This document discusses universal healthcare and moving towards universal coverage in Kenya. It provides an overview of universal healthcare, describing it as a system that provides a basic package of benefits to all members of a society. The document then discusses healthcare financing models, including tax-based systems, social health insurance, and private insurance. It provides an analysis of healthcare financing in Kenya currently and proposals to expand coverage through the National Hospital Insurance Fund to work towards universal coverage. The document concludes by outlining next steps needed to achieve universal healthcare in Kenya, including bridging equity gaps, ensuring a strong public health system, and improving efficiency.
Exploring the Potential Role Of Community Health Insurance Schemes In A Natio...David Lambert Tumwesigye
Exploring the Potential Role Of Community Health Insurance Schemes In A National Health Insurance Scheme-Presented to CHI practitioners of the Uganda Community Based Health Financing Association
The document presents a new investment framework for the global HIV response. It identifies six basic program activities that are essential for an effective HIV response. Implementing the framework is estimated to avert over 12 million new HIV infections and 7 million deaths between 2011-2020, while gaining nearly 30 million life years. The framework provides a roadmap to accelerate progress in the global HIV response through more strategic allocation of resources based on evidence of effective prevention, treatment, and support programs.
The Global Fund Strategy Framework 2012-2016 outlines the organization's vision, mission, guiding principles, goals, targets, and strategic objectives. The overarching goal is to save 10 million lives and prevent 140-180 million new infections by 2016. Key strategic objectives include investing more strategically in high-impact countries and populations, evolving the funding model to be more flexible and predictable, and actively supporting grant implementation success. The framework also aims to promote and protect human rights, sustain gains by increasing funding from current and new sources, and enhance partnerships to deliver results.
The document discusses alternative forms of health financing being tested or used in various countries to help people afford healthcare and avoid poverty from medical costs, such as community-funded insurance, microcredit services for insurance, taxes on goods like tobacco, and prioritizing resources currently spent on non-essential activities. Examples of health financing systems used in African countries include general tax revenue, donor funding, mandatory and voluntary insurance, community-based insurance, and exemptions from fees. While increasing tax revenue is difficult, improving tax compliance and efficiency along with gradually introducing alternative financing options may help fund healthcare.
Presentation for "The annual medicine overseas conference: Research and response in the midst of chaos" at the UK Royal Society of Medicine. http://www.rsm.ac.uk/academ/ccd03.php
This document provides an overview of health insurance schemes in low and middle income countries. It defines low, lower middle, and upper middle income countries based on GNI per capita. It then discusses the types of health insurance schemes commonly implemented in LMICs, including social/national health insurance funded through taxes and contributions, private health insurance, and community-based health insurance. The document also discusses factors that affect enrollment in these schemes and provides examples of specific country implementations, challenges faced, and opportunities to expand coverage.
The document discusses key concepts in health financing including definitions of health financing, universal health coverage, and sources of health care financing such as taxes, user fees, and insurance. It also summarizes different financial accounting systems used in Kenya like imprests, vouchers, and facility improvement funds. Finally, it outlines the roles of different government bodies in financial management including the treasury, parliament, and auditor general.
Exploring the Potential Role Of Community Health Insurance Schemes In A Natio...David Lambert Tumwesigye
Exploring the Potential Role Of Community Health Insurance Schemes In A National Health Insurance Scheme-Presented to CHI practitioners of the Uganda Community Based Health Financing Association
The document presents a new investment framework for the global HIV response. It identifies six basic program activities that are essential for an effective HIV response. Implementing the framework is estimated to avert over 12 million new HIV infections and 7 million deaths between 2011-2020, while gaining nearly 30 million life years. The framework provides a roadmap to accelerate progress in the global HIV response through more strategic allocation of resources based on evidence of effective prevention, treatment, and support programs.
The Global Fund Strategy Framework 2012-2016 outlines the organization's vision, mission, guiding principles, goals, targets, and strategic objectives. The overarching goal is to save 10 million lives and prevent 140-180 million new infections by 2016. Key strategic objectives include investing more strategically in high-impact countries and populations, evolving the funding model to be more flexible and predictable, and actively supporting grant implementation success. The framework also aims to promote and protect human rights, sustain gains by increasing funding from current and new sources, and enhance partnerships to deliver results.
The document discusses alternative forms of health financing being tested or used in various countries to help people afford healthcare and avoid poverty from medical costs, such as community-funded insurance, microcredit services for insurance, taxes on goods like tobacco, and prioritizing resources currently spent on non-essential activities. Examples of health financing systems used in African countries include general tax revenue, donor funding, mandatory and voluntary insurance, community-based insurance, and exemptions from fees. While increasing tax revenue is difficult, improving tax compliance and efficiency along with gradually introducing alternative financing options may help fund healthcare.
Presentation for "The annual medicine overseas conference: Research and response in the midst of chaos" at the UK Royal Society of Medicine. http://www.rsm.ac.uk/academ/ccd03.php
This document provides an overview of health insurance schemes in low and middle income countries. It defines low, lower middle, and upper middle income countries based on GNI per capita. It then discusses the types of health insurance schemes commonly implemented in LMICs, including social/national health insurance funded through taxes and contributions, private health insurance, and community-based health insurance. The document also discusses factors that affect enrollment in these schemes and provides examples of specific country implementations, challenges faced, and opportunities to expand coverage.
