Mitigating the regressivity of private mechanisms of financing healthcare: An Assessment of 29 countries.

Progressive financing of health care can help advance the equity and financial protection goals of health systems. All countries' health systems are financed in part through private mechanisms, including out-of-pocket payments and voluntary health insurance. Yet little is known about how these financing schemes are structured, and the extent to which policies in place mitigate regressivity. This study identifies the potential policies to mitigate regressivity in private financing, builds two qualitative tools to comparatively assess regressivity of these two sources of revenue, and applies this tool to a selection of 29 high-income countries. It provides new evidence on the variations in policy approaches taken, and resultant regressivity, of private mechanisms of financing health care. These results inform a comprehensive assessment of progressivity of health systems financing, considering all revenue streams, that appears in this special section of the journal.

Good while it lasted? Estimating the long-term and withdrawal effects of results-based financing in Malawi on maternal care utilisation using routine data.

OBJECTIVES: This study aimed to evaluate the effect of introduction and subsequent withdrawal of the Results-based Financing for Maternal and Newborn Health Initiative (RBF4MNH) in Malawi on utilisation of facility-based childbirths, antenatal care (ANC) and postnatal care (PNC). DESIGN: A controlled interrupted time series design was used with secondary data from the Malawian Health Management Information System. SETTING: Healthcare facilities at all levels identified as providing maternity services in four intervention districts and 20 non-intervention districts in Malawi. PARTICIPANTS: Routinely collected, secondary data of total monthly service utilisation of facility-based childbirths, ANC and PNC services. INTERVENTIONS: The intervention is the RBF4MNH initiative, introduced by the Malawian government in 2013 to improve maternal and infant health outcomes and withdrawn in 2018 after ceasing of donor funding. OUTCOME MEASURES: Differences in total volume and trends of utilisation of facility-based childbirths, ANC and PNC services, compared between intervention versus non-intervention districts, for the study period of 90 consecutive months. RESULTS: No significant effect was observed, on utilisation trends for any of the three services during the first 2.5 years of intervention. In the following 2.5 years after full implementation, we observed a small positive increase for facility-based childbirths (+0.62 childbirths/month/facility) and decrease for PNC (-0.55 consultations/month/facility) trends of utilisation respectively. After withdrawal, facility-based childbirths and ANC consultations dropped both in immediate volume after removal (-10.84 childbirths/facility and -20.66 consultations/facility, respectively), and in trends of utilisation over time (-0.27 childbirths/month/facility and -1.38 consultations/month/facility, respectively). PNC utilisation levels seemed unaffected in intervention districts against a decline in the rest of the country. CONCLUSIONS: Concurrent with wider literature, our results suggest that effects of complex health financing interventions, such as RBF4MNH, can take a long time to be seen. They might not be sustained beyond the implementation period if measures are not adopted to reform existing health financing structures.

Sustainable financing for vaccination towards advancing universal health coverage in the WHO African region: The strategic role of national health insurance.

There is a growing political interest in health reforms in Africa, and many countries are choosing national health insurance as their main financing mechanism for universal health coverage. Although vaccination is an essential health service that can influence progress toward universal health coverage, it is not often prioritized by these national health insurance systems. This paper highlights the potential gains of integrating vaccination into the package of health services that is provided through national health insurance and recommends practical policy actions that can enable countries to harness these benefits at population level.

Machine learning in health financing: benefits, risks and regulatory needs.

There is increasing use of machine learning for the health financing functions (revenue raising, pooling and purchasing), yet evidence lacks for its effects on the universal health coverage (UHC) objectives. This paper provides a synopsis of the use cases of machine learning and their potential benefits and risks. The assessment reveals that the various use cases of machine learning for health financing have the potential to affect all the UHC intermediate objectives - the equitable distribution of resources (both positively and negatively); efficiency (primarily positively); and transparency (both positively and negatively). There are also both positive and negative effects on all three UHC final goals, that is, utilization of health services in line with need, financial protection and quality care. When the use of machine learning facilitates or simplifies health financing tasks that are counterproductive to UHC objectives, there are various risks - for instance risk selection, cost reductions at the expense of quality care, reduced financial protection or over-surveillance. Whether the effects of using machine learning are positive or negative depends on how and for which purpose the technology is applied. Therefore, specific health financing guidance and regulations, particularly for (voluntary) health insurance, are needed. To inform the development of specific health financing guidance and regulation, we propose several key policy and research questions. To gain a better understanding of how machine learning affects health financing for UHC objectives, more systematic and rigorous research should accompany the application of machine learning.

