This paper describes the health financing policies used today by African countries to expand health coverage. It identifies key health financing policies used by African countries and measures the existence of regional patterns in the use of these policies.
... See More + The paper does not attempt to identify best practices, nor does it try to measure the effective coverage of the policies or their impact. Rather, it aims to add value to the existing literature by providing a systematic portrayal of the health financing policies that are in place across the region. The study concludes with a discussion about the implications of its findings for planning next steps to advance universal health. The rest of the paper is organized as follows. Section 2 describes the conceptual framework and methodology used in the study. Section 3 describes the different paths chosen by African countries to expand health coverage. Sections 4 and 5 describe the two key instruments used in that journey: the universal basic package of health services and the subpopulation health coverage programs. Section 6 reviews in detail some of the technical instruments required for the successful implementation of these policies. Section 7 uses the findings of the paper to discuss the cost estimations of implementing a broader benefit package to advance universal health coverage. The paper concludes with a summary of the findings and their implications.
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The study estimates the tobacco price elasticity of demand for the population of Moldova, and the price elasticity for 10 income groups is obtained.
... See More + This appears to be the first tobacco price elasticity estimation for income groups in Moldova. The study undertakes an extended cost-benefit analysis to estimate the distributional effect of a rise in tobacco taxes on income distribution. As inputs, it uses tobacco price elasticity, mortality attributed to tobacco, and the medical costs of tobacco-attributed diseases.
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This brief covers the following topics : Viet Nam’s snapshot; Existing national plans and policies to achieve UHC; Key challenges on the way to UHC; Collaborative efforts to accelerate progress toward UHC; References and definitions
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This brief presents: Ghana snapshot; existing national plans and policies to achieve universal health coverage (UHC); key challenges on the way to UHC; and collaborative efforts to accelerate progress toward UHC.
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The journey of TFESSD is the journey of the Millennium Development Goal era, setting the stage for a new focus on sustainable development. In 1999, the Government of Norway established an umbrella trust fund to consolidate its various thematic investments across the World Bank and strengthen the emphasis of sustainability in development.
... See More + In particular, Norway was interested in linking environment more closely with social development and poverty. In 2002 Finland joined the fund, and the Trust Fund for Environmental and Socially Sustainable Development (TFESSD) as we know it was born. Seventeen years later, TFESSD has closed down, with a portfolio of 531 projects worth over US$145 million. Looking back, TFESSD’s journey has followed that of the Millennium Development Goal (MDG) era. TFESSD financed cutting-edge social and environmental projects, such as climate change analysis, social protection, community-driven development, and poverty impact analysis. It was a trailblazer in many areas, including knowledge, partnerships, and inclusive development. For some time, TFESSD was the only World Bank unit providing funding for analysis on disability in development. Today, as the development world embarks on a new set of goals, the Sustainable Development Goals (SDGs), it is clear that many of TFESSD’s activities have helped lay a strong foundation at the World Bank to deliver on the SDGs. Many of the emerging issues that TFESSD funded have taken on new prominence at the Bank, such as climate change adaptation, social protection, poverty impact evaluations, and community-driven development. Donors are also exploring options for further funding. This report looks back at TFESSD’s impact over the years. With more than 530 projects, it is impossible to cover them all. Rather, this report highlights key projects that give a snapshot of the trust fund’s accomplishments over the years by window and lessons learned.
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The development objective of the Health System Support Project for Mauritania is to improve utilization and quality of reproductive maternal neonatal and child health (RMNCH) services in selected regions, and, in the event of an eligible crisis or emergency, to provide immediate and effective response to said eligible crisis or emergency.
... See More + The project comprises of four components. The first component, support to improving utilization of quality RMNCH services through performance-based financing (PBF) consists of following sub-components: (i) provision of PBF payments to health service providers; and (ii) verification and counter-verification. The second component, support to increasing demand for health services will support activities on the demand-side to promote and facilitate access to health services, especially for the poorest. It consists of following sub-components: (i) conditional cash transfers to stimulate demand for health care; and (ii) strengthening of community health. The third component, capacity building and project management will finance project management and comprehensive capacity-building activities, including substantial technical assistance. The fourth component, contingency emergency response (CERC) will be included under the project in accordance with operational policy (OP) 10.00 paragraphs 12 and 13, for projects in situations of urgent need of assistance or capacity constraints. This will allow for rapid reallocation of project proceeds in the event of a natural or man-made disaster or crisis that has caused, or is likely to imminently cause, a major adverse economic and or social impact.