The document discusses key concepts in health financing including definitions of health financing, universal health coverage, and sources of health care financing such as taxes, user fees, and insurance. It also summarizes different financial accounting systems used in Kenya like imprests, vouchers, and facility improvement funds. Finally, it outlines the roles of different government bodies in financial management including the treasury, parliament, and auditor general.
- Explicit insurance does not offer a panacea for HIV/AIDS service coverage on its own. Where insurance systems already exist, they can be expanded to include HIV/AIDS services.
- Introducing social health insurance is complicated and will take time to cover all people. The process should not be rushed and existing mechanisms should continue in the meantime. Some people will remain inadequately covered and should not be forgotten.
- Political commitment is indispensable for including HIV services in any coverage mechanism. A political-economy analysis will be useful. Financial feasibility is also key, and external funding may be needed initially before being replaced by government funds over time. Not all people will be able to contribute to insurance schemes
Health care financing involves accumulating, mobilizing, and allocating funds to cover the health needs of individuals and communities. The document discusses various principles and mechanisms of health care financing including revenue collection from taxes, insurance, and out-of-pocket payments. It also discusses risk pooling, where funds are pooled to spread financial risk across populations, and purchasing, where pooled funds are used to purchase services from providers. The objectives of health care financing are to maintain access to basic services, improve quality, and create incentives for efficient use of services.
Private Contracting for Universal Health Coverage Short version.pdfAlaa Hamed
This presentation was provided in February 2024 during a health economics course organized by the Egypt Health Authority. The presentation is divided into three parts. The first part focuses on alignment of the private sector engagement with the goals of universal health coverage. The second focuses on presenting what strategic purchasing means and its difference from passive purchasing and how contracting is one of the strategic purchasing functions. The third focuses on contracting the private sector for universal health coverage providing a definition for contracting and presenting the key types of contracting: Entry contracts, Services contracts and Concessions.
Malawi Mid-Year Review 2014-2015 Health Insurance Reformmohmalawi
Malawi Mid-Year Review 2014-2015
An overview of the discussion at the Expert Panel on Health Insurance
A look at the health sector reforms currently underway in Malawi
The swiss healthcare system without the health care financesRafael Rodriguez
The document summarizes key aspects of Switzerland's healthcare system. It outlines that the system is governed by the 1996 Health Insurance Law (LAMal) which mandates universal basic health insurance coverage. It describes the basic insurance package that covers hospital stays, outpatient care, nursing care, and other services. Supplementary private insurance can provide additional benefits. Healthcare is provided through independent general practitioners, specialists, and public or private hospitals. Insurers must provide basic policies and premiums are regulated, though deductibles and premium costs still vary between plans and regions.
This document discusses universal health coverage (UHC), which aims to provide access to good quality health services for all members of a society while protecting people from financial hardship due to health costs. UHC can be defined by who and what services are covered and how much of the cost is covered. The WHO defines UHC as access to effective health services without financial hardship. Achieving UHC requires an efficient health system providing services, workers, and medicines to the population as well as a financing system to protect people from health costs. Various funding models like compulsory insurance, tax-based financing, and social health insurance can be used. Egypt has both public and private healthcare sectors working towards UHC.
This document discusses health care financing in India. It defines health care financing as mobilizing funds for health care through mechanisms like taxes, insurance contributions, and out-of-pocket payments. In India, most health spending comes from private out-of-pocket payments rather than public sources. The government spends a low proportion of its budget on health care. Various mechanisms for health financing exist in India, including mandatory insurance programs, voluntary private insurance, employer-based coverage, and community-based schemes, but overall insurance penetration is low.
Primary health care aims to make health care accessible and affordable for all communities. It has eight key elements including education on health problems, nutrition promotion, water and sanitation access, and maternal/child healthcare. The principles of primary health care are equity, community participation, decentralization, accessibility, health promotion/prevention, effectiveness, integration, and efficiency. Health care can be financed through fees, taxes, insurance, or employment-related payments. The Millennium Development Goals set targets like reducing poverty and hunger by 2015 but progress was uneven, with maternal health goals largely unmet though other goals like reduced child mortality saw more success.
Practical concepts and strategies to increase and maintain financial protecti...HFG Project
Presented at “Financial Protection and Improved Access to Health Care: Peer-to-Peer Learning Workshop Finding Solutions to Common Challenges” in Accra, Ghana, February 2016. To learn more, visit: https://www.hfgproject.org/ghana-uhc-workshop
- Universal health coverage (UHC) aims to ensure all people receive essential health services without financial hardship. This includes equitable access to promotion, prevention, treatment, rehabilitation and palliative care.
- Key challenges to achieving UHC include half the world's population lacking full coverage of essential health services and over 800 million people spending over 10% of household budgets on health care.
- India aims to achieve UHC through programs like Ayushman Bharat which establishes health and wellness centers and provides insurance coverage for secondary and tertiary care through Pradhan Mantri Jan Arogya Yojana (PM-JAY).
This document discusses health care financing in India. It defines health care financing as mobilizing and allocating funds for specific health services and payment mechanisms. India relies heavily on private out-of-pocket spending for health care, with only about 10% having health insurance. Major challenges include linking insurance to employment when most work is informal, and excluding many poor from coverage. Community-based financing models show promise in providing social inclusion and financial protection. The conclusion calls for recognizing the role of health economists and addressing health financing within broader governance, economic, educational, and social contexts.
The document provides an overview of the German healthcare system. It describes how the system is based on both public and private insurance, with public insurance covering around 88% of the population. Public insurance is funded through income-related contributions from employers and employees. The system aims to provide equal coverage to all citizens regardless of income or age. It covers a wide range of medical services and utilizes various strategies to ensure quality of care and reduce disparities.
