Theory, Methods And Evidence by : David M Dror
Download or read book Financing Micro Health Insurance: Theory, Methods And Evidence written by David M Dror and published by World Scientific. This book was released on 2018-12-27 with total page 552 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare for all at affordable prices is still a major but universally elusive goal. Everyone spends money on healthcare, and it is the most impoverishing consumption item. Thus, most governments (and the United Nations) promote Universal Health Coverage — each country's unique blend of tools for healthcare financing, including taxes, subsidies and market controls.Most people in low- and middle-income countries (LMICs) have no health insurance of any kind. And most LMIC governments lack the political will, information, or resources to require their citizens to buy health insurance themselves or to subsidize insurance for all who cannot afford the price. This book deals with financing voluntary and contributory health insurance for resource-poor and rural groups in LMICs.This book addresses three issues. The first is how to catalyse demand for health insurance and develop insurance literacy among the largely illiterate and innumerate target population, using training programs to build an enabling consensus, allowing locals to create and administer such schemes. The second involves the process of developing simplified methods for risk assessment, which can help to underwrite risks, price the micro health insurance schemes, and ensure proper implementation. The third issue is formulating a compelling business case which would make this health insurance affordable, financially sustainable, and operationally scalable.This book develops insurance education and financial literacy for students of economics, business administration, insurance, development studies, and social work to prepare them for practical work as implementers, policymakers, or evaluators. A supplementary section for teachers and students includes comprehension questions.
Book Synopsis Universal Health Coverage for Inclusive and Sustainable Development by : Akiko Maeda
Download or read book Universal Health Coverage for Inclusive and Sustainable Development written by Akiko Maeda and published by World Bank Publications. This book was released on 2014-07-03 with total page 75 pages. Available in PDF, EPUB and Kindle. Book excerpt: The goals of universal health coverage (UHC) are to ensure that all people can access quality health services, to safeguard all people from public health risks, and to protect all people from impoverishment due to illness, whether from out-of-pocket payments for health care or loss of income when a household member falls sick. Countries as diverse as Brazil, France, Japan, Thailand, and Turkey have shown how UHC can serve as vital mechanisms for improving the health and welfare of their citizens, and lay the foundation for economic growth and competitiveness grounded in the principles of equity and sustainability. Ensuring universal access to affordable, quality health services will be an important contribution to ending extreme poverty by 2030 and boosting shared prosperity in low-income and middle-income countries (LMICs), where most of the world's poor live. The book synthesizes the experiences from 11 countries – Bangladesh, Brazil, France, Ethiopia, Ghana, Indonesia, Japan, Peru, Thailand, Turkey and Vietnam – in implementing policies and strategies to achieve and sustain UHC. These countries represent diverse geographic and economic conditions, but all have committed to UHC as a key national aspiration and are approaching it in different ways. The study examined the UHC policies for each country around three common themes: (i) the political economy and policy process for adopting, achieving, and sustaining UHC; (ii) health financing policies to enhance health coverage; and (iii) human resources for health policies for achieving UHC. The findings from these country studies are intended to provide lessons that can be used by countries aspiring to adopt, achieve, and sustain UHC. Although the path to UHC is specific to each country, countries can benefit from the experiences of others in learning about different approaches and avoiding potential risks.
Book Synopsis Ethiopia Health Extension Program by : Huihui Wang
Download or read book Ethiopia Health Extension Program written by Huihui Wang and published by World Bank Publications. This book was released on 2016-04-25 with total page 121 pages. Available in PDF, EPUB and Kindle. Book excerpt: As a low-income country, Ethiopia has made impressive progress in improving health outcomes. This report examines how Ethiopia s Health Extension Program (HEP) has contributed to the country s move toward Univeral Health Coverage (UHC), and to shed light on how other countries may learn from Ethiopia s experiences of HEP when designing their own path to UHC. HEP is one of the government s UHC strategies introduced in a context of limited resources and low coverage of essential health services. The key aspects of the program include the capacity building and mobilization of more than 30, 000 Health Extension Workers (HEWs) targeting more than 12 million model families, and the mobilization of health development army ? to support the community-based health system. Using the HEP-UHC conceptual model and data from Demographic and Health Surveys, the study examines how the HEP has contributed to the country s move toward UHC. During the period that the HEP has been implemented, the country has experienced significant improvements in many dimensions: in terms of socioeconomic, psychological, behavioral, and biological dimensions of the beneficiaries; and in terms of the coverage of health care services. The study finds an accelerated rate of improvements among the rural, less-educated, and the poor population, which is leading to an overall reduction in equity gaps and improvements in the equity indicators including the concentration indices - that suggest a more equitable distribution of resources and health outcomes. The HEP in Ethiopia has demonstrated that an institutionalized community approach is effective in helping a country make progress toward UHC. The elements of success in the HEP include the emphasis on community mobilization which identifies community priorities, engages and empowers community members, and supports their ability to solve local problems. The other aspect of HEP is the emphasis on institutionalization of the activities, which addresses the sustainability of community programs through high level of political commitment, and effective coordination of national policies and leveraging of support from partners. These findings may offer useful lessons for other low income countries facing similar challenges in developing and implementing a sustainable UHC strategy.
Book Synopsis Health Insurance in Developing Countries by : Aviva Ron
Download or read book Health Insurance in Developing Countries written by Aviva Ron and published by International Labour Organization. This book was released on 1990 with total page 248 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume describes the evolution of the social security approach to health insurance, from the first initiatives in Europe to the adaptation of the concept in other parts of the world. It then focuses on benefits and financing, and on the inter-relationship between the social security system and government agencies, particularly those dealing with health.; A concise review of the mechanisms involved in both the delivery of health services and providing payment is followed by an analysis of current administrative issues. The second part contains country profiles of health care programmes in.
Book Synopsis Social Health Insurance for Developing Nations by : William C. Hsiao
Download or read book Social Health Insurance for Developing Nations written by William C. Hsiao and published by World Bank Publications. This book was released on 2007 with total page 196 pages. Available in PDF, EPUB and Kindle. Book excerpt: Specialist groups have often advised health ministers and other decision makers in developing countries on the use of social health insurance (SHI) as a way of mobilizing revenue for health, reforming health sector performance, and providing universal coverage. This book reviews the specific design and implementation challenges facing SHI in low- and middle-income countries and presents case studies on Ghana, Kenya, Philippines, Colombia, and Thailand.
Download or read book Money for Nothing written by Jishnu Das and published by World Bank Publications. This book was released on 2005 with total page 41 pages. Available in PDF, EPUB and Kindle. Book excerpt: The quality of medical care received by patients varies for two reasons: differences in doctors' competence or differences in doctors' incentives. Using medical vignettes, the authors evaluated competence for a sample of doctors in Delhi. One month later, they observed the same doctors in their practice. The authors find three patterns in the data. First, what doctors do is less than what they know they should do-doctors operate well inside their knowledge frontier. Second, competence and effort are complementary so that doctors who know more also do more. Third, the gap between what doctors do and what they know responds to incentives: doctors in the fee-for-service private sector are closer in practice to their knowledge frontier than those in the fixed-salary public sector. Under-qualified private sector doctors, even though they know less, provide better care on average than their better-qualified counterparts in the public sector. These results indicate that to improve medical services, at least for poor people, there should be greater emphasis on changing the incentives of public providers rather than increasing provider competence through training.