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The report estimates the costs, impacts and financing scenarios to achieve the World Health Assembly global nutrition targets for stunting, anemia in women, exclusive breastfeeding and the scaling up of the treatment of severe wasting among young children.
... See More + To reach these four targets, the world needs $70 billion over 10 years to invest in high-impact nutrition-specific interventions. This investment would have enormous benefits: 65 million cases of stunting and 265 million cases of anemia in women would be prevented in 2025 as compared with the 2015 baseline. In addition, at least 91 million more children would be treated for severe wasting and 105 million additional babies would be exclusively breastfed during the first six months of life over 10 years. Altogether, achieving these targets would avert at least 3.7 million child deaths. Every dollar invested in this package of interventions would yield between $4 and $35 in economic returns, making investing in early nutrition one of the best value-for-money development actions. Although some of the targets—especially those for reducing stunting in children and anemia in women—are ambitious and will require concerted efforts in financing, scale-up, and sustained commitment, recent experience from several countries suggests that meeting these targets is feasible. These investments in the critical 1000 day window of early childhood are inalienable and portable and will pay lifelong dividends – not only for children directly affected but also for us all in the form of more robust societies – that will drive future economies.
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Publication 114429 APR 20, 2017
Shekar,Meera; Kakietek,Jakub Jan; Dayton,Julia M.; Walter,DylanFrenchDisclosed
The Lao economy is estimated to have grown at around 7 percent in 2016, a slight moderation from 7.4 percent in the previous year. A marked increase in power sector contribution and some from the manufacturing sector was partly offset by slight moderation in construction, flat mining output, and stable public spending.
... See More + Around 1,350MW of installed capacity was estimated to have come on stream in 2016 increasing the installed capacity of the power system by more than 20 percent to above 6,000MW. Output in agriculture recovered following last year's drought. Recent investments in agriculture have also resulted in greater commercialization of the sector and increased exports. Output in manufacturing continued to expand, albeit from a low base and mostly confined to the Special Economic Zones. Construction activity remained resilient in 2016 supported by the pipeline power projects as well as real estate development. On the other hand, mining output remained largely flat as ongoing operations reached maturity and no new projects of a more significant size were initiated. The number of tourist arrivals declined in the nine months of 2016 mostly due to fewer arrivals from the region; however, the impact was offset partly by an increase in western tourists who typically stay longer and have higher spending per day.
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In order to more directly link payments and funding at the provider level with the quantity and quality of health services performed, Cameroon started a Performance Based Financing (PBF) pilot in the health sector in 2012 in fourteen districts in three regions of the country: East, South West and North West.
... See More + Performance-based financing is a health systems management tool designed to increase the efficiency of health system inputs to improve the coverage and quality of priority maternal and child health services by paying health facilities bonuses linked to the quantity and quality of services delivered. The PBF pilot was accompanied by a prospective randomized impact evaluation. The evaluation used a combination of household and health facility surveys conducted at baseline and endline to assess the impact of the interventions. The research questions of the impact evaluation and the responses found are summarized in this report.
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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.
... See More + 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.
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Working Paper 122589 JAN 01, 2017
Janes,Laurin; Hou,Xiaohui; Barker,Katie; Sharma,Pranita; Brown,Sophie Victoria TurnerDisclosed
Global Health Investment Fund (GHIF) is a novel social impact fund established to finance the development of drugs, vaccines, and diagnostic tests for diseases that disproportionately burden low and middle income countries.
