A Framework Policy Analysis Of National Health Insurance Policymaking In Sub Saharan Africa
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A Framework Policy Analysis Of National Health Insurance Policymaking In Sub Saharan Africa
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Author : Amy Roll
language : en
Publisher:
Release Date : 2019
A Framework Policy Analysis Of National Health Insurance Policymaking In Sub Saharan Africa written by Amy Roll and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019 with categories.
A large proportion of the world's low- and middle-income population reside in sub-Saharan Africa where out-of-pocket payment systems have made healthcare inaccessible and unaffordable in many places. Universal health coverage (UHC) means that all people have access to high-quality health services and are protected against financial-risk while using those health services. Financing approaches to UHC include varieties of health insurance and tax-funded systems. National Health Insurance (NHI) is one such financing mechanism established by a national government with the goal of covering all or almost all citizens of the country. This descriptive, qualitative study used policy sources from four countries, Ghana, Kenya, Zambia, and South Africa, that are implementing or transitioning to an NHI scheme. The research goal was to understand how the introduction of an NHI scheme might affect national health policy making and to use the results to inform South Africa and other countries in sub-Saharan Africa that are introducing NHI. A conceptual framework of 16 NHI policy domains was developed. Data were extracted from policy sources and indexed according to the different policy domains. Results revealed that following passage of legislation, NHI bodies were making policy decisions in order to operationalize and manage implementation of the NHI. We found variation in the four countries in terms of the types of policies developed and the decision-making authority around those policies. A key finding was that that Ministries of Health retained decision-making power over the NHIs through regulations and appointment of board members. However, NHIs were often delegated policymaking authority in key areas including financing mechanisms, provider payments, member payments, benefit schemes, accreditation, and relationships with private health insurance schemes. This study helps fill an important gap in research concerning policymaking responsibility in a health system after an NHI is adopted. Lessons from the focus countries can inform the transition to an NHI scheme including introduction of policies and delegation of decision-making authority in countries in sub-Saharan Africa considering NHI as a UHC financing mechanism.
Social Health Insurance
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Author : Charles Normand
language : en
Publisher:
Release Date : 1994
Social Health Insurance written by Charles Normand and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1994 with Medical categories.
Universal Health Coverage For Inclusive And Sustainable Development
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Author : Akiko Maeda
language : en
Publisher: World Bank Publications
Release Date : 2014-07-10
Universal Health Coverage For Inclusive And Sustainable Development written by Akiko Maeda and has been published by World Bank Publications this book supported file pdf, txt, epub, kindle and other format this book has been release on 2014-07-10 with Business & Economics categories.
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.
Ghana National Health Insurance Scheme
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Author : Huihui Wang
language : en
Publisher: World Bank Publications
Release Date : 2017-08-14
Ghana National Health Insurance Scheme written by Huihui Wang and has been published by World Bank Publications this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-08-14 with Business & Economics categories.
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.
What S In What S Out
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Author : Amanda Glassman
language : en
Publisher: Brookings Institution Press
Release Date : 2017-10-10
What S In What S Out written by Amanda Glassman and has been published by Brookings Institution Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-10-10 with Medical categories.
Vaccinate children against deadly pneumococcal disease, or pay for cardiac patients to undergo lifesaving surgery? Cover the costs of dialysis for kidney patients, or channel the money toward preventing the conditions that lead to renal failure in the first place? Policymakers dealing with the realities of limited health care budgets face tough decisions like these regularly. And for many individuals, their personal health care choices are equally stark: paying for medical treatment could push them into poverty. Many low- and middle-income countries now aspire to universal health coverage, where governments ensure that all people have access to the quality health services they need without risk of impoverishment. But for universal health coverage to become reality, the health services offered must be consistent with the funds available—and this implies tough everyday choices for policymakers that could be the difference between life and death for those affected by any given condition or disease. The situation is particularly acute in low- and middle income countries where public spending on health is on the rise but still extremely low, and where demand for expanded services is growing rapidly. What’s In, What’s Out: Designing Benefits for Universal Health Coverage argues that the creation of an explicit health benefits plan—a defined list of services that are and are not available—is an essential element in creating a sustainable system of universal health coverage. With contributions from leading health economists and policy experts, the book considers the many dimensions of governance, institutions, methods, political economy, and ethics that are needed to decide what’s in and what’s out in a way that is fair, evidence-based, and sustainable over time.