Alors que l'apprentissage machine connaît un usage croissant pour les fonctions de financement de la santé (collecte de revenus, mise en commun et achat), les preuves manquent quant à ses effets sur les objectifs de la couverture sanitaire universelle (CSU). Ce document présente une synthèse des cas d'utilisation de l'apprentissage machine et de leurs avantages et risques potentiels. L'évaluation révèle que les différents cas d'utilisation de l'apprentissage machine pour le financement de la santé sont susceptibles d'affecter tous les objectifs intermédiaires de la CSU: la distribution équitable des ressources (à la fois positivement et négativement), l'efficacité (principalement positivement) et la transparence (à la fois positivement et négativement). Il existe également des effets positifs et négatifs sur les trois objectifs finaux de la CSU, à savoir l'utilisation des services de santé en fonction des besoins, la protection financière et la qualité des soins. Lorsque l'utilisation de l'apprentissage machine facilite ou simplifie des tâches de financement de la santé qui vont à l'encontre des objectifs de la CSU, différents risques se font jour, comme la sélection des risques, la réduction des coûts au détriment de la qualité des soins, la réduction de la protection financière ou la surveillance excessive. Les effets positifs ou négatifs de l'utilisation de l'apprentissage machine dépendent de la manière dont la technologie est appliquée et de l'objectif poursuivi. C'est pourquoi s'imposent des orientations et des réglementations spécifiques en matière de financement de la santé, en particulier pour l'assurance maladie (volontaire). Afin d'éclairer l'élaboration de telles orientations et réglementations, nous proposons plusieurs questions clés en matière de politique et de recherche. Pour mieux comprendre la façon dont l'apprentissage machine affecte le financement de la santé dans le cadre des objectifs de la CSU, une recherche plus systématique et plus rigoureuse devrait accompagner la mise en œuvre de l'apprentissage machine.

Aunque el uso del aprendizaje automático para las funciones de financiación sanitaria (recaudación de ingresos, mancomunación y compra) es cada vez mayor, no hay evidencias de sus efectos sobre los objetivos de la cobertura sanitaria universal (CSU). Este documento ofrece una sinopsis de los casos de uso del aprendizaje automático y sus posibles beneficios y riesgos. La evaluación revela que los diversos casos de uso del aprendizaje automático para la financiación sanitaria tienen el potencial de afectar a todos los objetivos intermedios de la CSU: la distribución equitativa de los recursos (tanto positiva como negativamente), la eficiencia (principalmente positiva) y la transparencia (tanto positiva como negativamente). También hay efectos positivos y negativos en los tres objetivos finales de la CSU, es decir, la utilización de los servicios sanitarios en función de las necesidades, la protección financiera y la atención de calidad. El uso del aprendizaje automático para facilitar o simplificar tareas de financiación sanitaria contraproducentes para los objetivos de la CSU plantea diversos riesgos, como la selección de riesgos, la reducción de costes a expensas de la calidad de la atención, la disminución de la protección financiera o el exceso de vigilancia. El carácter positivo o negativo de los efectos del aprendizaje automático depende de cómo y con qué fin se aplique la tecnología. Por lo tanto, se necesitan directrices y reglamentos específicos para la financiación sanitaria, en particular para los seguros de salud (voluntarios). Proponemos varias preguntas clave en materia de política e investigación para contribuir a la elaboración de directrices y reglamentos específicos sobre financiación sanitaria. A fin de comprender mejor cómo afecta el aprendizaje automático al logro de los objetivos de la CSU en el ámbito de la financiación sanitaria, la aplicación del aprendizaje automático debería ir acompañada de una investigación más sistemática y rigurosa.

Managing transitions from external assistance: cross-national learning about sustaining effective coverage.