... See More + As of December 2016, GHIF had invested in seven companies for development and manufacture of treatments for diseases such as cholera and river blindness, as well as diagnostic tests for tuberculosis, HIV, malaria, dengue, preeclampsia and gestational diabetes. GHIF’s most recent investment is financing further development of Tribendimidine, a drug to combat soil-transmitted helminth infections. These parasitic worms are among the most common infections found in poor communities, and affect nearly 900 million children worldwide. More broadly, GHIF’s investments are helping to end a global shortage of cholera vaccines and enabling cheaper, more effective diagnostic tests for HIV and malaria, providing more accurate results and reducing healthcare costs. GHIF is demonstrating that it is possible to have social impact and it expects to generate reasonable financial returns for investors. The keys to its success are the investor guarantee mechanism, affordable pricing, and partnerships. In the future, GHIF wants to scale and expand the model. In a year or two, it will review the portfolio and identify which interventions were most cost effective, as measured by lives saved per dollar, and the impact on its double bottom line. It anticipates raising capital for a successor fund. In addition, it plans to optimize areas that have proved successful. Given the enormous needs, GHIF expects that it will continue to focus on drugs, vaccines, and diagnostics for neglected diseases in emerging markets.
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South Asia Region (SAR) has decreased maternal mortality ratio (MMR) by 65 percent between 1990 and 2013, which was the greatest progress among all world regions.
... See More + Such achievement implores the question, What made SAR stand out against what is predicted by standard socioeconomic outcomes?Improving Maternal and Reproductive Health in South Asia: Drivers and Enablers identifies the interventions and factors that contributed to reducing MMR and improving maternal and reproductive health (MRH) outcomes in SAR. In this study, the analytical framework assumes that improving MRH outcomes is influenced by a multitude of forces from within and outside the health system and considers factors at the household and community levels, as well as interventions in other sectors and factors in the enabling environment. The analysis is based on a structured literature review of the interventions in SAR countries, relevant international experience, and review of the best available evidence from systematic reviews. The focus of the analysis is mainly on assessing the effectiveness of interventions. The findings from this study indicate that the most effective interventions that prevent maternal mortality are those that address the intra-partum stage - the point where most maternal deaths occur - and include improving skilled birth attendance coverage, increasing institutional delivery rates, and scaling up access to emergency obstetric care. There is also adequate evidence that investing in family planning to increase contraceptive use also played a key role during the inter-partum phase by preventing unwanted pregnancies and thus averting the risk of maternal mortality in SAR countries. Outside the programmatic interventions, the levels of household income, women’s education, and completion of secondary education of girls were also strongly correlated with improved MRH outcomes. Also, there is strong evidence that health financing schemes - both demand and supply side - and conditional cash transfer programs were effective in increasing the uptake of MRH services. The study points out to many other interventions with different degrees of effectiveness. The study also identified four major reasons for why SAR achieved this progress in MMR reduction.The best practices and evidence of what works synthesized in this study provide an important way forward for low- and middle-income countries toward achieving the health-related Sustainable Development Goals.
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This report assesses Indonesia’s health financing system. As an intrinsic and necessary element of universal health coverage (UHC), health financing is not only about assessing the sufficiency of resources, but also about how equitably and efficiently resources are raised, pooled, and allocated to make progress towards UHC.
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Strong economic growth in recent years has helped reduce poverty to 43 percent of the population. Yet, as Africa’s population expands, it is estimated to reach 2.5 billion by 2050, the region faces a critical challenge of creating the foundations for long-term inclusive growth.
... See More + Many countries still contend with high levels of child and maternal mortality, malnutrition is far too common, and most health systems are not able to deal effectively with epidemics and the growing burden of chronic diseases, such as diabetes. These challenges call for renewed commitments and accelerated progress toward Universal Health Coverage (UHC), the principle that everyone receives needed health services without financial hardship. The primary reason for investing in UHC is a moral one: it is not acceptable that some members of society should face death, disability, ill health or impoverishment for reasons that could be addressed at limited cost. However, UHC is also a good investment. Prevention of malnutrition and ill health is likely to have enormous benefits in terms of longer and more productive lives, higher earnings, and averted care costs. Effectively meeting demand for family planning will accelerate the fertility transition, which in turn will result in higher rates of economic growth and more rapid poverty reduction. And strong health and disease surveillance systems halt epidemics that take lives and disrupt economies. In 2015, the forgone economic growth due to Ebola amounts to more than a billion US dollars in the three countries hit by the epidemic.
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