The document discusses health insurance in India. It notes that India has a large population but low ranking on healthcare indexes and high out-of-pocket healthcare costs. There is a need to increase government health spending and expand health insurance coverage given its implications for economic development. It then discusses what health insurance is, the history of health insurance in India, common product types, trends in the industry, and low insurance penetration rates in India currently.
Universal Health Coverage (UHC) Day 12.12.14, NepalDeepak Karki
This presentation is made on the first ever Universal Health Coverage (UHC) Day 12.12.14 celebration in Nepal by Nepal Health Economics Association (NHEA).
Tax-based systems finance healthcare through taxes collected from the entire population of taxpayers, allowing risks to be pooled across a large group. This subsidizes care for the poor and sick by transferring wealth from the rich and healthy. However, overuse of free services remains a problem. Pay-as-you-go user fee systems represent a market-based solution but fees disproportionately reduce access for the poor. Risk-based private insurance guarantees entitlement by collecting risk-adjusted premiums but rising costs can cause the poor and sick to lose coverage. Social health insurance compulsorily collects premiums from a broad base to ensure universal coverage unlike private systems. Donor funding significantly finances developing countries' healthcare through government systems or private organizations.
This document outlines the course content for a health insurance course. It will cover topics such as defining health insurance, the development of national health systems, the purpose of health insurance, relationships between public and private systems, underwriting principles and processes, and more. The course aims to provide a comprehensive overview of how health insurance works from both private insurer and public system perspectives internationally.
This document discusses health care financing. It begins by defining key terms related to health care financing sources, including public expenditures, external aid, and private expenditures. It then outlines the main mechanisms of health care financing: general revenue, social insurance contributions, private insurance premiums, community financing, and direct out-of-pocket payments. For each mechanism, it provides a brief definition and description. The document concludes by stating that the role of health financing should be recognized, that it cannot be dealt with separately from other factors like governance and economic growth, and that governments need to actively participate to avoid market failures.
The document discusses moving towards universal access to health care in India. It defines key concepts of universal health care and outlines principles like public funding playing a central role, comprehensive services for all, and no fees at point of access. It examines issues like what services should be covered, how it will be funded through taxes or insurance, and how services will be organized between public and private sectors. Specific challenges in India like the large private sector and funding mechanisms are also discussed.
Each year, the OHE sponsors a lecture that explores a timely issue in medicine or health economics. At the 22nd Annual Lecture, the issues and challenges of universal health care coverage in low- and middle-income countries were presented by Professor Anne Mills of the London School of Hygiene and Tropical Medicine.
The audio of this lecture now is available at http://news.ohe.org/2014/08/19/annual-lecture-2014-universal-health-coverage/
The document discusses Thailand's development of a universal health coverage benefit package. It outlines the key steps Thailand took:
1) Establishing systematic processes for developing the package, involving stakeholders and using evidence-based criteria and health technology assessments.
2) Starting with a basic package focusing on primary care and high-impact services, then expanding over time as resources increased.
3) Introducing rigorous health technology assessment processes to evaluate new interventions, ensuring only cost-effective options were included.
Kenya healthcare monitor additional dataUHF-EAHF2012
The document summarizes key findings from the April 2012 Kenya Healthcare Monitor national omnibus survey. The survey assessed health service provision, medical insurance coverage, supply chain management, non-communicable diseases, and the impact of illness. It found that over 75% of Kenyans lacked medical insurance, and satisfaction with health services varied by region. The survey also examined willingness to pay for health insurance and rational drug use. Contact information was provided for the healthcare lead at Ipsos to request more data.
The document discusses the Health Market Innovations Awards which recognize outstanding health market innovation programs in East Africa. The Center for Health Market Innovations (CHMI) collects information on innovative programs that harness private sector engagement to improve health and financial protection for the poor. CHMI analyzes high-potential innovations and facilitates their diffusion through an online platform. The Health Market Innovations Awards are intended to create awareness of these programs, recognize implementers, and encourage more health market innovations in East Africa. A variety of public and private organizations are involved in the awards which will recognize an overall winner, category winners, and most promising programs.
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- Explicit insurance does not offer a panacea for HIV/AIDS service coverage on its own. Where insurance systems already exist, they can be expanded to include HIV/AIDS services.
- Introducing social health insurance is complicated and will take time to cover all people. The process should not be rushed and existing mechanisms should continue in the meantime. Some people will remain inadequately covered and should not be forgotten.
- Political commitment is indispensable for including HIV services in any coverage mechanism. A political-economy analysis will be useful. Financial feasibility is also key, and external funding may be needed initially before being replaced by government funds over time. Not all people will be able to contribute to insurance schemes
Health care financing involves accumulating, mobilizing, and allocating funds to cover the health needs of individuals and communities. The document discusses various principles and mechanisms of health care financing including revenue collection from taxes, insurance, and out-of-pocket payments. It also discusses risk pooling, where funds are pooled to spread financial risk across populations, and purchasing, where pooled funds are used to purchase services from providers. The objectives of health care financing are to maintain access to basic services, improve quality, and create incentives for efficient use of services.
Private Contracting for Universal Health Coverage Short version.pdfAlaa Hamed
This presentation was provided in February 2024 during a health economics course organized by the Egypt Health Authority. The presentation is divided into three parts. The first part focuses on alignment of the private sector engagement with the goals of universal health coverage. The second focuses on presenting what strategic purchasing means and its difference from passive purchasing and how contracting is one of the strategic purchasing functions. The third focuses on contracting the private sector for universal health coverage providing a definition for contracting and presenting the key types of contracting: Entry contracts, Services contracts and Concessions.