Performance Based Financing Toolkit
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Author : György Bèla Fritsche
language : en
Publisher: World Bank Publications
Release Date : 2014-02-27
Performance Based Financing Toolkit written by György Bèla Fritsche and has been published by World Bank Publications this book supported file pdf, txt, epub, kindle and other format this book has been release on 2014-02-27 with Business & Economics categories.
Performance-based financing (PBF) is a comprehensive health systems approach that is expanding in regions around the world. Based on first-hand experience of PBF pioneers, this toolkit provides the state-of-art knowledge, methods, and tools for setting up an effective PBF approach in lower-and middle income settings.
Implementation Research In Health
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Author : David H. Peters
language : en
Publisher: World Health Organization
Release Date : 2013
Implementation Research In Health written by David H. Peters and has been published by World Health Organization this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013 with Medical categories.
Interest in implementation research is growing, largely in recognition of the contribution it can make to maximizing the beneficial impact of health interventions. As a relatively new and, until recently, rather neglected field within the health sector, implementation research is something of an unknown quantity for many. There is therefore a need for greater clarity about what exactly implementation research is, and what it can offer. This Guide is designed to provide that clarity. Intended to support those conducting implementation research, those with responsibility for implementing programs, and those who have an interest in both, the Guide provides an introduction to basic implementation research concepts and language, briefly outlines what it involves, and describes the many opportunities that it presents. The main aim of the Guide is to boost implementation research capacity as well as demand for implementation research that is aligned with need, and that is of particular relevance to health systems in low- and middle-income countries (LMICs). Research on implementation requires the engagement of diverse stakeholders and multiple disciplines in order to address the complex implementation challenges they face. For this reason, the Guide is intended for a variety of actors who contribute to and/or are impacted by implementation research. This includes the decision-makers responsible for designing policies and managing programs whose decisions shape implementation and scale-up processes, as well as the practitioners and front-line workers who ultimately implement these decisions along with researchers from different disciplines who bring expertise in systematically collecting and analyzing information to inform implementation questions. The opening chapters (1-4) make the case for why implementation research is important to decision-making. They offer a workable definition of implementation research and illustrate the relevance of research to problems that are often considered to be simply administrative and provide examples of how such problems can be framed as implementation research questions. The early chapters also deal with the conduct of implementation research, emphasizing the importance of collaboration and discussing the role of implementers in the planning and designing of studies, the collection and analysis of data, as well as in the dissemination and use of results. The second half of the Guide (5-7) detail the various methods and study designs that can be used to carry out implementation research, and, using examples, illustrates the application of quantitative, qualitative, and mixed-method designs to answer complex questions related to implementation and scale-up. It offers guidance on conceptualizing an implementation research study from the identification of the problem, development of research questions, identification of implementation outcomes and variables, as well as the selection of the study design and methods while also addressing important questions of rigor.
Understanding The Policymaking Process In Developing Countries
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Author : William Ascher
language : en
Publisher: Cambridge University Press
Release Date : 2017-11-16
Understanding The Policymaking Process In Developing Countries written by William Ascher and has been published by Cambridge University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-11-16 with Business & Economics categories.
This book provides comprehensive, systematic, multi-disciplinary guidance to diagnose and improve policy processes in developing countries of all regions.
Implementing Health Financing Reform
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Author : Joseph Kutzin
language : en
Publisher: Observatory Studies
Release Date : 2010
Implementing Health Financing Reform written by Joseph Kutzin and has been published by Observatory Studies this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010 with Medical categories.
Analyses the experience with the financing reforms implemented by the countries of Central Europe, Eastern Europe, the Cauxasus and Central Asia.
Policy Analysis In National Security Affairs
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Author : Richard L. Kugler
language : en
Publisher: Government Printing Office
Release Date : 2006
Policy Analysis In National Security Affairs written by Richard L. Kugler and has been published by Government Printing Office this book supported file pdf, txt, epub, kindle and other format this book has been release on 2006 with Political Science categories.
This book addresses how to conduct policy analysis in the field of national security, including foreign policy and defense strategy. It is a philosophical and conceptual book for helphing people think deeply, clearly, and insightfully about complex policy issues. This books reflects the viewpoint that the best policies normally come from efforts to synthesize competing camps by drawing upon the best of each of them and by combining them to forge a sensible whole. While this book is written to be reader-friendly, it aspires to in-depth scholarship.