Extraordinary 5-year CapEx for health plan 2019-2024

The document details Capital Expenditure that the Ministry of Health will undertake in the five year period 2019-2024.

Ministry of Health Annual report 2016-2017: Highlights of key initiatives

This document highlights the major achievement of the Ministry of Health for the period 2016-2017. Contains information about compassionate care, the strengthening of the health system , treatment of non-communicable diseases, combating communicable diseases, protecting the health of mothers and children, rehabilitation and new investment in critical health infrastructure.

Gasto y financiamiento en salud: situacion y tendencias / Health spending and financing: the current situation and trends

Being knowledgeable about national health expenditures and sources of financing is essential for decision-making. This awareness also makes it possible to evaluate the equity of allocation and the efficiency of utilization of these resources. Changes in the financing have been a substantial component of health sector reform in the Americas. The goal has shifted from merely one of financial sustainability to simultaneously seeking equitable access to quality services. In this article the PAn American Health Organization (PAHO) presents a proposal for analyzing and designing a policy on health financing. The aim of the policy is to identify the mix of financing mechanisms most likely to simultaneously produce financial sustainability, equity, access, and efficiency. The PAHO proposal combines traditional mechanisms for generating resources (public funds from taxes, as well as private health insurance, national health insurance, and user fees) with complementary subsidy mechanisms for vulnerable groups. Health financing strategies ought to explicitly consider the financing both of care for individuals and of health interventions for the general public good, for which public financing is the most equitable and efficient approach (AU)

Reformas del sector de la salud y participacion social / Health sector reforms and societal involvement

This article begins by briefly reviewing different forms of citizen participation in the health system. The article then suggests the need for mechanisms for society to control each of the tasks that the health system should perform: defining overall policies, financing, insurance, service provision, and evaluating the effectiveness and efficiency of the system. In general, in the countries of Latin America and the Caribbean, health sector policy formulation continues to be carried out in a centralized manner, with limited involvement by individuals and little adaptation to local realities. The reform processes in the Region are progressing in defining or improving the financing responsibility so as to better reconcile the objectives of equity, efficiency, and freedom of choice. Nevertheless, little has been done to develop instruments for citizens to control the functions of financing and insurance. Appropriate instruments are still lacking for citizens to effectively manage service providers. Among the principal obstacles to citizens participation in the health sector in the Region are: inequality in the distribution of income and other forms of power, an embryonic recognition of the rights and the absence of mechanisms for people to truly exercise them, the weakness with which existing control mechanisms recognize social diversity and incorporate the views of minorities or of the most marginalized groups in society, weak civic organizations (AU)

Hacia una nueva seguridad social en el siglo XXI: sin solidaridad en el financiamiento no habra universalidad / Towards new social security systems in the 21st century: universal coverage is impossible without cohesion in financing

In the countries of Latin America and the Caribbean, social security systems have traditionally been almost exclusively the responsibility of the public sector. These systems have had major shortcomings, such as low coverage rates, unbalanced budgets, inadequate funding, and poor management of resources. In order to solve these problems and face the increased demands associated with demographic and epidemiological transitions, in the 1990s a number of countries began to reform their social security systems. These reforms have been characterized by three fundamental features: a) a search for a closer link between contributions and benefits, in order to better balance income and expenses, b) changes in the public-private composition of the systems that allow a greater private role in the financing and delivery of services, and c) an emphasis on market mechanisms as a way to promote efficiency in applying resources, and leaving to the State a role as a regulator and as a guarantor of basic benefits to groups that, because of their socioeconomic conditions, cannot make certain minimum contributions. This article looks at some of the problems raised by the reforms carried out so far, and the lessons that can be learned from them. The piece also analyzes the relationship between universal coverage and societal unity. In addition, the article suggests that the main challenge with social security reforms is that of moving toward universal systems that sinificantly expand coverage. In order to achieve that, it is necessary to strengthen the mechanisms of cohesion in financing and to improve efficiency by introducing market instruments that do not negatively affect the unitarian character of the financing. The piece concludes that it is necessary to increase coverage; improve management; be concerned about the design of the public-private makeup; identify the responsibilities of the private sector and of the government in financing, provision, and regulation of social security systems; and introduce and strengthen unity mechanisms in financing (AU)

The allocation of financial resources and utilisation of primary and secondary care services in Jamaica, 1984-1993

The rational allocation of resources within the health sector has become increasingly important over recent years particularly as efforts have been made to shift resources to support primary care strategies. This study reviews the allocation of resources at the operational level in the Jamaican health services over the period 1984 to 1993. Evidence as to whether this can be related to the utilisation of services and the population served is analysed and the proportional allocation between primary and secondary care services is examined. Additionally, the impact of various events during the period is assessed. The study finds some evidence of a shift in expenditure from hospitals to health departments, particularly in the final three years of the period. However this has to be seen in light of a very significant reduction in real terms in the total funds available to the Ministry of Health and in the allocations to hospitals and health departments. There is a strong correlation between share of the budget and share of population for the health departments although this is not consistent over the years. In respect of utilisation of services, there is some evidence that closure of hospital bed results in changes in average length of stay rather than in number of discharges. This has implications for the strategy of closure of hospital beds to achieve redistribution of resources as any savings achieved will not be indirect proportion to the number of beds closed. Various events examined, the introduction of hospital fees, the closure of hospital beds and Hurricane Gilbert, appear to have had only short term impact on the utilisation of services which returned to usual levels after a short period. The study suggests a model for the distribution of the Ministry of Health budget to support the strategies of primary health care and decentralisation of services. As an example, the 1993/94 Ministry of Health budget is redistributed and the rationale for this is explained. (AU)

