PROPOSED MECHANISMS FOR FINANCING HEALTHCARE FOR THE POOR.

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "PROPOSED MECHANISMS FOR FINANCING HEALTHCARE FOR THE POOR."

Transcription

1 PROPOSED MECHANISMS FOR FINANCING HEALTHCARE FOR THE POOR. Concept Summary Aug 2014 Insight Health Advisors Dr. Gitonga N.R, Prof. G. Mwabu, C. Otieno.

2 PURPOSE OF CONCEPT Propose a mechanism for mobilizing and allocating resources to finance healthcare for the absolute poor Secure guaranteed and ear-marked funding for this purpose Propose a clear and efficient way for the funds to flow to target beneficiaries Propose a system that provides government with various policy tools and options to meet the healthcare needs of the absolute poor Draw Lessons from existing interventions that are targeted at the poor Propose optimal institutional arrangements to implement the scheme Propose a transitional model for the existing fragmented approaches targeting the poor Position this mechanism as an input towards the conclusion of Kenya s draft healthcare financing strategy

3 1.BACKGROUND AND RATIONALE The overarching goal of HCF reform is Universal Health Coverage, which is defined as: Access to key promotive, preventive, curative and rehabilitative health interventions for all at an affordable cost, thereby achieving equity in access (WHO). There is strong global consensus on UHC: WHR 2010, 2013 African ministers for health and finance endorsed UHC in July 2012 UN Resolution to support UHC December th World Health Assembly asserted the place of UHC May Kenya has also committed itself to UHC (Draft HCF Policy, KHPF , NHSSP II and III draft, V2030 etc).

4 BARRIERS TO HEALTH CARE ACCESS Challenges in accessing health care among the low income earners and the poor: Geographical Barriers Quality Barriers Financial Barriers Distance to facilities Status of transportation infrastructure Hours of operation Poor technical quality Health worker attitude Acceptability of the care Direct cost of care user fees, cost of drugs Indirect costs transportation costs, lost wages

5 EVOLUTION OF HEALTHCARE FINANCING IN KENYA Free National Health Service NHIF Risk pooling for formal sector Cost recovery/user fees at public facilities Current Goal: UHC through risk pooling and other mechanisms

6 STATUS OF RISK POOLING IN VARIOUS POPULATION GROUPS Upper Middle Middle Low Low < $2 per day <$1 per day 1.6 Million 2.4 Million 4 Million 8 Million 16 Million 8 Million Current insurance coverage: NHIF: covers 7 million lives Private insurers: 1 million lives CBHI: 0.5 million lives Low income (8 million) and the poor (24 million), which constitute 80% of the population, have minimal or no cover through risk pooling 2009/2010 NHA shows only 12% of THE is in risk pooling (the rest is direct payment either supply or demand side) 6

7 Source: KHEUS 2007

8 Source: DHS 2009

9 Bringing the poor on board In order to achieve UHC, mechanisms are needed to overcome the barriers to access & utilization for the poor: This concept focuses on one of the key barriers financial access Mechanisms for both demand and supply side financing are needed to enable the poor to access primary and secondary/tertiary healthcare services. The draft HCF strategy proposed an Access and Equity Fund (subsidy) to finance care for the poor through risk pooling and other mechanisms. The absolute poor and poor will require a form of subsidy for any demand side financing mechanism to be adequate(cross subsidy is inadequate due small formal sector).

10 Basics of Pro-Poor HCF Increased investment in primary care will have the greatest public health returns and will be pro-poor. A basic package of primary healthcare services should be universally accessible to all at dispensaries and health centres (primary care level). Targeted access to secondary and tertiary care for the absolute poor (through risk pooling) is critical not only for public health purposes but also for financial protection of the poor. (Catastrophic health expenditure is a major cause of poverty). Earmarked/ring-fenced funds for the absolute poor are necessary.

11 HEALTHCARE FINANCING FOR THE POOR SUMMARY OF CURRENT APPROACHES

12 Relevant International Experience Health Equity Fund (HEF) in Cambodia: HEF accepted as an effective social health protection mechanism for the poor Involvement of target communities in management of the funds/services Use of means-testing to identify the poor Public financing of primary healthcare using government funds. HEF management costs were high but have improved from 45% at the start to 28% Clear and efficient referral system from primary to secondary/tertiary care necessary for success.

13 HCF initiatives for the poor in Kenya Current healthcare financing initiatives targeting the absolute poor & poor OBA (Output based Approach) HAKI (Health for All Kenyans Initiative) HSSF (Health Sector Support Fund) Health Insurance Subsidy Program (NHIF HISP) Traditional MOH supply side financing in public institutions Disease program funds Subsidized private services (FBO).

14 Overview of HCF mechanisms from perspective of coverage for the poor Mechanism Pros Cons MOH supply side (input) financing Mainstay of access for the poor (free services at the point of use) Potentially most cost-effective Some reforms to improve efficiency, effectiveness and targeting through PBF initiatives and HSSF Lack of incentives for efficiency, effectiveness, productivity, quality and responsiveness Benefits the wealthier quintiles more than the poor Over-emphasis on hospital based curative care mainly in urban areas. HSSF Better targeting and allocative efficiency Performance based hence potential for improved quality and productivity. Community involvement in management of funds Good model for AEF. Sustainability significant donor funding. Restricted use of the funds at facility levels hence user fees continued. Administrative expenses? Evolving roles of counties, MOH and CRA could pose challenge

15 Overview of HCF mechanisms from perspective of coverage for the poor Mechanism Pros Cons OBA Effective targeting Increased utilization of targeted priority services Choice of providers for the poor Improvements in quality and responsiveness of care Complete system for demand side financing activities with key lessons. Sustainability due to significant donor funding Limited benefit package? Administrative expenses NHIF Mandate for social health insurance. Established nation-wide infrastructure and systems for risk pooling Growing experience with informal sector HISP study a good start for including the poor through GOK subsidy The poor are excluded mainly due to inability to pay and lack of mechanisms to subsidize their contributions. No government or employer contribution to NHIF (only enrolled members contribute) Reforms needed in NHIF for better efficiency and accountability.

