Monitoring and evaluating progress towards Universal Health Coverage in Thailand.
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ABSTRACT:
SUBMITTER: Tangcharoensathien V
PROVIDER: S-EPMC4171094 | biostudies-literature |
REPOSITORIES: biostudies-literature
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| S-EPMC4170953 | biostudies-literature
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| S-EPMC4171093 | biostudies-literature
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| S-EPMC4170955 | biostudies-literature
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| S-EPMC4170954 | biostudies-literature
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| S-EPMC4170958 | biostudies-literature
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| S-EPMC4170961 | biostudies-literature
Project description:BackgroundThis paper aims to develop a Chinese version of Universal Health Coverage (UHC) indices and to measure China's progress towards UHC.MethodsNineteen indicators were selected based on expert consultations to construct indices of accessibility and affordability to measure UHC. Data were drawn from health statistics yearbooks, nationally representative surveys, and health system reform surveillance. The index of accessibility includes absolute accessibility (to essential health services), relative accessibility (to hospital care) and people's subjective perceptions. The index of affordability includes absolute affordability (the incidence of catastrophic health expenditure, CHE), relative affordability (the composition of health expenditure), and people's subjective perceptions.ResultsThe indices of accessibility and affordability both showed steady increases over the 17 years considered. Absolute accessibility had the most significant improvement (from 23.6 in 2002 to 73.8 in 2018), while the index of relative accessibility decreased from 81.4 in 2002 to 67.3 in 2018. The index of absolute affordability decreased significantly from 46.6 in 2002 to 30.5 in 2010 and then exhibited an increasing trend afterwards, reaching 52.1 in 2018. The index of relative affordability continuously increased during the observation period, from 35.3 to 75.4.ConclusionsChina has made great progress in increasing the accessibility and affordability of health services since the health system reforms in 2009. However, integrating primary health care and hospital care and containing escalating medical expenditure to further reduce patients' financial burdens are key challenges for strengthening the Chinese health system.
| S-EPMC8088770 | biostudies-literature
Project description:The information that people need to protect and manage their own health and the health of those for whom they are responsible is a fundamental element of an effective people-centred healthcare system. Achieving universal health coverage (UHC) requires universal access to essential health information. While it was recently recognised by the World Medical Association, universal access to essential health information is not yet reflected in official monitoring of progress on UHC for the sustainable development goals (SDGs). In this paper, we outline key features that characterise universal access to essential health information and indicate how it is increasingly achievable. We highlight the growing evidence of the impact of wider access to practical and actionable information on health for the public, carers and frontline health workers and provide illustrative, evidence-based, examples of how increasing access to essential health information can accelerate the achievement of UHC and other health targets of the SDGs. The paper ends with an assessment of reasons why universal access to essential health information has not yet been achieved, and an associated call to action to key stakeholders-such as governments, multilaterals, funding bodies, policy-makers, health professionals and knowledge intermediaries-to explicitly recognise the foundational role of universal access to essential health information for achieving UHC and the rest of the health SDGs, to include it in the relevant SDG target and associated monitoring indicators, and to incorporate actions in their own policies and programmes to promote and enable this access.
| S-EPMC7245367 | biostudies-literature
Project description:BackgroundSouth Africa is committed to advancing universal health coverage (UHC). The usefulness and potential of using routine health facility data for monitoring progress towards UHC, in the form of the 16-tracer WHO service coverage index (SCI), was assessed.MethodsAlternative approaches to calculating the WHO SCI from routine data, allowing for disaggregation to district level, were explored. Data extraction, coding, transformation and modelling processes were applied to generate time series for these alternatives. Equity was assessed using socio-economic quintiles by district.ResultsThe UHC SCI at a national level was 46.1 in 2007-2008 and 56.9 in 2016-2017. Only for the latter period, could the index be calculated for all indicators at a district level. Alternative indicators were formulated for 9 of 16 tracers in the index. Routine or repeated survey data could be used for 14 tracers. Apart from the NCD indicators, a gradient of poorer performance in the most deprived districts was evident in 2016-2017.ConclusionsIt is possible to construct the UHC SCI for South Africa from predominantly routine data sources. Overall, there is evidence from district level data of a trend towards reduced inequity in relation to specific categories (notably RMNCH). Progress towards UHC has the potential to overcome fragmentation and enable harmonisation and interoperability of information systems. Private sector reporting of data into routine information systems should be encouraged.
| S-EPMC8435360 | biostudies-literature
Project description:BackgroundAround the world, millions of people are impoverished due to health care spending. The highest catastrophic health expenditures are found in countries in transition. Our study analyzes the extent of financial protection by estimating the incidence of catastrophic health care expenditure in Myanmar and its association with sociodemographic factors.MethodsWe performed a secondary analysis of data from the household surveys conducted by the Livelihoods and Food Security Trust Fund (LIFT) in 2013 and 2015 in Myanmar. To estimate the magnitude of catastrophic health care expenditure, we applied the definition of catastrophic payment proposed by the World Health Organization (WHO); a household's out-of-pocket payment for health care is considered catastrophic if it exceeds 40% of the household capacity to pay. We also examined the changes in catastrophic payments at three different threshold levels (20, 30, 40%) with one equation allowing for a negative capacity to pay (modified WHO approach) and another equation with adjusted negative capacity to pay (standard WHO approach).ResultsIn 2013, the incidence of catastrophic expenditure was 21, 13, 7% (standard WHO approach) and 48, 43, 41% (modified WHO approach) at the 20, 30, 40% threshold level respectively, while in 2015, these estimates were 18, 8, 6% (standard WHO approach) and 47, 41, 39% (modified WHO approach) respectively. Geographical location, gender of the household head, total number of household members, number of children under 5, and number of disabled persons in the household were statistically significantly associated with catastrophic health care expenditures in both studied years 2013 and 2015. Education of household head was statistically significantly associated with catastrophic health expenditure in 2013. We found that the incidence of catastrophic expenditures varied by the approach used to estimate expenditures.ConclusionsAlthough the level of catastrophic health care expenditure varies depending on the approach and threshold used, the problem of catastrophic expenditures in Myanmar cannot be denied. The government of Myanmar needs to scale up the current Social Security Scheme (SSS) or establish a new financial protection mechanism for the population. Vulnerable groups, such as households with a household head with a low-level of education, households with children under the age of 5?years or disabled persons, and low-income households should be prioritized by policymakers to improve access to essential health care.
| S-EPMC6664746 | biostudies-literature