Review of health financing in Jamaica and a survey of the feasibility of national health insurance

Assesses Jamaica's Health Sector Initiatives Project which has as its objectives the improvement of the quality and efficiency of health services and to find alternatives for reducing the critical financial constraints in the health sector. Reviews current financing arrangements and allocation of health expenditures in Jamaica as well as earlier studies on health financing in Jamaica, particularly those related to insurance options. Finally, attempts to determine the feasibiity of National Health Insurance options following national and regional consultations. (AU)

Analysis of investment process in health and the environment in Suriname

Documents a proposal for activities aimed at enhancing the capability of identifying and appraising investment initiatives in the health and environment sectors of Suriname. Presents a macro-economic review which covers the Structural Adjustment Programme and the Multi-annual Development Plan, highlighting the health and environment sectors including legal regulations. Identifies and characterizes the key institutions in both sectors, determining their interrelationships and relating them to the stage in the flow of investments. Analyzes, trends in investments in both sectors; consistency between policies and investments; the degree of cooperation; and the existence of clear procedures for investment programming, budgeting and project preparation. (AU)

Local health systems in Montserrat, Grenada, Carriacou and Petit Martinique

Reports on a consultancy aimed at evaluating the various aspects of health care provided at the district level in the three countries. The document examines the most important variables in the political and administrative base of local health system; and makes a comparative analysis and recommendations for operational integration and development of local health systems in the countries involved. Findings show that the countries share several common characteristics and that the planning process tended to be more centralised than decentralised. States that the community has never really been involved in the decision-making process. Generally health care is financed by government. Statistical data show considerable improvement in the health of the population over the last decade. However, the system can be more cost-effectively run if strategies suggested are implemented. Observes that the absence of political will remains the single key factor affecting progress in Barbados and to some extent in Grenada

Health care financing in Grenada: how to share the responsibility of paying for better services

Presents details of a study of the health services sector and the current and prospective means of financing its operation. Findings show that the public health system accounted for nearly 14.6 percent of the government's recurrent budget or about EC$23.5 million in 1990/91, whilst Grenadian spent EC$3 million on private consultations and medicine. The combined total amounts to EC$265 per capita, which is significantly more than in Dominica and St. Lucia. Details on how the public and private sectors share the responsibility of paying for health services are given. Concludes that public health system is well organized in terms of structure and distribution of physical facilities, but inefficient in the management of personnel and material resources. Recommendations and suggestions as to ways non-tax sources can share the responsibility of paying for better health services are given

Comparative health care financing in St. Lucia, Grenada and Dominica

Presents the findings of a study of health care financing in the English-speaking Caribbean. The initial objective of the study was to explore whether increased support for maternal and child health might be provided through an expansion of social insurance coverage to include health benefits for workers and their dependents and also to find out how countries can adapt the organization, financing and delivery of health services so as to continue to provide primary health care equitably and efficiently, while at the same time providing essential secondary and tertiary level services. Details of the comparative study of the health systems in the three countries in terms of the adequacy of the health care provided at different levels and the real resources with which it is provided. Findings show that the level of health care spending both from public and private sources vary considerably among the islands. Includes statistical data on expenditure on health as well as the findings of a survey of consumers' view on the organization and quality of health care in the islands

Five year health sector plan

Presents a plan aimed at guiding the development of the infrastructure, manpower, management and the delivery and provision of health services on the islands of Grenada, Carriacou and Petit Martinique. Objectives include decreasing mortality and morbidity and strengthening the initiatives of health for all by the year 2000. Details on the current health services; priority programmes for health development; health infrastucture and facilities; and details of legislation pertaining to health are given. Also outlines health policy statements of the Government. The general objectives of the plan are outlined and the strategies that should be used to achieve these goals are included

Financing health care in Jamaica

Focuses on health care in Jamaica and ways of financing it. Looks at the macro-economic performance of the public health sector with the Ministry of Health receiving increased dollar support. Argues that despite severe difficulties, government has maintained its commitment to health. Discusses the public health care system in Jamaica, current financial issues, the cost of hospital care, efficiency of hospital care, shortage of doctors, nurses and the equity in hospital service delivery. Comments on private health care delivery with its in-patient and out-patient care. Analyses the efficiency and financial standing of the private health care sector and its link with third party payers. Examines health care demand, the access to health care service, the utliization of health care and the expenditure on it. Proposes some alternate health care financing through privatisation, divestiture, privatisation of public hospitals and instituting health facilities trust. Discusses outstanding issues in privatisation such as user fee policy and the administrative and financial management reforms to be put in place. Recommends reform to user fee, improving information, establishing a new national laboratory and upgrading skills of administrative management in order to improve health care. (AU)