Policy Note: Thailand Health Systems in Transition
By 2002, Universal Health Coverage was achieved through three public insurance schemes: the C...ivil Servant Medical Benefit Scheme (CSMBS) for civil servants and their dependents, Social Health Insurance (SHI) for formal sector employees, and the Universal Coverage Scheme (UCS) for the remainder of the population.
The establishment of these three schemes has changed the way health care is financed. A supply-led system, under which all Ministry of Public Health (MOPH) health facilities received an annual budget allocation from the MOPH, has now been completely replaced by a system in which the three public purchasers - separated through a purchaser-provider split - manage a demand-led system of financing.
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As countries aim to progress towards the Sustainable Development Goals (SDGs) and achieving universal health coverage, health inequities driven by ...racial discrimination and intersecting factors remain pervasive. Inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities are of concern globally; they are unjust, preventable and remediable.
Health systems themselves are important determinants of health and health equity. They can perpetuate health inequities by reflecting structural racism and discriminatory practices of wider society. For instance, systemic racism, implicit bias, misinformed clinical practice, or discrimination by health professionals contributes to health inequities. However, health systems can also be a leading force for tackling the inequities faced by populations experiencing racial discrimination.
Primary health care (PHC) is the essential strategy for reorientating health systems and societies to become healthier, equitable, effective and sustainable. In 2018, on the 40th anniversary of the Declaration of Alma-Ata, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) renewed the emphasis on PHC with their strategy,
WHO outlines 14 strategic and operational levers for policy-makers to strengthen PHC. Within each lever, there are multiple potential entry points for targeted actions to address racial discrimination, foster intercultural care, and reduce health inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities.
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The 2018 global health financing report presents health spending data for all WHO Member States between 2000 and 2016 based on the SHA 2011 methodology. It shows a transformation trajectory for the ...global spending on health, with increasing domestic public funding and declining external financing. This report also presents, for the first time, spending on primary health care and specific diseases and looks closely at the relationship between spending and service coverage
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An adequate amount of prepaid resources for health is important to ensure access to health services and for the pursuit of universal health ...lass="attribute-to-highlight medbox">coverage. Previous studies on global health financing have described the relationship between economic development and health financing. In this study, we further explore global health financing trends and examine how the sources of funds used, types of services purchased, and development assistance for health disbursed change with economic development. We also identify countries that deviate from the trends.
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For the first time WHO and UNICEF bring together the data on sanitation coverage and investment, and how it impacts health, economies, and the environment. Citing evidence on what works from success...ful countries and global guidelines, WHO and UNICEF call for strong government leadership and investment in resilient sanitation services. The report charts an ambitious way forward following the SDG6 global acceleration framework themes of governance, financing, capacity development, data and information, and innovation to achieve universal access to safe sanitation.
Read the full publication report here: https://www.who.int/publications/i/item/9789240014473.
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Lessons from three African Countries.
Achieving Health for All, and in particular universal health coverage (UHC), will not happen without fully f...unctioning basic water, sanitation and hygiene (WASH) services in all health care facilities. Such services are needed to provide quality care, ensure adherence to infection prevention and control (IPC) norms and standards and guarantee that facilities are able to provide environments that respect the dignity and human rights of all care seekers, especially mothers, newborns and children. WHO undertook a series of national situational analyses in three countries (Ghana, Ethiopia and Rwanda) to understand current barriers to change, accountability structures and measures to strengthen WASH in health care facilities and more broadly, the quality of health service delivery.
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Health systems the world over have embraced the value of community health workers (CHWs) in extending essential services to the community level, improving ...>health equity and progressing toward universal health coverage. Governments now have an opportunity to institutionalize CHW programs and professionalize this essential cadre of the health workforce. What will it take to ensure CHW programs, at scale, can achieve their full potential?
Fortunately, policymakers, funders, NGOs, and other partners seeking to design, revamp, or strengthen CHW programs have a suite of tools at their disposal. One of the longest-standing and most rigorously field-tested of these tools is the Community Health Worker Assessment and Improvement Matrix (CHW AIM), an assessment tool which can be used to design, evaluate and strengthen CHW programs.
You can find this assessment tool on this page here. The matrix is also downloaded on MEDBOX, but if you want, you can register for free and get the matrix. After that follow the points underneath.
accessed 23.07.2021
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This technical note provides tailored advice on further adjustments in health financing policy in the context of war based on principles of universal health ...x">coverage, solidarity and equity.
It summarizes international evidence and accounts for specific features of health financing reform in Ukraine.
The primary focus will be on short-term adjustments and to a lesser extent on medium-term measures.
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Providing financial protection to the population for larger health care expenses arising out of hospital-based care, has come forth as a crucial element in the attainment of Universal Health ...lass="attribute-to-highlight medbox">Coverage (UHC) through the recent health financing reforms of low-and middle-income countries (LMIC). Over the last decade, the state of Assam in India, in an effort to ensure equitable health care access, has formulated multiple health protection schemes at different points of time. This has resulted in several such schemas which have had their own objectives, designs, institutional setups, and governance mechanisms. Moreover, they have reportedly been operating in relative silos.
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This report presents key findings from a study carried out on the ‘Mainstreaming quality of care in empanelled hospitals under PMJAY’. It provides a detailed analysis of current coverage and perceptions of quality accreditation and certification... across PMJAY empanelled hospitals from three different states
(Haryana, Uttar Pradesh and Gujarat).