The often-prominent role of external assistance in health financing in low- and middle-income countries raises the question of how such resources can enable the sustained or even expanded coverage of key health services and initiatives even after donor funding is no longer available. In response to this question, this paper analyses the process and outcomes of donor transitions in health-where countries or regions within countries are no longer eligible to receive grants or concessional loans from external sources based on eligibility criteria or change in donor policy. The comparative analysis of multiple donor transitions in four countries-China, Georgia, Sri Lanka and Uganda-identifies 16 factors related to policy actors, policy process, the content of donor-funded initiatives and the broader political-economic context that were associated with sustained coverage of previously donor supported interventions. From a contextual standpoint, these factors relate to favourable economic and political environments for domestic systems to prioritize coverage for donor-supported interventions. Clear and transparent transition processes also enabled a smoother transition. How the donor-supported initiatives and services were organized within the context of the overall health system was found to be critically important, both before and during the transition process. This includes a targeted approach to integrate, strengthen and align key elements of the governance, financing, input management and service delivery arrangements with domestic systems. The findings of this analysis have important implications for how both donors and country policy makers can better structure external assistance that enables sustained coverage regardless of the source of funding. In particular, donors can better support sustained coverage through supporting long-term structural and institutional reform, clear co-financing policies, ensuring alignment with local salary scales and engaging with communities to ensure a continued focus on equitable access post-transition.

LGBTQ+ inequity in crowdfunding cancer costs: The influence of online reach and LGBTQ+ state policy.

BACKGROUND: Emerging literature suggests that LGBTQ+ cancer survivors are more likely to experience financial burden than non-LGBTQ+ survivors. However, LGBTQ+ cancer survivors experience with cost-coping behaviors such as crowdfunding is understudied. METHODS: We aimed to assess LGBTQ+ inequity in cancer crowdfunding by combining community-engaged and technology-based methods. Crowdfunding campaigns were web-scraped from GoFundMe and classified as cancer-related and LGBTQ+ or non-LGBTQ+ using term dictionaries. Bivariate analyses and generalized linear models were used to assess differential effects in total goal amount raised by LGBTQ+ status. Stratified models were run by online reach and LGBTQ+ inclusivity of state policy. RESULTS: A total of N = 188,342 active cancer-related crowdfunding campaigns were web-scraped from GoFundMe in November 2022, of which N = 535 were LGBTQ+ and ranged from 2014 to 2022. In multivariable models of recent campaigns (2019-2022), LGBTQ+ campaigns raised $1608 (95% CI: -2139, -1077) less than non-LGBTQ+ campaigns. LGBTQ+ campaigns with low (26-45 donors), moderate (46-87 donors), and high (88-240 donors) online reach raised on average $1152 (95% CI: -$1589, -$716), $1050 (95% CI: -$1737, -$364), and $2655 (95% CI: -$4312, -$998) less than non-LGBTQ+ campaigns respectively. When stratified by LGBTQ+ inclusivity of state level policy states with anti-LGBTQ+ policy/lacking equitable policy raised on average $1910 (95% CI: -2640, -1182) less than non-LGBTQ+ campaigns from the same states. CONCLUSIONS AND RELEVANCE: Our findings revealed LGBTQ+ inequity in cancer-related crowdfunding, suggesting that LGBTQ+ cancer survivors may be less able to address financial burden via crowdfunding in comparison to non-LGBTQ+ cancer survivors-potentially widening existing economic inequities.

Making development assistance work for Africa: from aid-dependent disease control to the new public health order.