16 Overview of HCF mechanisms from perspective of coverage for the poor Mechanism Pros Cons HAKI Lessons on costing and innovative purchasing of care (capitation/fixed reimbursements) Removal of user fees. Better targeting Sustainability - donor funding Pilot with only limited experience/lifespan? Administrative expenses Vertical Disease Programs Rapid reach and results Better targeting Major contributor to reduction of OOP due to free services. Can be motivated to contribute to an AEF to cover wider benefit package and be better integrated Not sustainable Limited benefit package (often only a few conditions/services covered). Not well integrated.

17 FEATURES OF A SUCCESSFUL MECHANISM FOR PRO-POOR HCF Administrative simplicity with low overhead costs (maximize direct benefit cost and minimize management costs) Blend in with existing systems: regulatory, oversight, governance, purchasing, quality assurance, pooling of funds Guaranteed funding source: Government-led through general tax revenue. Targeting Mechanism-need to balance cost of targeting with its effectiveness Mechanism must have a broad objective and function more as a tool of influencing quality improvement and responsiveness of health providers and not just a tool of protecting the poor.

18 SOURCES OF FUNDS Government funds Main source of funding: A clear policy is needed to secure earmarked government funds for financing healthcare for the poor and vulnerable households building on existing social protection initiatives and budgetary allocations MTP II Goal 4 confirms govt. commitment to subsidize healthcare for absolute poor and has budgets set (Yr 1-1B, Yr B, Yr 3-31B, Yr 4-60B) Starting Financing options (direct provision, insurance etc). When will the funds be factored in budget? Which areas will start to benefit? How will poor be identified?

19 SOURCES OF FUNDS Contd. Donor funds Direct funding from donors to GoK This is good for start-up, but donors could consider a requirement for GoK to match contributions in order to ensure sustainability Program funding through partners GoK needs to create incentives (and sanctions?) to encourage partners to channel more of their funds meant for the poor through an integrated mechanism. Harmonize all health funds meant for the poor and underserved (including proposed Trust Fund for Aids, malaria and TB and NCD s, Maternity Fund etc) Private Sector Corporate social responsibility from private foundations and large corporate organizations. Social protection or equity tax? Unclaimed financial assets?

20 USES OF THE FUNDS (MANDATE) To finance insurance premiums/contributions for the absolute poor for secondary care coverage (NHIF, county schemes, micro-health insurance schemes) To finance primary healthcare at primary care facilitates through supply-side financing Direct Provision through county health systems To pay for vouchers if need be for targeting specific, high-priority health services (e.g. MDG-related services)

21 IDENTIFICATION OF THE POOR Primary care: In the short to medium term primary healthcare should be provided free (at the point of service) to all (eliminate targeting costs, fast implementation, address widespread primary care challenges). In the medium to long term there may be need to target the primary care subsidy to the poor and vulnerable for effectiveness and sustainability Secondary care through risk pooling - health insurance : Work with Social Protection Secretariat in MOLSP in identifying and reaching the poor to avoid duplication.

22 QUESTIONS TO DEBATE Source of Funds. How much can the govt. afford to raise (fiscal space?) How do we incentivize and give confidence to other sources (donors and private sector) to contribute? What role should cross-subsidy play and is there capacity for that with current NHIF pooled funds? Which counties do we cover first? (Due to budget constraints? How do you decide where to start?) When and how will the MTP II funds be budgeted? NHIF. What are the triggers to indicate successful reforms? What is the role of NHIF under a devolved system? Is there a role for subsidized health microinsurance in reaching the poor and how can this be linked to NHIF (e.g Re-Insurance)?

23 Discussion

Universal Health Coverage: Concepts and Principles. David B Evans, Director Health Systems Financing

Universal Health Coverage: Concepts and Principles. David B Evans, Director Health Systems Financing Universal Health Coverage: Concepts and Principles David B Evans, Director Health Systems Financing Outline Universal Coverage: definitions and the state of the world Health financing systems for Universal

More information

Stakeholders Mee.ng on Healthcare Financing in Kenya Health Care Financing Reforms in Kenya. Elkana Ong u* Chief Economist (MOMS) 30 th August,2012

Stakeholders Mee.ng on Healthcare Financing in Kenya Health Care Financing Reforms in Kenya. Elkana Ong u* Chief Economist (MOMS) 30 th August,2012 Stakeholders Mee.ng on Healthcare Financing in Kenya Health Care Financing Reforms in Kenya Elkana Ong u* Chief Economist (MOMS) 30 th August,2012 Presenta.on Outline Kenya health sector vision Objec.ves

More information

Universal Health Coverage in Africa. Germano Mwabu University of Nairobi and Kobe University, June 1, 2013, TICAD V, Yokohama, Japan.

Universal Health Coverage in Africa. Germano Mwabu University of Nairobi and Kobe University, June 1, 2013, TICAD V, Yokohama, Japan. Universal Health Coverage in Africa Germano Mwabu University of Nairobi and Kobe University, June 1, 2013, TICAD V, Yokohama, Japan. Introduction Health status in Africa has improved over the last two

More information

Introduction of a national health insurance scheme

Introduction of a national health insurance scheme International Social Security Association Meeting of Directors of Social Security Organizations in the English-speaking Caribbean Tortola, British Virgin Islands, 4-6 July 2005 Introduction of a national

More information

Current challenges in delivering social security health insurance

Current challenges in delivering social security health insurance International Social Security Association Afric ISSA Meeting of Directors of Social Security Organizations in Asia and the Pacific Seoul, Republic of Korea, 9-11 November 2005 Current challenges in delivering

