Moving towards universal health coverage: health insurance reforms in nine developing countries in Africa and Asia.
Lancet
; 380(9845): 933-43, 2012 Sep 08.
Article
em En
| MEDLINE
| ID: mdl-22959390
ABSTRACT
We analyse nine low-income and lower-middle-income countries in Africa and Asia that have implemented national health insurance reforms designed to move towards universal health coverage. Using the functions-of-health-systems framework, we describe these countries' approaches to raising prepaid revenues, pooling risk, and purchasing services. Then, using the coverage-box framework, we assess their progress across three dimensions of coverage who, what services, and what proportion of health costs are covered. We identify some patterns in the structure of these countries' reforms, such as use of tax revenues to subsidise target populations, steps towards broader risk pools, and emphasis on purchasing services through demand-side financing mechanisms. However, none of the reforms purely conform to common health-system archetypes, nor are they identical to each other. We report some trends in these countries' progress towards universal coverage, such as increasing enrolment in government health insurance, a movement towards expanded benefits packages, and decreasing out-of-pocket spending accompanied by increasing government share of spending on health. Common, comparable indicators of progress towards universal coverage are needed to enable countries undergoing reforms to assess outcomes and make midcourse corrections in policy and implementation.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Reforma dos Serviços de Saúde
/
Cobertura Universal do Seguro de Saúde
/
Países em Desenvolvimento
Limite:
Humans
País/Região como assunto:
Africa
/
Asia
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article