Malawi Mid-Year Review 2014-2015 Health Insurance Reformmohmalawi
Malawi Mid-Year Review 2014-2015
An overview of the discussion at the Expert Panel on Health Insurance
A look at the health sector reforms currently underway in Malawi
The swiss healthcare system without the health care financesRafael Rodriguez
The document summarizes key aspects of Switzerland's healthcare system. It outlines that the system is governed by the 1996 Health Insurance Law (LAMal) which mandates universal basic health insurance coverage. It describes the basic insurance package that covers hospital stays, outpatient care, nursing care, and other services. Supplementary private insurance can provide additional benefits. Healthcare is provided through independent general practitioners, specialists, and public or private hospitals. Insurers must provide basic policies and premiums are regulated, though deductibles and premium costs still vary between plans and regions.
This document discusses universal health coverage (UHC), which aims to provide access to good quality health services for all members of a society while protecting people from financial hardship due to health costs. UHC can be defined by who and what services are covered and how much of the cost is covered. The WHO defines UHC as access to effective health services without financial hardship. Achieving UHC requires an efficient health system providing services, workers, and medicines to the population as well as a financing system to protect people from health costs. Various funding models like compulsory insurance, tax-based financing, and social health insurance can be used. Egypt has both public and private healthcare sectors working towards UHC.
This document discusses health care financing in India. It defines health care financing as mobilizing funds for health care through mechanisms like taxes, insurance contributions, and out-of-pocket payments. In India, most health spending comes from private out-of-pocket payments rather than public sources. The government spends a low proportion of its budget on health care. Various mechanisms for health financing exist in India, including mandatory insurance programs, voluntary private insurance, employer-based coverage, and community-based schemes, but overall insurance penetration is low.
Primary health care aims to make health care accessible and affordable for all communities. It has eight key elements including education on health problems, nutrition promotion, water and sanitation access, and maternal/child healthcare. The principles of primary health care are equity, community participation, decentralization, accessibility, health promotion/prevention, effectiveness, integration, and efficiency. Health care can be financed through fees, taxes, insurance, or employment-related payments. The Millennium Development Goals set targets like reducing poverty and hunger by 2015 but progress was uneven, with maternal health goals largely unmet though other goals like reduced child mortality saw more success.
Practical concepts and strategies to increase and maintain financial protecti...HFG Project
Presented at “Financial Protection and Improved Access to Health Care: Peer-to-Peer Learning Workshop Finding Solutions to Common Challenges” in Accra, Ghana, February 2016. To learn more, visit: https://www.hfgproject.org/ghana-uhc-workshop
- Universal health coverage (UHC) aims to ensure all people receive essential health services without financial hardship. This includes equitable access to promotion, prevention, treatment, rehabilitation and palliative care.
- Key challenges to achieving UHC include half the world's population lacking full coverage of essential health services and over 800 million people spending over 10% of household budgets on health care.
- India aims to achieve UHC through programs like Ayushman Bharat which establishes health and wellness centers and provides insurance coverage for secondary and tertiary care through Pradhan Mantri Jan Arogya Yojana (PM-JAY).
This document discusses health care financing in India. It defines health care financing as mobilizing and allocating funds for specific health services and payment mechanisms. India relies heavily on private out-of-pocket spending for health care, with only about 10% having health insurance. Major challenges include linking insurance to employment when most work is informal, and excluding many poor from coverage. Community-based financing models show promise in providing social inclusion and financial protection. The conclusion calls for recognizing the role of health economists and addressing health financing within broader governance, economic, educational, and social contexts.
The document provides an overview of the German healthcare system. It describes how the system is based on both public and private insurance, with public insurance covering around 88% of the population. Public insurance is funded through income-related contributions from employers and employees. The system aims to provide equal coverage to all citizens regardless of income or age. It covers a wide range of medical services and utilizes various strategies to ensure quality of care and reduce disparities.
The document discusses health insurance in India. It notes that India has a large population but low ranking on healthcare indexes and high out-of-pocket healthcare costs. There is a need to increase government health spending and expand health insurance coverage given its implications for economic development. It then discusses what health insurance is, the history of health insurance in India, common product types, trends in the industry, and low insurance penetration rates in India currently.
Universal Health Coverage (UHC) Day 12.12.14, NepalDeepak Karki
This presentation is made on the first ever Universal Health Coverage (UHC) Day 12.12.14 celebration in Nepal by Nepal Health Economics Association (NHEA).
Tax-based systems finance healthcare through taxes collected from the entire population of taxpayers, allowing risks to be pooled across a large group. This subsidizes care for the poor and sick by transferring wealth from the rich and healthy. However, overuse of free services remains a problem. Pay-as-you-go user fee systems represent a market-based solution but fees disproportionately reduce access for the poor. Risk-based private insurance guarantees entitlement by collecting risk-adjusted premiums but rising costs can cause the poor and sick to lose coverage. Social health insurance compulsorily collects premiums from a broad base to ensure universal coverage unlike private systems. Donor funding significantly finances developing countries' healthcare through government systems or private organizations.
This document outlines the course content for a health insurance course. It will cover topics such as defining health insurance, the development of national health systems, the purpose of health insurance, relationships between public and private systems, underwriting principles and processes, and more. The course aims to provide a comprehensive overview of how health insurance works from both private insurer and public system perspectives internationally.