More information

A PROVIDER-DRIVEN HEALTH PLAN IN KENYA

A PROVIDER-DRIVEN HEALTH PLAN IN KENYA Bima Poa A PROVIDER-DRIVEN HEALTH PLAN IN KENYA Introducing Bima Poa Bima Poa, which means cool insurance in Swahili, is a provider-driven health plan in Western Kenya. It combines health insurance for

More information

Private Health Insurance Options in Egypt Discussion with EISA Chairman and senior staff

Private Health Insurance Options in Egypt Discussion with EISA Chairman and senior staff Private Health Insurance Options in Egypt Discussion with EISA Chairman and senior staff Ibrahim Shehata April 27, 2006 Background Health expenditure is dominated by household direct out-ofpocket payments

More information

Kenya Country Report

Kenya Country Report Kenya Country Report African Health Markets for Equity Dr. Nirmala Ravishankar, Dr. Amit Thakker and Joel Lehmann June 2013 This report documents the results from the inception phase activities of the

More information

Islamic Republic of Afghanistan Ministry of Public Health. Contents. Health Financing Policy 2012 2020

Islamic Republic of Afghanistan Ministry of Public Health. Contents. Health Financing Policy 2012 2020 Islamic Republic of Afghanistan Ministry of Public Health Contents Health Financing Policy 2012 2020 Table of Content 1. Introduction 1 1.1 Brief County Profile 1 1.2 Health Status Data 1 1.3 Sources

More information

Universal Health Coverage: The Regional Agenda

Universal Health Coverage: The Regional Agenda Universal Health Coverage: The Regional Agenda Cristian Morales Regional Advisor, Financing and Health Economics (moralesc@paho.org) Content 1 2 3 4 Why an UHC agenda for the Americas? What is UHC? What

More information

Development of Health Insurance Scheme for the Rural Population in China

Development of Health Insurance Scheme for the Rural Population in China Development of Health Insurance Scheme for the Rural Population in China Meng Qingyue China Center for Health Development Studies Peking University DPO Conference, NayPyiTaw, Feb 15, 2012 China has experienced

More information

Presentations by panellists were followed by a dialogue with members of the Council. These discussions are hereunder summarized.

Presentations by panellists were followed by a dialogue with members of the Council. These discussions are hereunder summarized. Panel Discussion on Universal Health Coverage at the Center of Sustainable Development: Contributions of Sciences, Technology and Innovations to Health Systems Strengthening Geneva, 3 July 2013 On 3 July

More information

National Health Insurance Policy 2013

National Health Insurance Policy 2013 National Health Insurance Policy 2013 1. Background The Interim Constitution of Nepal 2007 provides for free basic health care as a fundamental right of citizens. Accordingly, the Government of Nepal has

More information

National Health Research Policy

National Health Research Policy National Health Research Policy The establishment of a Department of Health Research (DHR) in the Ministry of Health is recognition by the GOI of the key role that health research should play in the nation.

More information

Introduction to Universal Health Coverage and Financing

Introduction to Universal Health Coverage and Financing Introduction to Universal Health Coverage and Financing Awad MATARIA, PhD Health Economist World Health Organization Eastern-Mediterranean Regional Office Regional Workshop on Cost-Effectiveness Analysis:

More information

PROGRESS TOWARDS UNIVERSAL HEALTH COVERAGE IN ETHIOPIA. By Girma B. Bati Commissioner, EECMY-DASSC February 22-26, 2015 Nairobi, Kenya

PROGRESS TOWARDS UNIVERSAL HEALTH COVERAGE IN ETHIOPIA. By Girma B. Bati Commissioner, EECMY-DASSC February 22-26, 2015 Nairobi, Kenya PROGRESS TOWARDS UNIVERSAL HEALTH COVERAGE IN ETHIOPIA By Girma B. Bati Commissioner, EECMY-DASSC February 22-26, 2015 Nairobi, Kenya ETHIOPIAN EVANGELICAL CHURCH MEKANE YESUS EECMY: A fast growing African

More information

A Comparative Analysis of Health Markets and Private For Profit, Pro-Poor Interventions in East Africa

A Comparative Analysis of Health Markets and Private For Profit, Pro-Poor Interventions in East Africa A Comparative Analysis of Health Markets and Private For-Profit, Pr A Comparative Analysis of Health Markets and Private For Profit, Pro-Poor Interventions in East Africa Salome Wawire Presentation Outline

More information

NATIONAL HEALTH ACCOUNTS:

NATIONAL HEALTH ACCOUNTS: THE REPUBLIC OF UGANDA MINISTRY OF HEALTH NATIONAL HEALTH ACCOUNTS: KEY MESSAGES (FY2010/11 & 2011/12) NATIIONAL HEALTH ACCOUNTS: KEY MESSAGES Introduction The overall purpose of the National Health Accounts

More information

Is health care financing in Uganda equitable?

Is health care financing in Uganda equitable? Is health care financing in Uganda equitable? Zikusooka CM 1, Kyomuhang R 2, Orem JN 3, Tumwine M 1 1- HealthNet Consult, Kampala 2- Medical Research Council, Uganda 3- World Health Organisation/Uganda

More information

WORLD HEALTH ORGANIZATION

WORLD HEALTH ORGANIZATION WORLD HEALTH ORGANIZATION FIFTY-SIXTH WORLD HEALTH ASSEMBLY A56/27 Provisional agenda item 14.18 24 April 2003 International Conference on Primary Health Care, Alma-Ata: twenty-fifth anniversary Report

More information

PPP- ROLE OF BUSINESS IN AFRICA S HEALTHCARE THE HYGEIA GROUP S EXPERIENCE

PPP- ROLE OF BUSINESS IN AFRICA S HEALTHCARE THE HYGEIA GROUP S EXPERIENCE PPP- ROLE OF BUSINESS IN AFRICA S HEALTHCARE THE HYGEIA GROUP S EXPERIENCE FOLA LAOYE MARCH 2006 NIGERIAN HEALTHCARE OVERVIEW ROLE OF PPP IN NIGERIA HYGEIA S RESPONSE TO PPP IN NIGERIA NIGERIAN HEALTHCARE

More information

Ensuring that health financing policy supports universal health coverage efforts

Ensuring that health financing policy supports universal health coverage efforts National Conference on Ensuring that health financing policy supports universal health coverage efforts Matthew Jowett PhD Senior Health Financing Specialist WHO Geneva What is universal health coverage?