The Coronavirus disease (COVID-19) pandemic has revealed the fragility of pre-crisis African health systems, in which too little was invested over the past decades. Yet, development assistance for health (DAH) more than doubled between 2000 and 2020, raising questions about the role and effectiveness of DAH in triggering and sustaining health systems investments. This paper analyses the inter-regional variations and trends of DAH in Africa in relation to some key indicators of health system financing and service delivery performance, examining (1) the trends of DAH in the five regional economic communities of Africa since 2000; (2) the relationship between DAH spending and health system performance indicators and (3) the quantitative and qualitative dimensions of aid substitution for domestic financing, policy-making and accountability. Africa is diverse and the health financing picture has evolved differently in its subregions. DAH represents 10% of total spending in Africa in 2020, but DAH benefitted Southern Africa significantly more than other regions over the past two decades. Results in terms of progress towards universal health coverage (UHC) are slightly associated with DAH. Overall, DAH may also have substituted for public domestic funding and undermined the formation of sustainable UHC financing models. As the COVID-19 crisis hit, DAH did not increase at the country level. We conclude that the current architecture of official development assistance (ODA) is no longer fit for purpose. It requires urgent transformation to place countries at the centre of its use. Domestic financing of public health institutions should be at the core of African social contracts. We call for a deliberate reassessment of ODA modalities, repurposing DAH on what it could sustainably finance. Finally, we call for a new transparent framework to monitor DAH that captures its contribution to building institutions and systems.

Innovative domestic financing mechanisms for health in Africa: An evidence review.

OBJECTIVES: This article synthesizes the evidence on what have been called innovative domestic financing mechanisms for health (i.e. any domestic revenue-raising mechanism allowing governments to diversify away from traditional approaches such as general taxation, value-added tax, user fees or any type of health insurance) aimed at increasing fiscal space for health in African countries. The article seeks to answer the following questions: What types of domestic innovative financial mechanisms have been used to finance health care across Africa? How much additional revenue have these innovative financing mechanisms raised? Has the revenue raised through these mechanisms been, or was it meant to be, earmarked for health? What is known about the policy process associated with their design and implementation? METHODS: A systematic review of the published and grey literature was conducted. The review focused on identifying articles providing quantitative information about the additional financial resources generated through innovative domestic financing mechanisms for health care in Africa, and/or qualitative information about the policy process associated with the design or effective implementation of these financing mechanisms. RESULTS: The search led to an initial list of 4035 articles. Ultimately, 15 studies were selected for narrative analysis. A wide range of study methods were identified, from literature reviews to qualitative and quantitative analysis and case studies. The financing mechanisms implemented or planned for were varied, the most common being taxes on mobile phones, alcohol and money transfers. Few articles documented the revenue that could be raised through these mechanisms. For those that did, the revenue projected to be raised was relatively low, ranging from 0.01% of GDP for alcohol tax alone to 0.49% of GDP if multiple levies were applied. In any case, virtually none of the mechanisms have apparently been implemented. The articles revealed that, prior to implementation, the political acceptability, the readiness of institutions to adapt to the proposed reform and the potential distortionary impact these reforms may have on the targeted industry all require careful consideration. From a design perspective, the fundamental question of earmarking proved complex both politically and administratively, with very few mechanisms actually earmarked, thus questioning whether they could effectively fill part of the health-financing gap. Finally, ensuring that these mechanisms supported the underlying equity objectives of universal health coverage was recognized as important. CONCLUSIONS: Additional research is needed to understand better the potential of innovative domestic revenue generating mechanisms to fill the financing gap for health in Africa and diversify away from more traditional financing approaches. Whilst their revenue potential in absolute terms seems limited, they could represent an avenue for broader tax reforms in support of health. This will require sustained dialogue between Ministries of Health and Ministries of Finance.

Getting ready for reduced donor dependency: the co-financing of family planning commodities.

Family planning (FP) programmes in low and lower-middle income countries are confronting the dual impact of reduced external donor commitments and stagnant or reduced domestic financing, worsened by economic consequences of the COVID-19 pandemic. Co-financing-a donor-government agreement to jointly fund aspects of a programme, with transition towards the government assuming increasing responsibility for total cost-can be a powerful tool to help build national ownership, fiscal sustainability and programme visibility. Using Gavi's successful co-financing model as reference, the current paper draws out a set of key considerations for developing policies on co-financing of FP commodities in resource-poor settings. Macroeconomic and contextual sensitivities must be incorporated while classifying countries and determining co-financing obligations-using the actual GNI per capita on a scale or sovereign credit ratings, in conjunction with programmatic indicators, may be preferred. It is also important for policies to allow sufficiently long time for countries to transition-dependent on the country context, may be up to 10 years as allowed under the US Agency for International Development FP graduation policy and flexibility to revisit the terms following externalities that can influence the fiscal space for health. Incentivizing new domestic financing to pay for co-financing dues is critical, so as not to displace government funding from related health or social sector programs. Pragmatic ways to ensure country compliance can include engaging both the ministries of health and finance as co-signatories to identify and address known administrative and fiscal challenges; establishing dedicated co-financing account with the finance ministry; and instituting a mutual monitoring mechanism. Lastly, the overall process of policymaking can benefit from an alignment of goals and interests of the key development partners.

