Healthcare coverage: main goal.
They set Millennium Development Goals: not really reached.
SDG target:
“achieve universal health coverage, including financial risk protection, access to quality essential health-
care services and access to safe, effective, quality and affordable essential medicines and vaccines for
all”.
UHC is about ensuring that everyone
– the poor and the rich –
get the health services they need without suffering financial hardship.
UHC:
Three questions to be answered
1) Who is covered - POPULATION
2) Which services are covered - SERVICES
3) Proportion of the costs covered - COSTS
If we want to improve the situation of poor households:
— raising more money for health
— moving away from payments at the point of use
— using resources for health more efficiently and more equitably
It is hard to measure progress towards UHC, but mostly include either one or both of the following:
• Access: ratio doctors/nurses, population covered, travel time…
• Financial protection: reimbursement rate, OOP payments, prices of medical care…
Three main restrictions in moving towards universal coverage:
—limited resources – More money for health
External money: inefficiencies in donor support
Paris declaration on Aid effectiveness
fungibility of donor money – where the money is headed to
Internal money: reprioritize government budgets
Increase efficiency of revenue collection
Domestic optinos for innovative financing: tobacco tax, tourism tax, tax on airtickets.
—overreliance on direct payments at the point of use
They performed a case study on Kenyas dairy farmers
, most relevant the drop in sale prices
savings most relevant
They worked with PharmAccess to provide health insurance:
Low enrolment rates (11%)
—> to ensure financial protection: pre-financing
Abolishing users fee to reduce OOP to less than 15%