More information

Empirical Assessment of the Various Sustainable Financing Mechanisms for Health Care Services in Kenya

Empirical Assessment of the Various Sustainable Financing Mechanisms for Health Care Services in Kenya Empirical Assessment of the Various Sustainable Financing Mechanisms for Health Care Services in Kenya Abstract Timothy C. Okech (PhD) Chandaria School of Business, United States International University-

More information

53rd DIRECTING COUNCIL

53rd DIRECTING COUNCIL 53rd DIRECTING COUNCIL 66th SESSION OF THE REGIONAL COMMITTEE OF WHO FOR THE AMERICAS Washington, D.C., USA, 29 September-3 October 2014 CD53.R14 Original: Spanish RESOLUTION CD53.R14 STRATEGY FOR UNIVERSAL

More information

TOWARDS UNIVERSAL HEALTH COVERAGE IN RWANDA

TOWARDS UNIVERSAL HEALTH COVERAGE IN RWANDA TOWARDS UNIVERSAL HEALTH COVERAGE IN RWANDA Summary Notes from Briefing by Caroline Kayonga * Permanent Secretary, Ministry of Health, Rwanda 10/22/2007 10/23/2007 OUTLINE 1. A brief history of health

More information

Social Health Insurance In Three Asian Countries: China, Thailand and Vietnam 1 July 2014 Roli Talampas Asian Center UP Diliman

Social Health Insurance In Three Asian Countries: China, Thailand and Vietnam 1 July 2014 Roli Talampas Asian Center UP Diliman Social Health Insurance In Three Asian Countries: China, Thailand and Vietnam 1 July 2014 Roli Talampas Asian Center UP Diliman Outline Objectives & Questions Framework Methods Findings Summary Objectives

More information

Building up Health Insurance: the Experience of Ghana

Building up Health Insurance: the Experience of Ghana Building up Health Insurance: the Experience of Ghana Dr. Caroline Jehu-Appiah Ghana Health Service 5 th April 2011, Basel Presentation outline Background Achievements Challenges Success factors Way forward

More information

3. The first stage public consultation conducted from March to June 2008 aimed at consulting the public on

3. The first stage public consultation conducted from March to June 2008 aimed at consulting the public on EXECUTIVE SUMMARY The Government published the Healthcare Reform Consultation Document Your Health, Your Life (the Consultation Document ) on 13 March 2008 to initiate the public consultation on healthcare

More information

FEDERAL REPUBLIC OF NIGERIA ZERO DRAFT

FEDERAL REPUBLIC OF NIGERIA ZERO DRAFT FEDERAL REPUBLIC OF NIGERIA ZERO DRAFT NATIONAL HEALTH FINANCING POLICY 2006 Foreword The National Health Financing Policy represents the collective will of the governments and people of this country to

More information

Empirical Analysis of Possible Alternative Sustainable Financing Options for Primary Health Care Services in Kenya

Empirical Analysis of Possible Alternative Sustainable Financing Options for Primary Health Care Services in Kenya IOSR Journal of Pharmacy (IOSRPHR) ISSN: 2250-3013, Vol. 2, Issue 4 (July2012), PP 84-96 www.iosrphr.org Empirical Analysis of Possible Alternative Sustainable Financing Options for Primary Health Care

More information

Market Assessment of Private Prepaid Schemes in Kenya

Market Assessment of Private Prepaid Schemes in Kenya Market Assessment of Private Prepaid Schemes in Kenya Market Assessment of Private Prepaid Schemes in Kenya October 2011 MARKET ASSESSMENT of private prepaid HEALTH SCHEMes Disclaimer This report has been

More information

Financing Options for National Health

Financing Options for National Health Financing Options for National Health Insurance (NHI) in South Africa Presentation to Wits School of Public Health Presenter: Mark Blecher CD: Health & Social Development January 2013 Introduction Inspired

More information

The Impact of Micro-Health Insurance on the Access to Health Care Services among the Informal Sector Employees in Urban Areas of Nigeria.

The Impact of Micro-Health Insurance on the Access to Health Care Services among the Informal Sector Employees in Urban Areas of Nigeria. The Impact of Micro-Health Insurance on the Access to Health Care Services among the Informal Sector Employees in Urban Areas of Nigeria. BY: Saheed O. OLAYIWOLA Department of Economics, University of

More information

Medicare Part D. MMA establishes a standard Part D drug benefit, which consists of four components or phases.

Medicare Part D. MMA establishes a standard Part D drug benefit, which consists of four components or phases. Medicare Part D The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) added voluntary prescription drug coverage to Medicare, the federal health insurance program for seniors

More information

1. Bank Group Support to Health Financing

1. Bank Group Support to Health Financing 1. Bank Group Support to Health Financing Highlights The way that health services are financed affects human welfare because it influences how health systems perform in improving health outcomes, and more

More information

China s 12th Five-Year Plan: Healthcare sector

China s 12th Five-Year Plan: Healthcare sector China s 12th Five-Year Plan: Healthcare sector May 2011 KPMG CHINA One of the guiding principles of the 12th Five-Year Plan (5YP) is inclusive growth : helping ensure that the benefits of the country s

More information

Profiles in Coverage: Arizona Healthcare Group

Profiles in Coverage: Arizona Healthcare Group May 2007 S t a t e Co v e r a g e I n i t i a t i v e s Profiles in Coverage: Arizona Healthcare Group Overview Healthcare Group of Arizona (HCG) was created by the Arizona State Legislature in 1985 to