Assessing equity and efficiency of health financing towards universal health coverage between regions in Tanzania.

Equity and efficiency in health financing are intermediate universal health coverage (UHC) objectives. While there is growing attention to monitoring these goals at the national level, subnational assessment is also needed to uncover potential divergences across subnational units. We assessed whether health funds were allocated or contributed equitably and spent efficiently across 26 regions in Tanzania in 2017/18 for four sources of funding. Government and donor health basket fund (HBF) expenditure data were obtained from government authorities. Household contributions to health insurance and out-of-pocket payments were obtained from the national household budget survey. We used the Kakwani index (KI) to measure regional funding equity, whereby regional GDP per capita measured regional economic status. Efficiency analysis included four financing inputs and two UHC outputs (maternal health service coverage and financial protection indices). Data envelopment analysis estimated efficiency scores. There was substantial variation in per capita regional funding, especially in insurance contributions (TZS 473-13,520), and service coverage performance (49-86.3%). There was less variation in per capita HBF spending (TZS 1294-2394) and financial protection (93.5-99.4%). Government spending (KI: -0.047, p = 0.348) was proportional to regional economic status; but HBF spending (KI: -0.195, p < 0.001) was significantly progressive (equitably distributed), being targeted to regions with high economic need (poor). The burden of contributing to social health insurance (NHIF) was proportional (KI: 0.058, p = 0.613), while the burden of paying for community-based insurance (CHF, KI: -0.152, p=0.012) and out-of-pocket payments (KI: -0.187, p=0.005) was higher among the poor (regressive). The average efficiency score across regions was 90%, indicating that 90% of financial resources were used optimally, while 10% were wasted or underutilised. Tanzania should continue mobilising domestic resources for health towards UHC, and reduce reliance on inequitable out-of-pocket payments and community-based health insurance. Policymakers must enhance resource allocation formulas, public financial management, and sub-national resource tracking to improve equity and efficiency in resource use.

External influences over Senegalese health financing policy: delaying universal health coverage?

Senegal has long sought solutions to achieve universal health coverage (UHC). However, in a context dependent on international aid, the country faces multiple external pressures to choose policy instruments. In this commentary, we propose an analysis of this influence. The empirical material comes from our involvement in analysing health reforms for 20 years and from many interviews and observations. While studies have shown that community-based health insurance (CBHI) was not an appropriate solution for UHC, some international actors have influenced their continued application. Another global partner proposed an alternative (professional and departmental CBHI), which was counteracted and delayed. These issues of powers and influences of international and national consultants, established in a neo-liberal approach to health, have lost at least a decade from UHC in Senegal. The alternative now appears to be acquired and is scaling up at the country level, witnessing a change in the current policy paradigm.

Factors inhibiting and enabling performance-based financing in health care delivery across low and middle-income countries: a scoping review