This document discusses health care financing. It begins by defining key terms related to health care financing sources, including public expenditures, external aid, and private expenditures. It then outlines the main mechanisms of health care financing: general revenue, social insurance contributions, private insurance premiums, community financing, and direct out-of-pocket payments. For each mechanism, it provides a brief definition and description. The document concludes by stating that the role of health financing should be recognized, that it cannot be dealt with separately from other factors like governance and economic growth, and that governments need to actively participate to avoid market failures.
The document discusses moving towards universal access to health care in India. It defines key concepts of universal health care and outlines principles like public funding playing a central role, comprehensive services for all, and no fees at point of access. It examines issues like what services should be covered, how it will be funded through taxes or insurance, and how services will be organized between public and private sectors. Specific challenges in India like the large private sector and funding mechanisms are also discussed.
Each year, the OHE sponsors a lecture that explores a timely issue in medicine or health economics. At the 22nd Annual Lecture, the issues and challenges of universal health care coverage in low- and middle-income countries were presented by Professor Anne Mills of the London School of Hygiene and Tropical Medicine.
The audio of this lecture now is available at http://news.ohe.org/2014/08/19/annual-lecture-2014-universal-health-coverage/
The document discusses Thailand's development of a universal health coverage benefit package. It outlines the key steps Thailand took:
1) Establishing systematic processes for developing the package, involving stakeholders and using evidence-based criteria and health technology assessments.
2) Starting with a basic package focusing on primary care and high-impact services, then expanding over time as resources increased.
3) Introducing rigorous health technology assessment processes to evaluate new interventions, ensuring only cost-effective options were included.
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Kenya healthcare monitor additional dataUHF-EAHF2012
The document summarizes key findings from the April 2012 Kenya Healthcare Monitor national omnibus survey. The survey assessed health service provision, medical insurance coverage, supply chain management, non-communicable diseases, and the impact of illness. It found that over 75% of Kenyans lacked medical insurance, and satisfaction with health services varied by region. The survey also examined willingness to pay for health insurance and rational drug use. Contact information was provided for the healthcare lead at Ipsos to request more data.
The document discusses the Health Market Innovations Awards which recognize outstanding health market innovation programs in East Africa. The Center for Health Market Innovations (CHMI) collects information on innovative programs that harness private sector engagement to improve health and financial protection for the poor. CHMI analyzes high-potential innovations and facilitates their diffusion through an online platform. The Health Market Innovations Awards are intended to create awareness of these programs, recognize implementers, and encourage more health market innovations in East Africa. A variety of public and private organizations are involved in the awards which will recognize an overall winner, category winners, and most promising programs.
The document summarizes Kenya's process of engaging the private sector in public-private partnerships (PPPs) for healthcare over the past decade. It outlines a 4-step process: 1) assessing the private health sector, 2) holding public-private dialogues to develop a shared vision, 3) reaching agreements on a PPP framework and roadmap, and 4) taking actions to implement PPPs. Key achievements include institutionalizing ongoing dialogue, growing political support, and establishing a PPP unit in the Ministries of Health. Moving forward, priorities are creating an enabling environment for PPPs through policies and guidelines, strengthening ministry capacity to manage PPPs, and implementing initial partnership projects.
The document discusses the Rockefeller Foundation's mission to promote well-being and resilience. It notes that old approaches are less successful and vulnerable populations face increased risks. New solutions must involve different actors collaborating in new ways, like governments, non-profits, foundations, and businesses. As an example, it highlights M-Pesa in Kenya, which launched in 2007 and now has over 14 million customers, accounting for over half of bank accounts in the country. The document also notes that out-of-pocket health expenditures account for 50-80% of total health spending in many African countries.
The document discusses a business proposal from AGITO Medical and VBH Denmark to establish a company in East Africa that will sell, service, and repair pre-owned medical equipment from Western and Japanese brands at affordable prices, providing a complete solution from dismantling and transportation to testing, maintenance, and mobile medical clinics. The companies have experience in medical equipment, logistics, and consultancy with locations in multiple countries and aim to expand their multinational presence and quality services.
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This document discusses private sector participation in development cooperation based on experiences in East Africa. It provides examples of public-private partnerships that have increased access to healthcare services. These include (1) demand side financing systems in Kenya and Uganda that introduced competition and quality among providers; (2) a social franchising network in Kenya called AMUA that has served over 700,000 clients through private clinics; and (3) a healthcare waste management partnership in Kenya that provides affordable services to small clinics. The document outlines mutual benefits of cooperation for donors, governments, and private stakeholders and challenges to address, and provides an outlook on innovative solutions the private sector can offer.
This document discusses a project called FUNZOKenya that aims to transform health workforce training in Kenya. It does this through a national training mechanism that works with various partners, including training institutions, to [1] increase the number of new health workers trained, [2] address current training needs and skills gaps, and [3] build the capacities of training institutions. It identifies four drivers of change - financing, public-private participation, technology, and accountability - and outlines strategies within each area to strengthen health workforce training. The partnership with the Kenya Healthcare Federation focuses on expanding access to loans and scholarships for training and increasing admission capacities in remote and underserved areas. The expected results are an increased number of trained health workers
The document discusses challenges around achieving Millennium Development Goals 4 and 5, which aim to reduce child mortality and improve maternal health. It notes that infant mortality in Africa remains high due to issues like low breastfeeding rates, suboptimal infant feeding practices, and limited access to nutrition education from healthcare professionals. The document proposes addressing these challenges through efforts like building the capacity of healthcare workers, increasing nutrition education, and innovating products to fortify foods and address nutrient deficiencies that impact child and maternal health outcomes.