More information

Alternative Sustainable Financing of Public Health Care in Kenya

Alternative Sustainable Financing of Public Health Care in Kenya International Journal of Business and Social Science Vol. 3 No. 16 [Special Issue August 2012] Alternative Sustainable Financing of Public Health Care in Kenya Timothy C. Okech, PhD 1 Chandaria School

More information

Harmonization of Health Insurance Schemes in China

Harmonization of Health Insurance Schemes in China Harmonization of Health Insurance Schemes in China Hai Fang Professor of Health Economics China Center for Health Development Studies Peking University China Presentation at the First National Conference

More information

Health Security for All

Health Security for All Health Security for All A joint partnership between Government of Jharkhand and ILO Sub Regional Office for South Asia, New Delhi Dr. Shivendu Ministry of Health, Family Welfare, Medical Education and

More information

OHIO HEALTHCARE COVERAGE REFORM INITIATIVE April 2008

OHIO HEALTHCARE COVERAGE REFORM INITIATIVE April 2008 OHIO HEALTHCARE COVERAGE REFORM INITIATIVE April 2008 Envisioned Future State for a Healthy Ohio Ohioans are achieving and maintaining optimal health through personal wellness management and a health care

More information

SAINT LUCIA COUNTRY CONSULTATION ON THE UNIVERSAL HEALTH COVERAGE STRATEGY. Country Overview

SAINT LUCIA COUNTRY CONSULTATION ON THE UNIVERSAL HEALTH COVERAGE STRATEGY. Country Overview SAINT LUCIA COUNTRY CONSULTATION ON THE UNIVERSAL HEALTH COVERAGE STRATEGY Country Overview Increased demands are being placed on the Saint Lucian Health System as the epidemiological profile is now dominated

More information

G20 Labour and Employment Ministers Declaration Moscow, 18-19 July 2013

G20 Labour and Employment Ministers Declaration Moscow, 18-19 July 2013 G20 Labour and Employment Ministers Declaration Moscow, 18-19 July 2013 1. We, the Ministers of Labour and Employment from G20 countries met in Moscow on July 18-19, 2013 to discuss the global labour market

More information

Applying the Value Chain Framework to the Health Sector. Concept Note

Applying the Value Chain Framework to the Health Sector. Concept Note Applying the Value Chain Framework to the Health Sector Concept Note I) Definition of value chain analysis Value chain analysis is an economic development strategy to reduce poverty by better integrating

More information

Health Care Reform Update. Spring 2014

Health Care Reform Update. Spring 2014 Health Care Reform Update Spring 2014 Quincy Quinlan Texas Association of Counties 512 478 8753 quincyq@county.org http://www.county.org Today s Agenda Timeline Fees/Taxes Individual Mandate Marketplace

More information

Social Protection and Healthcare Financing: Ghana s NHIS Experience by Danaa Nantogmah, FES Ghana

Social Protection and Healthcare Financing: Ghana s NHIS Experience by Danaa Nantogmah, FES Ghana Social Protection and Healthcare Financing: Ghana s NHIS Experience by Danaa Nantogmah, FES Ghana Introduction and Background The 2010 provisional census results estimated Ghana s population at 24,233,431

More information

SETTING NEW STANDARDS IN A CHALLENGING ENVIRONMENT FOLA LAOYE IFC HEALTHCARE CONFERENCE 2009

SETTING NEW STANDARDS IN A CHALLENGING ENVIRONMENT FOLA LAOYE IFC HEALTHCARE CONFERENCE 2009 SETTING NEW STANDARDS IN A CHALLENGING ENVIRONMENT FOLA LAOYE IFC HEALTHCARE CONFERENCE 2009 BACKGROUND ON NIGERIA Nigeria Most populous country in Africa and 8th most populous country in the world; population

More information

Government of Kenya Ministry of Water and Irrigation

Government of Kenya Ministry of Water and Irrigation Government of Kenya Ministry of Water and Irrigation The Water Act, 2002 (No. 8 of 2002) The National Water Services Strategy (NWSS) 2007 2015, May 2007 IN EXERCISE of the powers conferred by section 107(2)

More information

Making Insurance Work for the Poor Current Practices and Lessons Learnt Craig Churchill, ILO October 2005 Munich

Making Insurance Work for the Poor Current Practices and Lessons Learnt Craig Churchill, ILO October 2005 Munich Making Insurance Work for the Poor Current Practices and Lessons Learnt Craig Churchill, ILO October 2005 Munich Savings, credit, risk prevention Small insurance companies Just another product offered

More information

JAMAICA. Agricultural Insurance: Scope and Limitations for Weather Risk Management. Diego Arias Economist. 18 June 2009

JAMAICA. Agricultural Insurance: Scope and Limitations for Weather Risk Management. Diego Arias Economist. 18 June 2009 JAMAICA Agricultural Insurance: Scope and Limitations for Weather Risk Management Diego Arias Economist 18 June 2009 Financed partly by the AAACP EU Support to the Caribbean Agenda The global market Products

More information

COUNTRY CASE STUDIES TAX AND INSURANCE FUNDING FOR HEALTH SYSTEMS FACILITATOR S NOTES. Prepared by: Health Economics Unit, University of Cape Town

COUNTRY CASE STUDIES TAX AND INSURANCE FUNDING FOR HEALTH SYSTEMS FACILITATOR S NOTES. Prepared by: Health Economics Unit, University of Cape Town COUNTRY CASE STUDIES TAX AND INSURANCE FUNDING FOR HEALTH SYSTEMS FACILITATOR S NOTES Prepared by: Health Economics Unit, University of Cape Town Preparation of this material was funded through a grant

More information

Financing Private Health: A focus on Community Based Health Insurance. Dr. Ambrose Nyangao Intervention Manager 5 h June 2014

Financing Private Health: A focus on Community Based Health Insurance. Dr. Ambrose Nyangao Intervention Manager 5 h June 2014 Financing Private Health: A focus on Community Based Health Insurance Dr. Ambrose Nyangao Intervention Manager 5 h June 2014 Comparing Kenya s private health markets with neighbouring markets: A focus