Background: Emerging financing strategies in the health sector have been developed to improve the impact of investments and enhance healthcare outcomes. One promising approach is Results-based Financing, which establishes a connection between financial incentives and pre-established performance targets. This innovative approach holds the potential to strengthenhealthcare delivery and strengthen overall healthcare systems.Aim:The scoping review endeavored to systematically delineate the body of evidence pertaining tofacilitators and barriers to the implementation of performance-based financing within the realm of healthcare provision in low-and middle-income nations.Methods:The review used Preferred Reporting Items for Systematic Reviews and a Meta-Analysis extension for Scoping Reviews checklist to select, appraise, and report the findings. We searched PubMed, Web of Science, and Google Scholar databases and grey literature published between January 2000 and March 2022. We conducted the abstract screening with two independent reviewers. We also performed full-article screening. We used the six methodological frameworks proposed by Arksey and O'Malley. The results were thematically analyzed.Results:Of the 1071 searched studies, 34 met the eligibility criteria. 41% of the studies were descriptive, 26% cross-sectional, 18% trial, and 15% cohort studies. The enabling and inhibiting factors of performance-based financing in healthcaredelivery have been identified. Moreover, the review revealed that performance-based financing's influence on service delivery is context-specific.Conclusion:The facilitators and impediments to the effectiveness of performance-based financing in enhancing service delivery are contingent upon a holistic comprehension of the contextual factors, meticulous design, and efficient execution. Factors such as the level of care facilities, presence of community-based initiatives, stakeholder involvement, and participatory design emerge as key facilitators. Conversely, barriers such as communication obstacles, inadequacies in the PBF models, and deficiencies in the healthcare workforce are recognized as inhibitors. By harnessing the insights derived from a multitude of evidence incorporated in this scrutiny, stakeholders can deftly navigate the intricacies of performance-based financing, while also considering the prospective areas for further exploration and research

Les soins et services de santé sont-ils financièrement accessibles ? De nouvelles bases factuelles sur la protection financière en France

Cette étude fait partie d’une série de rapports par pays qui présentent de nouvelles bases factuelles sur la protection financière – l’accessibilité financière aux soins et services de santé – au sein des systèmes de santé en Europe. Les restes à charge catastrophiques sont inférieurs en France par rapport à ceux enregistrés dans de nombreux pays de l’Union européenne (UE), mais les besoins de soins dentaires non satisfaits sont supérieurs à la moyenne de l’UE et ces deux constats sont associés à d’importantes inégalités liées au revenu. Les restes à charge catastrophiques affectent le quintile des ménages les plus pauvres et ils sont principalement dus aux restes à charge associés aux médicaments en ambulatoire, aux produits médicaux et aux soins externes. Il est très probable qu’ils soient le reflet d’un système de participations financières généralisées, importantes et complexes pour des soins et services de santé financés publiquement, notamment des dépassements d’honoraires élevés pour les matériels et produits médicaux et pour les soins et services ambulatoires. La couverture maladie complémentaire (ou complémentaire santé) qui rembourse une partie des dépenses de santé couvre près de 95 % de la population et améliore la protection financière de la plupart des individus grâce aux efforts continus du gouvernement visant à garantir un accès gratuit ou subventionné à cette couverture aux personnes aux revenus les plus modestes. Néanmoins, la complémentaire santé ne résout pas tous les problèmes d’accessibilité financière aux soins : les ménages aux revenus les plus modestes sont les plus susceptibles de ne pas détenir de complémentaire et celle-ci constitue une source de financement particulièrement régressive du système de santé. Elle implique par ailleurs un coût de transaction et des coûts financiers élevés pour les pouvoirs publics et les salariés. Depuis 2019, le gouvernement a pris des mesures visant à réduire les dépassements d’honoraires pour les produits médicaux. Pour aller plus loin, le gouvernement peut utiliser plus efficacement les ressources publiques en réduisant les participations financières et en permettant que le système de santé repose moins sur la couverture maladie complémentaire : par exemple, en exonérant les ménages à faibles revenus et les personnes atteintes d’une maladie chronique de toute participation financière, en introduisant un plafond sur toutes les participations financières, en limitant davantage les dépassements d’honoraires et en réduisant la régressivité du financement de la complémentaire santé.

Can people afford to pay for health care? New evidence on financial protection in France: summary

This report assesses the extent to which people in France experience financial hardship when they use health care. It covers the period from 2011 to 2024 using data from household budget surveys from 2011 and 2017 (the latest available year), data on unmet need for health services up to 2022 (the latest available year) and information on coverage policy (population coverage, service coverage and user charges) up to March 2024. Its key findings are as follows.