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Access to health workers who are fit for purpose, motivated and protected is a fundamental force of health service delivery and the achievement of universal ...x">health coverage and the health and health-related Sustainable Development Goals. Data and knowledge of the distribution, skill mix and future development needs of the health workforce can mean the difference between enabling or impeding health systems performance, inclusive economic growth and global health security preparedness and response
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Rebuilding Liberia’s health system is crucial for improving the country’s overall health outcomes. This annual report highlights key achievements, challenges,and lessons learned in implementi...ng programmes of technical cooperation with the Government of Liberia from January to December 2022. The key achievements are summarized under the thematic areas of Universal Health Coverage, Health Emergencies and Corporate and Enabling Support.
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Background
The ambitious development agenda of the Sustainable Development Goals (SDGs) requires substantial investments across several sectors, including for SDG 3 (healthy lives and wellbeing). No estimates of the additional resources needed to strengthen comprehensive ...highlight medbox">health service delivery towards the attainment of SDG 3 and universal health coverage in low-income and middle-income countries have been published.
Methods
We developed a framework for health systems strengthening, within which population-level and individual-level health service coverage is gradually scaled up over time. We developed projections for 67 low-income and middle-income countries from 2016 to 2030, representing 95% of the total population in low-income and middle-income countries. We considered four service delivery platforms, and modelled two scenarios with differing levels of ambition: a progress scenario, in which countries’ advancement towards global targets is constrained by their health system’s assumed absorptive capacity, and an ambitious scenario, in which most countries attain the global targets. We estimated the associated costs and health effects, including reduced prevalence of illness, lives saved, and increases in life expectancy. We projected available funding by country and year, taking into account economic growth and anticipated allocation towards the health sector, to allow for an analysis of affordability and financial sustainability.
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The evaluation covers the period January 2020 to August 2023. The geographical scope of the evaluation has involved the three levels of WHO (global, regional and country levels) and external key partners. The programmatic evaluation scope was concerned with assessing the SP-PHC in the following area...s/evaluation criteria: relevance, coherence, effectiveness, efficiency, added value, sustainability and equity, gender and human rights considerations. The evaluation did not assess the Universal Health Coverage Partnership (UHC-P) as it has its own separate governing body and reviews/evaluations, but instead considered how the SP-PHC had enhanced the value of the UHC-P and vice versa. The resilience and essential public health functions (REPHF) team and Systems’ Governance and Stewardship (SGS) were also not within the scope of this evaluation. However, these workstreams were considered in the wider conclusions and recommendations for the SP-PHC, as appropriate. Finally, the evaluation was focused on the SP-PHC; its scope did not include assessing the configuration and capacity of WHO’s departments and functions as they relate to UHC and health systems.
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Volunteer community health workers (CHWs) are a major strategy for increasing access to and coverage of basic health interventions. Our village ...an class="attribute-to-highlight medbox">health worker training course reviews the process of training and continuing education of CHWs as an important component of involving communities in their own health service delivery. Participants will be guided through the steps of planning training and continuing education activities for village volunteers.
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As the culminating volume in the DCP3 series, volume 9 will provide an overview of DCP3 findings and methods, a summary of messages and substantive lessons to be taken from DCP3, and a further discussion of cross-cutting and synthesizing topics across the first eight volumes. The introductory chapte...rs (1-3) in this volume take as their starting point the elements of the Essential Packages presented in the overview chapters of each volume. First, the chapter on intersectoral policy priorities for health includes fiscal and intersectoral policies and assembles a subset of the population policies and applies strict criteria for a low-income setting in order to propose a "highest-priority" essential package. Second, the chapter on packages of care and delivery platforms for universal health coverage (UHC) includes health sector interventions, primarily clinical and public health services, and uses the same approach to propose a highest priority package of interventions and policies that meet similar criteria, provides cost estimates, and describes a pathway to UHC.
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Rwanda’s fourth health sector strategic plan (HSSP4) is meant to provide the health sector with a Strategic Plan that will highlight its commitments and priorities for the coming 6 years. It will ...be fully integrated in the overall economic development plan of the Government. HSSP4 will fulfill the country’s commitment expressed in the national constitution, National Strategy for Transformation (NST) and the aspirations of the Health Sector Policy 2015. The strategies herein adhere to the Universal Health Coverage (UHC) principles towards realisation of the Sustainable Development Goals (SDGs). HSSP4 therefore lays a foundation for Vision 2050 (“The Rwanda We Want”), which will transform Rwanda into a high-income country by 2050. HSSP4 anticipates the epidemiological transition of the country, the increase in population and life expectancy and the expected increase of the health needs of the elderly, notably in Non Communicable Diseases (NCDs). HSSP4 also anticipates a decrease in external financial inflows, hence it is imperative to build secure / resilient health systems.
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Policy Note #3: Myanmar Health Systems in Transition Policy Notes Series
A network of basic health facilities has been established in each of the 330 townships, covering both rural and urban ar...eas. For the vast majority of Myanmar’s people, particularly the 70% who reside in rural areas, the township health system (THS) is the only government-funded source of preventive, promotive and curative services.
To achieve the national policy objective of progressing towards universal health coverage (UHC) through a primary health-care approach by 2030, the THS is critical to success. It is responsible for the bulk of health care delivery – particularly in rural areas – and is at the heart of national health development in Myanmar. However, if the THS is to be the backbone of health care provision, it currently suffers from a severe case of osteoporosis.
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The National Health Plan (NHP) aims to strengthen the country’s health system and pave the way towards Universal Health ...-highlight medbox">Coverage (UHC),choosing a path that is explicitly pro-poor. The main goal of NHP 2017-2021 is to extend access to a Basic Essential Package of Health Services (EPHS) to the entire population by 2020 while increasing financial protection.
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The National Health Plan (NHP) aims to strengthen the country’s health system and pave the way towards Universal Health ...-highlight medbox">Coverage (UHC),choosing a path that is explicitly pro-poor. The main goal of NHP 2017-2021 is to extend access to a Basic Essential Package of Health Services (EPHS) to the entire population by 2020 while increasing financial protection.
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