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This document discusses access to affordable antiretrovirals (ARVs) in East Africa. It summarizes that Quality Chemical Industries Ltd (QCIL) in Uganda aims to increase access to newer and safer medicines by taking advantage of flexibilities under international trade agreements. QCIL has attained WHO and other certifications and currently produces ARVs and antimalarials. It has helped alleviate shortages in Uganda and signed agreements with other countries, but faces challenges from dumping and lack of harmonization. The conclusion calls for public-private partnerships across East Africa to improve long-term access to medicines.
International Hospital Kampala (IHK) is a 115-bed hospital in Uganda that provides specialist consultations, surgeries, and other healthcare services. It is looking to expand its facilities and specialties through a partnership with Fortis Healthcare, one of the largest hospital chains in Asia. Fortis aims to upgrade IHK's infrastructure, introduce new departments and equipment, and leverage Fortis' network of hospitals to strengthen IHK's programs and refer patients for complex care. This will help develop Uganda's healthcare sector and establish IHK as a regional medical hub through clinical expertise sharing and staff training across Fortis' global network.
The document discusses how Polycom solutions can help address challenges in the healthcare industry through collaborative healthcare. The healthcare landscape is facing rising costs, an aging population, and increased chronic diseases. This is straining limited resources and requiring improved access to care. Collaborative healthcare using Polycom's voice and video communications can help by promoting greater interactions between providers and patients, giving patients better access to care wherever located, and making hospitals more efficient. Polycom's solutions support applications for healthcare administration, education, telemedicine, and improving patient care.
The document discusses the opportunity for greater mobile adoption in Africa based on statistics showing rapid growth of mobile phone users on the continent. It notes that while only 20% of Africans have bank accounts, 50% have mobile phones, showing the potential for mobile money services to expand financial access. Mobile money allows people to send cash to others through their mobile phones, replacing traditional money transfer methods. This has become a game changer and plays a significant role in African economies by facilitating transactions outside the traditional banking system. The document outlines several mobile money products and services and their value in industries like health by offering a convenient payment solution and introducing more people to savings.
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The document describes an output-based aid (OBA) reproductive health voucher project in Uganda. The project provides vouchers to poor women for maternal health services including antenatal visits, transport for delivery, safe delivery, referrals, and postnatal care from private health facilities. Previous programs funded over 100,000 vouchers and saw positive impacts like increased utilization of services and reduced inequity. The current program aims to continue improving access, quality and satisfaction with maternal healthcare for poor women in Uganda.
The document discusses a USAID program called Health Initiatives for the Private Sector (HIPS) that works with Ugandan banks and businesses to improve access to health services. Specifically, it will provide technical assistance to help health sector businesses qualify for loans from partner banks for expansion. The loans will be at market rates and terms, and banks are looking for borrowers with strong financials, coherent strategies, competent management, and clear governance structures. The Development Credit Authority partnership between USAID and an Ugandan bank was approved in April 2012 and will officially launch in June 2012 to begin accepting loan applications.
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Metropolitan Hospital in Nairobi developed an in-house hospital management information system called AMS 2000 to address financial losses due to poor management. AMS 2000 is a fully integrated, modular, and scalable open-source system that manages patient records, billing, claims, and other operations. It provides real-time data and analytics to improve management decision making, clinical processes, and financial performance. The system's integration capabilities help streamline administration and claims processing between the hospital and insurance payers.
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The Africa Health Fund invests in private healthcare companies in Africa to expand access to healthcare for low-income populations. It provides both equity and debt financing of $250,000 to $5 million for established, profitable companies. The Fund focuses on sectors like healthcare delivery, diagnostics, manufacturing, and retail pharmacy. It also offers technical assistance to strengthen operations and management in portfolio companies. With over $100 million in assets, the Africa Health Fund aims to finance socially responsible, financially sustainable private healthcare across the continent.
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This document describes the Kenya Healthcare Monitor, a partnership between the Kenya Healthcare Federation (KHF) and Ipsos to conduct regular mixed-method surveys assessing key elements of Kenya's health sector. The surveys are intended as an advocacy, accountability, and strategic planning tool. The partnership is a win-win-win, providing benefits to the public sector, KHF, and Ipsos in the form of improved transparency, brand promotion, strategic data, and new business opportunities. The surveys utilize 5 thematic areas and collection methods, including a national survey, to measure indicators like medical insurance coverage, willingness to pay for insurance, and rational drug use.
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Dr, kamunyo eahf conference universal health care 2012
1. East Africa Healthcare Federation
Conference 2012
Towards Universal Healthcare
Dr. Peter Kamunyo,
Divisional Director – Healthcare, Aon
Kenya
2. Contents
• Overview & Setting the context
– The case for Universal Health care
– Universal Health Care in Africa
• Healthcare Financing in Kenya
• The Role of NHIF towards
Universal Healthcare
3. Universal Health Care
• AKA universal health coverage, universal coverage, universal
care or social health protection
• Describes health care systems organized around providing a
specified package of benefits to ALL members of a society.
• Aim
– providing financial risk protection,
– improved access to health services, and
– improved health outcomes.
• The ultimate objective of any healthcare financing system-
“effective access to affordable healthcare services of adequate
quality and financial protection in case of sickness”
(International Labor organization)
• Universal health care is not a one-size-fits-all concept; nor does
it imply coverage for all people for everything.