More information

2019 Healthcare That Works for All

2019 Healthcare That Works for All 2019 Healthcare That Works for All This paper is one of a series describing what a decade of successful change in healthcare could look like in 2019. Each paper focuses on one aspect of healthcare. To

More information

Do risk sharing mechanisms improve access to health services in low and middle-income

Do risk sharing mechanisms improve access to health services in low and middle-income August 2008 SUPPORT Summary of a systematic review Do risk sharing mechanisms improve access to health services in low and middle-income countries? The introduction of user charges in many low and middle-income

More information

Draft Health Reform Plan Roadmap

Draft Health Reform Plan Roadmap Draft Health Reform Plan Roadmap 1. Goals for June 20 th KHPA Board Meeting Review demographics of Kansas uninsured Review of 2005 Mercer health insurance study (in reference section) Determine overarching

More information

Timeline of New Health Care Law and Its Impact on American Businesses

Timeline of New Health Care Law and Its Impact on American Businesses Timeline of New Health Care Law and Its Impact on American Businesses Summaries of the Patient Protection and Affordable Health Care Act (Public Law 111-148) Health Care and Education Reconciliation Act

More information

COUNTRY CASE STUDY HEALTH INSURANCE IN SOUTH AFRICA. Prepared by: Vimbayi Mutyambizi Health Economics Unit, University of Cape Town

COUNTRY CASE STUDY HEALTH INSURANCE IN SOUTH AFRICA. Prepared by: Vimbayi Mutyambizi Health Economics Unit, University of Cape Town COUNTRY CASE STUDY HEALTH INSURANCE IN SOUTH AFRICA Prepared by: Vimbayi Mutyambizi Health Economics Unit, University of Cape Town Preparation of this material was funded through a grant from the Rockefeller

More information

Getting Ready for 2014: The Big Year for Healthcare Reform Anne Arundel County SHRM. David Johnson jdjohnson@rcmd.com November 15, 2012

Getting Ready for 2014: The Big Year for Healthcare Reform Anne Arundel County SHRM. David Johnson jdjohnson@rcmd.com November 15, 2012 Getting Ready for 2014: The Big Year for Healthcare Reform Anne Arundel County SHRM David Johnson jdjohnson@rcmd.com November 15, 2012 0 Topics for Discussion 1. Recap of Supreme Court Decision on Affordable

More information

Kenya Health Initiative - Improving Basic Patient Safety Standards in Private and Public Health Sector Facilities

Kenya Health Initiative - Improving Basic Patient Safety Standards in Private and Public Health Sector Facilities Kenya Health Initiative - Improving Basic Patient Safety Standards in Private and Public Health Sector Facilities 1- Background and Context By Dr Njeri Mwaura, Operations Officer, IFC Presented at the

More information

A Health Insurance Exchange in Maryland

A Health Insurance Exchange in Maryland A Health Insurance Exchange in Maryland A Presentation before the Joint Committee on Health Care Delivery and Financing June 14, 2007 Rex Cowdry, M.D. Executive Director MHCC Study MHCC has been asked

More information

How can we reach the poor with marketbased

How can we reach the poor with marketbased How can we reach the poor with marketbased approaches? Mimi Jenkins 2016 Colorado WASH Symposium University of Colorado Boulder 1 March 2016 Point of View Market-based WASH delivery approaches can reach

More information

Jamaica: Recent Initiatives in Early Childhood Policy

Jamaica: Recent Initiatives in Early Childhood Policy Jamaica: Recent Initiatives in Early Childhood Policy Omar Davies and Rose Davies * Over the past decade, interest in early childhood education and development has increased in Jamaica. This increased

More information

Mandatory Private Health Insurance as Supplementary Financing

Mandatory Private Health Insurance as Supplementary Financing Chapter 12 SUPPLEMENTARY FINANCING OPTION (5) MANDATORY PRIVATE HEALTH INSURANCE Mandatory Private Health Insurance as Supplementary Financing 12.1 Mandatory private health insurance is where private health

More information

Regional Inequality in Healthcare in China

Regional Inequality in Healthcare in China Regional Inequality in Healthcare in China QIAN Jiwei* Regional inequality in healthcare in China is particularly wide. Since 2007, the central government has increased earmarked healthcare transfers to

More information

Brief PROSPECTS FOR SUSTAINABLE HEALTH FINANCING IN TANZANIA. Overview. Levels and Sources of Financing for Health

Brief PROSPECTS FOR SUSTAINABLE HEALTH FINANCING IN TANZANIA. Overview. Levels and Sources of Financing for Health PROSPECTS FOR SUSTAINABLE HEALTH FINANCING IN TANZANIA Brief Katie West-Slevin and Arin Dutta Health Policy Project, Futures Group Overview While Tanzania has made significant progress on priority health

More information

(2013-2022) LONG TERM STRATEGY FOR THE DEVELOPMENT OF THE HEALTH INSURANCE OF MONGOLIA SOCIAL INSURANCE GENERAL OFFICE

(2013-2022) LONG TERM STRATEGY FOR THE DEVELOPMENT OF THE HEALTH INSURANCE OF MONGOLIA SOCIAL INSURANCE GENERAL OFFICE GOVERNMENT OF MONGOLIA MINISTRY OF POPULATION DEVELOPMENT AND SOCIAL PROTECTION SOCIAL INSURANCE GENERAL OFFICE LONG TERM STRATEGY FOR THE DEVELOPMENT OF THE HEALTH INSURANCE OF MONGOLIA () Ulaanbaatar

More information

BACKGROUND PAPER COUNTRY STRATEGIC PLANS

BACKGROUND PAPER COUNTRY STRATEGIC PLANS BACKGROUND PAPER COUNTRY STRATEGIC PLANS Informal Consultation 21 September 2015 World Food Programme Rome, Italy Introduction 1. This paper follows from the 29 June 2015 discussion of the Executive Board

