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Jamaica's effort in improving universal access within fiscal constraints (English)

Jamaica's primary health care system was a model for the Caribbean region in the 1990s. Because of it, Jamaicans enjoy relatively better health status than people in other countries of similar income level in the Caribbean region. However, Jamaica's health system is being severely challenged by persistent and reemerging infectious diseases and by the rapid increase in noncommunicable diseases (NCDs) and injuries. At the same time, the country has suffered from low economic growth and carries a high debt burden, which leaves limited fiscal space for improving health care. The Government of Jamaica has been trying to sustain the gain in health outcomes and improve access to health care for its population in an environment of constrained resources during the last decade. With the establishment of the Jamaica National Health Fund (NHF) in 2003 and the abolition of user fees at public facilities in 2008, the Government of Jamaica has taken steps toward achieving universal coverage. This study reviews the achievements and challenges in expanding universal access in Jamaica and assesses the impact of the NHF's drug-subsidy programs and the abolition of user fees on universal access, and discusses policy options for achieving universal coverage.


  • Author

    Chao, Shiyan

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    Working Paper (Numbered Series)

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    Latin America & Caribbean,

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  • Doc Name

    Jamaica's effort in improving universal access within fiscal constraints

  • Keywords

    abolition of user fee;universal access to health care;private pharmacies;public health facility;health promotion and disease prevention;national health insurance plan;primary health care system;access to health service;access to care;universal coverage;united nations general assembly;demand for health care;cost of health care;life expectancy at birth;primary health care services;information and communication technology;private health services;health expenditure;global economic crisis;quality of care;benefit package;health care benefit;private health insurance;health promotion activities;health care cost;public health management;emerging infectious disease;source of revenue;health promotion activity;public health system;public health service;Public Facilities;prescription drug;rheumatic heart disease;family planning clinic;public information program;basic health care;inpatient hospital care;providing universal access;primary care facilities;improvements in health;improving health care;availability of drug;social assistance program;proportion of woman;ischemic heart disease;provision of care;human resource development;health system efficiency;national surveillance system;infant mortality rate;cost of drug;private health care;delivering health care;Health Service Delivery;treatment and care;reducing child mortality;policy and institution;public health regulation;country case study;quality health care service;national health care;rational drug use;public health activity;affordable health care;burden of disease;public health programs;Universal Health Care;gdp growth rate;submission of claim;cost of service;choice of provider;source of financing;supply of service;point of service;public health center;health care facilities;receipt of payment;distribution of pharmaceuticals;human resource capacity;availability of resource;accessing health care;international capital market;purchasing power parity;health care facility;degree of fragmentation;human resource management;public sector resource;high-risk sexual behavior;government procurement procedure;health finance;chronic disease;reference price;fiscal space;



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Chao, Shiyan

Jamaica's effort in improving universal access within fiscal constraints (English). Universal Health Coverage (UNICO) studies series ; no. 6 Washington, D.C. : World Bank Group.