Resource allocation and health financing

Social transfers: A critical strategy to meet the MDGs
Bourne AW and Morgan F: HelpAge International, 2010

This brief outlines the role that social transfers have to play in providing an inclusive framework to reduce intergenerational and chronic poverty. The authors argue that the Millennium Development Goals (MDGs), in common with many development, policies and programmes, focus effort on children, young people and the ‘working-age’ poor. However, they fail to recognise and support the social, economic and caring needs and contributions of older people. The paper highlights HelpAge's call on the international community to invest in government-led social transfer schemes in order to accelerate progress to achieve the MDGs. HelpAge calls for multilateral and bilateral development agencies to commit to working in partnership with national governments and invest in the development or scaling up of long-term, sustainable social transfer schemes, disaggregated monitoring of aid budgets and national government budgets to track the impact of social transfers, and recognition by the United Nations’ MDG database of the need for age-disaggregated data to ensure the effective monitoring and evaluation of the MDGs for all age groups.

Social, Cultural and Environmental Contexts and the Measurement of the Burden of Disease
AN EXPLORATORY COMPARISON IN THE DEVELOPED AND DEVELOPING WORLD

Daniel D. Reidpath, Pascale Allotey, Aka Kouame, Robert A. Cummins March 2001. Funding Agencies: Global Forum for Health Research, The University of Melbourne (MRCEG Scheme).
Internationally, there is growing commitment to health policies and programs that are "evidence-based": that is, that they derive from a body of research that has been proven true, effective or successful. In establishing an evidence-base, there is a continued concern with replicability of research, with the robustness of findings across time and place, and in the absence of replication, with an explanation for the lack of fit. In this endeavour, considerable attention has been paid to common tools, common protocols and consistent, shared measures – validated questionnaires, common tools to assess physical and mental health and summary indices for quality of life, health inputs and health outcomes. This concern for comparability in public health matches a concern by economists and health planners, locally, nationally and internationally, to rationalise, to set priorities and goals, to allocate funds on the objective basis of need and impact, and to direct resources where the outcome will be most effective.

Further details: /newsletter/id/28616
Sociodemographic patterns of health insurance coverage in Namibia
Allcock S; Young E; Sandhu M: International Journal for Equity in Health 18(16) 1-11, 2019

This paper aimed at assessing the prevalence of health insurance, the relation between health insurance and health service utilisation and to explore the sociodemographic factors associated with health insurance in Namibia. Such findings may help to inform health policy to improve financial access to healthcare in the country. Using data on 14,443 individuals, aged 15 to 64 years, from the 2013 Namibia Demographic and Health Survey, the association between health insurance and health service utilisation was investigated using multivariable mixed effects Poisson regression analyses. Just 17.5% of this population were insured. In fully-adjusted analyses, education was significantly positively associated with health insurance, independent of other sociodemographic factors. Female sex and wealth were also independently associated with insurance. There was a complex interaction between sex, education and wealth in the context of health insurance. With increasing education, women were more likely to be insured and education had a greater impact on the likelihood of health insurance in lower wealth quintiles. In this population, health insurance was associated with health service utilisation but insurance coverage was low, and was independently associated with sex, education and wealth. Education may play a key role in health insurance coverage, especially for women and the less wealthy. The authors suggest that the findings may help to inform the targeting of strategies to improve financial protection from healthcare-associated costs in Namibia.

South Africa: Medical Schemes Act 131 of 1998

The act is intended to consolidate the laws relating to registered medical schemes; to provide for the establishment of the Council for Medical Schemes as a juristic person; to provide for the appointment of the Registrar of Medical Schemes; to make provision for the registration and control of certain activities of medical schemes; to protect the interests of members of medical schemes; to provide for measures for the coordination of medical schemes; and to provide for incidental matters.

South Africa: New social grants plan cautiously welcomed
IRIN Plus News, 23 November 2006

South Africa's Department of Health confirmed on Thursday that a new social grant system was on the cards for chronically ill people, including those living with HIV/AIDS. At present, government policy stipulates that HIV positive grant recipients be deregistered once antiretroviral (ARV) treatment restores them to good health and they are able to start seeking work. However, local AIDS activists charged that with national unemployment estimated at around 35 percent, most beneficiaries were usually jobless and too ill to work before they started receiving the monthly stipend. The article describes these issues raised.