Can people afford to pay for health care? New evidence on financial protection in France

This review is part of a series of country-based studies generating new evidence on financial protection – affordable access to health care – in health systems in Europe. Catastrophic health spending is lower in France than in many other European Union (EU) countries, but unmet need for dental care is above the EU average and both outcomes are marked by significant income inequality. Catastrophic health spending is heavily concentrated in the poorest fifth of households and mainly driven by out-of-pocket payments for outpatient medicines, medical products and outpatient care. This is likely to reflect widespread, heavy and complex user charges (co-payments) for publicly financed health care, including substantial balance billing for medical products and outpatient care. Complementary health insurance (CHI) covering user charges covers around 95% of the population and improves financial protection for most people due to sustained Government efforts to secure free or subsidized access to CHI for people with very low incomes. However, CHI does not fully address the problems caused by user charges: households with the lowest incomes are the least likely to have any form of CHI and CHI is a highly regressive way of financing the health system. It also involves significant transaction and financial costs for the Government and employers. Since 2019 the Government has taken steps to reduce balance billing for medical products. Building on this, the Government can use public resources more efficiently by reducing user charges and limiting the health system’s reliance on CHI – for example, exempting households with low incomes and people with chronic conditions from all co-payments; introducing an income-based cap on all co-payments; further limiting balance billing; and reducing the regressivity of CHI.

Оё одамон имконияти молиявии пардохти хизматрасонии тиббиро доранд? Далелҳои нав оид ба ҳимояи молиявӣ дар Тоҷикистон

Дар ин гузориши ҷамъбастӣ арзёбӣ карда мешавад, ки то чӣ андоза мардум дар Тоҷикистон ҳангоми истифода аз хизматрасониҳои тиббӣ ва пардохти нақдӣ аз ҷайби худ ба мушкилоти молиявӣ дучор мешавад. Таҳлили ҳимояи молиявӣ одатан маълумотро дар бораи эҳтиёҷоти қонеънашуда ба кӯмаки тиббӣ дар бар мегирад, аммо ин маълумот барои Тоҷикистон дастрас нест. Дар гузориш маълумоти Тадқиқоти буҷети хонаводаҳо истифода карда шудааст, ки аз ҷониби Агентии омори назди Президенти Ҷумҳурии Тоҷикистон дар давраҳои аз соли 2016 то 2019 ва аз 2021 то 2022 гузаронида шудааст. Хулосаҳои асосии гузориш чунин мебошанд.

В состоянии ли люди платить за услуги здравоохранения? Новые данные о финансовой защите в Таджикистане: Сводный отчет

В этом сводном отчете оценивается степень, в которой население Таджикистана испытывают финансовые трудности при использовании услуг здравоохранения и осуществляют выплаты из кармана (прямые платежи, осуществляемые населением). Анализ финансовой защиты обычно включает данные о неудовлетворенных потребностях в услугах здравоохранения, но эти данные недоступны для Таджикистана. В отчете использованы микроданные обследований бюджетов домашних хозяйств, проведенных Агентством по статистике при Президенте Республики Таджикистан в период с 2016 по 2019 гг. и с 2021 по 2022 гг. Основные выводы отчета заключаются в следующем.

Техническая справка по вопросам укрепления сестринских и акушерских кадров в целях улучшения показателей здравоохранения: что известно о расширении сестринских функций: фактические данные и уроки для внедрения

Во время пандемии COVID-19 руководители, определяющие политику, и широкая общественность признали важный вклад сестринских работников в борьбу с пандемией и непростые условия, в которых им приходилось работать. В результате в Европе и в мире повысилось внимание к стратегической роли сестринских кадров. Высшее сестринское образование способствует обеспечению безопасности пациентов и улучшению результатов для пациентов, групп населения и систем здравоохранения. Расширение сестринских функций определено в качестве одного из эффективных кадровых решений в области здравоохранения, которое позволяет улучшить доступ к медицинским услугам для недостаточно обслуживаемых и проживающих на отдаленных территориях групп населения и решить проблему нехватки персонала в учреждениях первичной медико-санитарной помощи, способствуя тем самым достижению всеобщего охвата услугами здравоохранения. В настоящей технической справке основное внимание уделено изложению механизмов, с помощью которых государства-члены Европейского региона расширяют сестринские функции, и описаны возможные пути содействия процессам реализации соответствующих программ.