More information

Microinsurance. and Social Health Protection: and Threats. Date 13/11/2008. Harrie Oostingh

Microinsurance. and Social Health Protection: and Threats. Date 13/11/2008. Harrie Oostingh Microinsurance and Social Health Protection: Opportunities and Threats Date 13/11/2008 Harrie Oostingh Rationale for Health Micro Insurance 5.6 billion people are unprotected against consequences of illness

More information

THE COMMODITY RISK MANAGEMENT GROUP WORLD BANK

THE COMMODITY RISK MANAGEMENT GROUP WORLD BANK THE COMMODITY RISK MANAGEMENT GROUP WORLD BANK Agricultural Insurance: Scope and Limitations for Rural Risk Management 5 March 2009 Agenda The global market Products Organisation of agricultural insurance

More information

UNIVERSAL HEALTH COVERAGE IN THE AMERICAS. Dr. Carissa F. Etienne Director PAHO/WHO

UNIVERSAL HEALTH COVERAGE IN THE AMERICAS. Dr. Carissa F. Etienne Director PAHO/WHO UNIVERSAL HEALTH COVERAGE IN THE AMERICAS Dr. Carissa F. Etienne Director PAHO/WHO Population in LAC 1900-2010 LAC North America LAC North America age age Number of people of both sexes Number of people

More information

The Community Health Fund in Tanzania

The Community Health Fund in Tanzania 10 The Community Health Fund in Tanzania R. M. Shirima, Community Health Fund Consultant, Ministry of Health, Tanzania In collaboration with the World Bank and other donors, the government of Tanzania

More information

Impact of the Individual Mandate The individual mandate will impact many of

Impact of the Individual Mandate The individual mandate will impact many of Special Focus Area: The Affordable Care Act - Implications for Bellevue In early 2010, Congress passed and the President signed the Patient Protection and Affordable Care Act. Commonly known as the Affordable

More information

Health Care Reform Frequently Asked Questions

Health Care Reform Frequently Asked Questions Health Care Reform Frequently Asked Questions On March 23, 2010, President Obama signed federal health care reform into law, also known as the Patient Protection and Affordability Act. A second, or reconciliation

More information

Questions and Answers on Universal Health Coverage and the post-2015 Framework

Questions and Answers on Universal Health Coverage and the post-2015 Framework Questions and Answers on Universal Health Coverage and the post-2015 Framework How does universal health coverage contribute to sustainable development? Universal health coverage (UHC) has a direct impact

More information

Colombia REACHING THE POOR WITH HEALTH SERVICES. Using Proxy-Means Testing to Expand Health Insurance for the Poor. Differences between Rich and Poor

Colombia REACHING THE POOR WITH HEALTH SERVICES. Using Proxy-Means Testing to Expand Health Insurance for the Poor. Differences between Rich and Poor REACHING THE POOR WITH HEALTH SERVICES 27 Colombia Using Proxy-Means Testing to Expand Health Insurance for the Poor Colombia s poor now stand a chance of holding off financial catastrophe when felled

More information

Comparison of Health Care Reform Proposals

Comparison of Health Care Reform Proposals Comparison of Health Care Reform Proposals Individuals Covered Every Californian will have improved access with more healthcare options and services that are more affordable and costefficient. Reallocates

More information

Social Health Insurance in Viet Nam

Social Health Insurance in Viet Nam Social Health Insurance in Viet Nam Nghiem Tran Dung Health Insurance Dept, Ministry of Health Ha Noi,, 12 Oct. 2010 1 Outline of presentation Background information Development (summary) of SHI in Viet

More information

Health Care Financing Options for Hong Kong

Health Care Financing Options for Hong Kong Health Care Financing Options for Hong Kong - Pursuing the Ideal: An Academic View - Teh-wei Hu University of California, Berkeley Presented at The Hong Kong Hospital Authority Convention 2006 May 8-9,

More information

Most of the workers in the developing world are

Most of the workers in the developing world are WIEGO Policy Brief (Social Protection) N o 9 September 2012 The Ghana National Health Insurance Scheme: Assessing Access by Informal Workers Laura Alfers 1 Most of the workers in the developing world are

More information

Bermuda Health Council Corporate Plan 2015-2016. Bermuda. Health Council

Bermuda Health Council Corporate Plan 2015-2016. Bermuda. Health Council Bermuda Health Council Corporate Plan 2015-2016 Bermuda ea Health Council Bermuda Health Council Corporate Plan 2015-2016 Contact us: If you would like any further information about the Bermuda Health

More information

Costs of Maternal Health Care Serv ices in Masaka District, Uganda. Executive Summary. Special Initiatives Report 16

Costs of Maternal Health Care Serv ices in Masaka District, Uganda. Executive Summary. Special Initiatives Report 16 Costs of Maternal Health Care Serv ices in Masaka District, Uganda Special Initiatives Report 16 Cambridge, MA Lexington, MA Hadley, MA Bethesda, MD Washington, DC Chicago, IL Cairo, Egypt Johannesburg,

More information

Rwanda Health Financing Policy

Rwanda Health Financing Policy Rwanda Health Financing Policy Government of Rwanda Ministry of Health December 2009 1 Table of Contents List of Tables... 3 List of Figures... 3 List of Annexes... 3 Foreword... Error! Bookmark not defined.

More information

Voters Health Care Platform

Voters Health Care Platform Voters Health Care Platform This Voters Health Care Platform is based on five years of research and dialog with thousands of Americans across the country. It draws on the ideas and wishes of Americans

More information

THE STATE OF HEALTHCARE DELIVERY IN GHANA. HON. DR VICTOR BAMPOE DEPUTY MINISTER OF HEALTH Atlanta Ga.