• Determined by three critical dimensions:
– who is covered,
– what services are covered, and
– how much of the cost is covered
4. Universal coverage
Total health expenditure Total health expenditure
Height: what
proportion of
Height:
the costs are
what
covered?
proportion
Include of the costs
Reduce cost other
sharing are covered?
services
Extend to
non-
Depth: covered
which Coverage
benefits are mechanism
Breadth: who is covered? covered? Depth:
which
Breadth: who is benefits are
covered? covered?
5. Funding models
• Universal health care in most countries has been achieved by a mixed
model of funding.
• General taxation revenue is the primary source of funding
• European systems - financed through a mix of public and private
contributions.
• The majority of universal health care systems are funded primarily by
tax revenue (e.g. Portugal, Spain, Denmark and Sweden).
• Some nations, such as Germany, France and Japan employ a multi-
payer system in which health care is funded by private and public
contributions.
• These contributions are compulsory and defined according to law.
• Universal health care systems are modestly redistributive.
• Progressivity of health care financing has limited implications for
overall income inequality.
6. Forms of healthcare financing
1. Compulsory insurance: This is usually enforced via legislation requiring
residents to purchase insurance, though sometimes, in effect, the
government provides the insurance.
2. Tax-based financing: In tax-based financing, individuals contribute to the
provision of health services through various taxes.
3. Social Health Insurance: In social health insurance, contributions from
workers, the self-employed, enterprises and government are pooled into a
single or multiple funds on a compulsory basis.
4. Private insurance: In private health insurance, premiums are paid directly
from employers, associations, individuals and families to insurance
companies, which pool risks across their membership base.
5. Single payer: used to describe a funding mechanism meeting the costs of
medical care from a single fund.
6. Community-based Health Insurance: A particular form of private health
insurance that has often emerged in environments where financial risk
protection mechanisms only have a limited impact is community-based
health insurance. Contributions are not risk-related, and there is generally a
high level of community involvement in the running of such schemes.
7. Healthcare Financing in Sub Saharan Africa
Private Public
User charges / out- Social Health
of-pocket costs Insurance (SHI)
Community Based Taxation (direct,
Health Insurance indirect, general,
(CBHI) Public Private earmarked)
Partnerships
Private Health
Insurance (PHI)
Medical Savings
Accounts (MSAs)
Informal payments
8. Healthcare Financing Triangle
Synergy between the
stakeholders End user
Patient
Payer Provider
Insurance companies
NGO funding Medical Service Providers
Public health schemes Doctors etc.
Government
9. Other considerations
• Extent of government involvement in providing
care and/or health insurance varies
• The common denominator for all such programs
is some form of government action aimed at
extending access to health care as widely as
possible and setting minimum standards.
• Most implement universal health care through
legislation, regulation and taxation.
• Legislation and regulation direct what care must
be provided, to whom, and on what basis.
• Usually some costs are borne by the patient at
the time of consumption but the bulk of costs
come from a combination of compulsory
insurance and tax revenues.
• Some programs are paid for entirely out of tax
revenues.
10. Universal Health Care Globally
GERMANY
• Germany has the world's oldest universal health care system, with
origins dating back to Otto von Bismarck's social legislation, which
included the Health Insurance Bill of 1883, Accident Insurance Bill of
1884, and Old Age and Disability Insurance Bill of 1889.
BRITAIN
• In Britain, the National Insurance Act 1911 marked the first steps
there towards universal health care, covering most employed persons
and their financial dependents and all persons who had been
continuous contributors to the scheme for at least five years whether
they were working or not.
• This system of health insurance continued in force until the creation
of the National Health Service in 1948 which extended health care
security to all legal residents.
UNITED STATES OF AMERICA
• Most current universal health care systems were implemented in the
period following the Second World War as a process of deliberate
health care reform, intended to make health care available to all, in
the spirit of Article 25 of the Universal Declaration of Human Rights of
1948, signed by every country doing so. The US did not ratify the
social and economic rights sections, including Article 25's right to
health.
11. Universal Health Care in Africa
• At least 50 percent of Sub-Saharan Africa’s total health
expenditure is financed by out-of-pocket payments from
its largely impoverished population.
• In 2001, the heads of state of the African Union countries
met in Abuja, Nigeria, and pledged to allocate at least 15
percent of their national budgets to the health sector in
the Abuja Declaration.
• A decade later, only two African countries, South Africa
and Rwanda, have managed to reach this goal, according
to the World Health Organization, WHO.
• Twenty-seven African countries have increased their
expenditure on health care, but 12 countries – including
Kenya – have kept theirs the same and seven African
countries have reduced theirs.
12. Sustainable Universal Healthcare Financing
• Healthcare financing options that have the capacity to endure
over long periods of time
Medicines &
Treat
Services
Education &
Teach
Outreach
Build Infrastructure
Serve Social
Advocacy
The sustainability of Africa's healthcare sector will depend on the
availability of robust and diverse insurance options for patients.