South African National Department of Health (NDoH) Finalising Draft of National Health Insurance Financing Models
Hlabangane S: EHealth News, South Africa, September 2016

South African Health Minister, Dr Aaron Motsoaledi, announced that a draft set of the National Health Insurance (NHI) ‘financing scenarios’ are ready for provincial health Members of Executive Councils (MECs) in October 2016. According to the legal brief Policy Watch, the Minister said that – in finalising government policy on universal healthcare – the department will consider each scenario and carefully reflect on the ”very useful suggestions” received from stakeholders following the release of a draft White Paper in December 2015 for comment. Noting that the costs associated with implementing universal healthcare are ”influenced by many factors, including design elements and the pace of implementation,” Dr Motsoaledi emphasised the importance of focusing on the implications of each funding scenario for incrementally introducing the necessary reforms. With that in mind, the draft scenarios will be informed by an “estimation framework” based on “configurations” of projected service demand, service delivery and associated costs ‘at each level of care. There are views that there are many uncertainties and unaddressed issues in the White Paper, including in the funding model. Meanwhile, the Treasury has allocated South African Rand 4.5bn to renovate healthcare facilities across 11 NHI pilot projects and allocated SAR300 million on developing a national electronic medicine stock management system, a key element for NHI outlined in the White paper.

South Africa’s national health insurance will drive costs down, says Shisana
Bateman C: South African Medical Journal 99(12): 846–850, December 2009

The national health insurance (NHI) plan, due for legislation in June 2010, will be phased in one facility at a time over the next five years, costing higher income earners more (via a payroll tax) but in no way limiting their choice of provider. That was the assurance given by the chair of the NHI Ministerial Advisory Committee, Dr Olive Shisana, who said the incremental accreditation of healthcare facilities was to ensure the delivery of quality health care based on agreed standards. The Ministerial Advisory Committee of 24 experts drawn from the entire healthcare spectrum, is required to deliver draft proposals on NHI legislation to Health Minister Dr Aaron Motsoaledi by March 2010. Public input will happen as soon as cabinet approves the policy proposals, so that the ensuing and legally required three-month consultation process can be completed in time for Motsoaledi’s review. That would leave just enough time for legal crafting for presentation to parliament by June 2010.

Spending, Accountability, and Recovery Measures included in IMF COVID-19 loans
Oxfam, United Kingdom, 2020

To respond to the outbreak of the COVID-19 pandemic, the International Monetary Fund (IMF) has committed $1 trillion and so far provided $89 billion worth of financial assistance to countries around the world. Oxfam has tracked this COVID-19 financing and fiscal measures referenced in each of the 91 packages approved so far using official IMF reports for the respective countries. The tracker covers the amounts of funding IMF committed and disbursed to borrowing countries by region, types of financing instruments the Fund has employed, the borrowing countries’ current debt situation, fiscal policy measures, particularly social spending aimed at addressing the crisis, anti-corruption and transparency measures which countries have committed to undertake, and proposed fiscal measures for the recovery period. The text provided in this tracker is a compilation of select and relevant quotes/excerpts from official IMF reports while the debt data was drawn from the World Bank’s Debtor Reporting System. The tracker has been compiled for the benefit of persons and institutions wanting a snapshot view of what governments are borrowing, what they intend to do with these funds, what the IMF is encouraging countries to take during the pandemic and in the recovery period, and to give citizens and civil society a tool to hold their governments and the IMF accountable.

Spot the difference - the effect of anti-measles campaigns in southern africa

The measles vaccine is safe and highly effective, so why is this disease still the leading cause of death among African children? The governments of seven countries in southern Africa have implemented targeted measles elimination campaigns over the past five years with help from the World Health Organisation (WHO). How successful have they been? This study shows that the WHO-recommended strategies for measles elimination are feasible and effective in the region, even in very low-income countries and those with high HIV prevalence. The report points out that lasting reduction in measles disease and deaths in southern Africa will require: Sustained national commitment; Continued high levels of routine and follow-up campaign vaccination coverage; Complete and timely surveillance of all suspected cases with laboratory confirmation; Careful community investigation of confirmed measles cases to assess the extent of secondary spread.

State of the art: AIDS and economics

The first section explores the role of economics in addressing the HIV/AIDS epidemic. Essays address use of resources, globalisation and HIV and economic evaluations of social interventions. Papers in section two consider the impacts of the disease, especially economic impacts, and consider methods of measuring those impacts. The final part of the document considers how economics can be used to respond to the pandemic, through assessment of resource allocations, economic evaluation and cost effectiveness as well as analysis of trials looking at prevention and treatment options.

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