THE STATE OF HEALTHCARE DELIVERY IN GHANA. HON. DR VICTOR BAMPOE DEPUTY MINISTER OF HEALTH Atlanta Ga. THE STATE OF HEALTHCARE DELIVERY IN GHANA HON. DR VICTOR BAMPOE DEPUTY MINISTER OF HEALTH Atlanta Ga. Outline 1. Where are we? 2. What are we doing? 3. What can you do? 4. Challenges HEALTH STATUS Where

More information

Health Care Implementation Timeline

Health Care Implementation Timeline Health Care Implementation Timeline The massive healthcare (H.R. 3590) and its companion reconciliation bill (H.R. 4872) passed by the Senate and House in early 2010 will go into effect over several years.

More information

THE NATIONAL HEALTH INSURANCE PLAN TURKS & CAICOS ISLANDS Presented by Zaneta Burton QUICK FACTS TURKS & CAICOS Total Population approx. 30,000 Turks & Caicos Islanders 34% of total Population Expatriate

More information

Joint Select Committee on Health Care Reform

Joint Select Committee on Health Care Reform LD 1611 An Act To Provide Affordable Health Insurance to Small Businesses and Individuals and To Control Health Care Costs PUBLIC 469 Sponsor(s) Committee Report Amendments Adopted O'NEIL OTP-AM H-565

More information

Pioneering Social Health Insurance in Tanzania: The case of the National Health Insurance Fund. (NHIF)

Pioneering Social Health Insurance in Tanzania: The case of the National Health Insurance Fund. (NHIF) IMPROVING ACCESS THROUGH EFFECTIVE HEALTH FINANCING Pioneering Social Health Insurance in Tanzania: The case of the National Health Insurance Fund. (NHIF) Presented by the Director General of NHIF Mr.

More information

EVALUATION OF BANK/CDFI PARTNERSHIP OPPORTUNITIES

EVALUATION OF BANK/CDFI PARTNERSHIP OPPORTUNITIES IV. EVALUATION OF BANK/CDFI PARTNERSHIP OPPORTUNITIES Banks should carefully review prospective relationships with CDFIs. In particular, they should evaluate the CDFI s service area relative to the bank

More information

The Global Financing Facility A New Era in Development Finance

The Global Financing Facility A New Era in Development Finance The Global Financing Facility A New Era in Development Finance Although a large number of countries, particularly in Africa and South Asia, will miss the 2015 Millennium Development Goal targets to improve

More information

UNIVERSAL HEALTH COVERAGE IN AFRICA: FROM CONCEPT TO ACTION BACKGROUND... 1 10 THE CURRENT SITUATION AND LESSONS LEARNED FROM UHC EXPERIENCES...

UNIVERSAL HEALTH COVERAGE IN AFRICA: FROM CONCEPT TO ACTION BACKGROUND... 1 10 THE CURRENT SITUATION AND LESSONS LEARNED FROM UHC EXPERIENCES... AFRICAN UNION UNION AFRICAINE UNIÃO AFRICANA 1 st African Ministers of Health meeting jointly convened by the AUC and WHO 1 ère réunion des ministres africains de la Santé organisée conjointement par la

More information

Building Partnerships for Aid Effectiveness. 1. Introduction

Building Partnerships for Aid Effectiveness. 1. Introduction Building Partnerships for Aid Effectiveness 1. Introduction I would like to begin by expressing my gratitude to the Ugandan National Academy of Sciences for according me the honour of addressing this important

More information

Thinking of introducing social health insurance? Ten questions

Thinking of introducing social health insurance? Ten questions Thinking of introducing social health insurance? Ten questions Ole Doetinchem, Guy Carrin and David Evans World Health Report (2010) Background Paper, 26 HEALTH SYSTEMS FINANCING The path to universal

More information

HOW WILL THE ACA AFFECT SIZES? Lisa Clemans-Cope, The Urban Institute

HOW WILL THE ACA AFFECT SIZES? Lisa Clemans-Cope, The Urban Institute HOW WILL THE ACA AFFECT EMPLOYERS OF DIFFERENT SIZES? Lisa Clemans-Cope, The Urban Institute ACA impacts on employers can vary on various characteristics ti Employer size; Whether currently offer insurance;

More information

Health in the post-2015 Development Framework: How to meet the needs of the most marginalized and excluded

Health in the post-2015 Development Framework: How to meet the needs of the most marginalized and excluded Policy briefing Health in the post-2015 Development Framework: How to meet the needs of the most marginalized and excluded Introduction For the past two years, UN Member States, UN agencies, civil society

More information

IFMSA Policy Statement Universal Health Coverage

IFMSA Policy Statement Universal Health Coverage IFMSA Policy Statement Universal Health Coverage Adopted during the 64th August Meeting General Assembly in Ohrid, FYR of Macedonia, 7th August 2015 Summary In recognition of the lingering inequities in

More information

Medical Insurance for the Poor: impact on access and affordability of health services in Georgia

Medical Insurance for the Poor: impact on access and affordability of health services in Georgia Medical Insurance for the Poor: impact on access and affordability of health services in Georgia The health care in Georgia is currently affordable for very rich and very poor Key informant Key Messages:

More information

South Africa s health system What are the gaps? Ronelle Burger

South Africa s health system What are the gaps? Ronelle Burger South Africa s health system What are the gaps? Ronelle Burger Features of SA health system Quadruple burden of disease (Mayosi et al, 2009) communicable diseases e.g. tuberculosis and HIV/AIDS growing

More information

Promoting private health insurance in Ukraine

Promoting private health insurance in Ukraine Institute for Economic Research and Policy Consulting in Ukraine German Advisory Group on Economic Reform Reytarska 8/5-A, 01034 Kyiv, Tel. (+38044) 278-6342, 278-6360, Fax 278-6336 E-mail: institute@ier.kiev.ua,

More information

Summary of the Major Provisions in the Patient Protection and Affordable Health Care Act

Summary of the Major Provisions in the Patient Protection and Affordable Health Care Act Summary of the Major Provisions in the Patient Protection and Affordable Care Act Updated 10/22/10 On March 23, 2010, President Barack Obama signed into law comprehensive health care reform legislation,

More information