13. Sustainable Healthcare Financing
• Sustainable healthcare (Sustainable health
financing, universal coverage and social
health insurance) is a joint effort between
public and private stakeholders
Private Community
Social Health Health Based health
Insurance Insurance insurance
14. Healthcare Challenges in Kenya
• High burden of disease, including HIV/AIDS , Malaria, TB
• Healthcare infrastructure is insufficient and in some cases
old and dilapidated
• Acute shortage of health human resources
• Insufficient funding and inefficient use of resources is one
of the major underlying factor of the challenges
• Only about 40% of Kenyans live within 4 kms of a
functioning facility, mostly in rural areas; 70% access in
urban areas
• Public health facilities are overcrowded, while there is still
some underutilized capacity in private and Faith Based
facilities (exact figures not known) – issue of cost of care
and quality
• Whereas the policy and the plans emphasize preventive,
demand for curative services continue to increase
15. Healthcare Challenges in Kenya
• Households bear the highest cost of care – direct costs,
taxes and premiums
• About 40% of sick Kenyans do not seek care when sick due
to cost
• Removal of user fees in primary health facilities led to
shortages in health commodities due to lack of
compensation for loss of revenue
• About 1 million Kenyans drop below poverty line yearly as
a result of a sickness in the family
• Evidence from other countries show loss of productivity as
a result of illness, especially malaria and HIV/AIDS
• To achieve Vision 2030, we have to break the vicious cycle
of Disease – Poverty – Disease.
• 23% of Kenyans derives their earnings and support from
Formal sector of whom over 94% are insured.
• Approx. 80% of Kenyans are uninsured.
• 45% of Kenyans live below 1$ a day 17% of Kenyans are
living in abject poverty
16. The Funding of Healthcare Delivery in Kenya
Households, Donors, 29.4%
36.7%
Local
Foundations,
0.1%
Private
Companies,
3.4% Not specified,
Public, 30.0%
0.4%
17. Current Coverage Landscape
Kenya current coverage
landscape
Kenya current coverage: Height:
NHIF what
proportion
of the costs
are
covered?
User fees for
outpatient
services
+ residual fees for
inpatient services
Outpatient
services not NHIF
NHIF covered
Poor and most of informal Tax-funded services
sector not covered Depth: which
benefits are
covered?
Breadth: who is
covered?
18. Vision 2030
• Kenya will restructure the health delivery system and also shift the
emphasis to “promotive” care in order to lower the nations’ disease
burden.
• Provision of affordable and quality health care services is enshrined
in the bill of rights chapter of the new constitution.
• According the National Health Sector Strategic Plan (2005-10); the
Health Ministries Strategic Plans (2008-12) and Vision 2030, the key
objectives can be summarized as follows:
– Increase equitable access to health services
– Improve quality and responsiveness of services
– Improve efficiency and effectiveness of service delivery
– Enhance the regulatory capacity
– Foster partnerships in the delivery of services
– Improve the financing of the sector
19. What we need to ask?
1. How can poor people access health
services?
2. Which services are essential?
3. How much would this services cost?
4. How should contributions for the
financing of the sector be collected?
5. How are Providers paid for services?
6. Inclusion of all service providers into the
national planning and financing process
20. Universal Health Coverage in Kenya
• Since independence, universal coverage in health
has been a major objective. However the it has
eluded the policy makers and implementers alike.
• The delivery system has been dogged by several
weaknesses and threats that include the following :
-
– The perceived failure of the system to cater for the
indigents.
– Inequitable distribution of health resources leading to the
collapse of the referral system
– High cost of medication due to low coverage of medical
insurance
• A number of interventions have been tried
and some have achieved high success rate.
21. A step towards Universal Healthcare in
Kenya
• National Hospital Insurance Fund (NHIF) in
Kenya has recently taken on the challenge
of providing medical cover at low cost for a
large population of government workers.
• Part of their solution is to use capitation
schemes to deliver primary care.
• Currently, about 2 million of Kenya’s 40
million residents have public health
insurance under the National Hospital
Insurance Fund, which relies on
contributions from high-earning Kenyans to
cover hospital benefits for members and
their dependents
22. Snapshot of the National Hospital Insurance Fund
(NHIF)
• National Hospital Insurance Fund is a State Parastatal that was
established in 1966 as a department under the Ministry of Health.
• The original Act of Parliament that set up this Fund in 1966 has over
the years been reviewed to accommodate the changing healthcare
needs of the Kenyan population, employment and restructuring in
the health sector.
• Currently an NHIF Act No 9 of 1998 governs the Fund.
• The transformation of NHIF from a department of the Ministry of
Health to a state of corporation was aimed at improving
effectiveness and efficiency.
• The Fund's core mandate is to provide medical insurance cover to all
its members and their declared dependants (spouse and children).
• The NHIF membership is open to all Kenyans who have attained the
age of 18 years and years and have a monthly income of more than
Ksh 1,000.
23. Proposed NHIF Scheme
Total health expenditure
Pay higher
reimbursement and in
return lower residual Height: what
user fees proportion
of the costs
Include are covered?
outpatient
services
Increase
NHIF NHIF
coverage Tax-funded Depth:
which benefits
are covered?
Breadth: who is covered?
24. Way Forward
• Universal health care is the only way
to guarantee Kenyans medical care.
• Universal Health care has worked for
many other countries and we need
to borrow from their successes and
learn from their failures.
25. What we need to do
– Bridge equity gaps in access to quality health care and
nutrition services: Including developing health infrastructure
in favour of deprived communities;
– Ensuring that public health system remains backbone of
health system care: Including accelerating the
implementation of the National Health
insurance, Strengthening the exemption policy to enhance
access of poor and vulnerable groups to healthcare;
– Strengthening Efficiency in Service Delivery: Including
providing incentive schemes to support the retention and
redistribution of trained health personnel;
– Develop low-cost market – address high private hospital
costs