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Going Universal: How 24 Countries Are Implementing Universal Health Coverage Reforms from the Bottom Up
The quest for universal health coverage (UHC) has gathered real momentumover the past decade, with countries on every continent now taking part. This iswelcome news, since a lack of universal coverage means that hundreds ofmillions of people around the world either do not get the health care servicesthey need, or they have to pay dearly for them, often falling into poverty as aresult. But the UHC agenda also poses an enormous challenge to policy makersacross the globe, and many countries are eager to learn from the experiencesof others as they undertake the long journey toward UHC.Going Universal: How 24 Developing Countries Are Implementing UniversalHealth Coverage Reforms from the Bottom Up draws on a wealth of newevidence to help enrich the global knowledge base on UHC. It provides asynthesis of UHC reform programs that placed a special focus on expandingcoverage in ways inclusive of the poor. The main objective was to documentand analyze their experiences based on a systematic data collection effort thatsought to capture in great detail how they have been implementing UHCreforms. The main chapters oer an in-depth analysis of how countries areaddressing five key challenges: covering people, expanding benefits, managingmoney, improving the supply of health care services, and strengtheningaccountability.The UHC reform programs described in the volume are new, massive, andtransformational. Most were launched during the past decade, and togetherthey now cover more than 2 billion people. But most importantly, the authorsfind that the programs are fundamentally changing the way health systemsoperate, offering the potential to achieve greater equity and better results forthe money spent. The authors identify key risks that lie ahead, as well as anemerging agenda that requires more country and global learning. Overall, thisbook offers those contributing to the achievement of UHC worldwide avaluable new resource to help chart a way forward.
eBook
Learning from economic downturns
Many countries around the world are moving toward universal health coverage, while navigating through periods of economic crisis. The impact of the economic downturn of 2008-09 on the health care sector has renewed efforts to make health systems more resilient during and after economic downturns. Health policy makers and development practitioners are grappling with how to better identify areas that make the health sector vulnerable to economic downturns, and how to track and mitigate the impact of economic downturns. To effectively manage the challenges resulting from economic uncertainty, the health sector must look at recent failures and successes as a learning opportunity for improvement, with the end result being greater health system resilience. This book, financed by the rapid social response program at the World Bank, responds to these challenges facing the health sector. It introduces a framework for assessing, tracking, and mitigating (A.T.M. framework) the impact of economic downturns on the health sector. This framework provides policy makers and practitioners in the health sector with a more systematic way to design and implement policies that can protect people, particularly the poor, from the negative effects of economic downturns. This book illustrates the benefit of implementing rapid surveys to track the impacts of crises in real time as economies shrink, and emphasizes the importance of building effective health information systems that can regularly monitor system changes. Analysis of several country case studies in developing countries sheds light on the importance of linking the health sector with the social protection sector, particularly social safety nets, using the common identification and targeting methods to reach the poor and the vulnerable. The more recent lessons from several European Union (EU) countries emphasize the importance of political economy in implementing policy reforms during economic downturns and again illustrate how the data can help facilitate more evidence-based policy making.
eBook
Going universal
This book is based on systematic data collection among 26 universal health coverage (UHC) programs across 24 countries in the UHC studies. The main objective of this report is to document and analyze the experiences of 24 countries based on a systematic data collection that sought to capture in great detail how they are doing so. Thus the book aims to extend, on number of countries covered and detail of information collected the large number of case studies that have already enriched the global knowledge base on UHC. The UHC cube raises the real-world dilemma of which dimension to prioritize, given the inevitable trade-offs. The recent Lancet Global Commission 2035 analyzed alternative pathways to progressive universalism, and espoused support for two options. The first will make coverage available to the whole population but target the poor by prioritizing health interventions for diseases that disproportionately affect that group. The second will provide a larger package of interventions to the full population but with some patient copayment, from which poor people will be exempt.
eBook
Public policy and the challenge of chronic noncommunicable diseases
Noncommunicable diseases (NCDs) are by far the major cause of death in lower-middle, upper-middle, and high-income countries; by 2015, they will also be the leading cause of death in low-income countries.
eBook
Getting better
Fifty years ago, health outcomes in the countries of Eastern Europe and Central Asia were not far behind those in Western Europe and well ahead of most other regions of the world. But progress since then has been slow. While life expectancy in the ECA region today is close to the global average, the gap with its western neighbors has doubled, and other middle-income regions have all surpassed ECA. Some countries in the region are doing better, but full convergence with the worlds most advanced health systems is still a long way off. At the same time, survey evidence suggests that the health sector is the top priority for additional investment among populations across the region. The experience of high-income countries also suggests that popular demand for strong and accessible health systems will only grow over time. Yet these aspirations must be reconciled with current fiscal realities. In brief, health sector issues are a challenge here to stay for policy-makers across the ECA region. This report draws on new evidence to explore the development challenge facing health sectors in ECA, and highlights three key agendas to help policy-makers seeking to achieve more rapid convergence with the worlds best performing health systems. The first is the health agenda, where the task is to strengthen public health and primary care interventions to help launch the \"cardiovascular revolution\" that has taken place in the West in recent decades. The second is the financing agenda, in which growing demand for medical care must be satisfied without imposing undue burden on households or government budgets. The third agenda relates to broader institutional arrangements. Here there are some key reform ingredients common to most advanced health systems that are still missing in many ECA countries. A common theme in each of these three agendas is the emphasis on
improving outcomes, or \"Getting Better\".
eBook