Background: Health insurance is the primary mechanism that enables people to obtain health care services. There are three major types of health insurance involves private health insurance, social health insurance and community-based health insurance. Aims: This systematic review aims to identify the implication on equity after implementation of health insurance focusing on selected Asian countries. The review is based on the three dimensions of universal health coverage (UHC): population coverage, and service coverage and financial coverage. Materials and methods: A systematic search for articles was conducted form 4 search engines, Scopus, Science Direct, Proquest, and Google scholar. A total of 13 articles were selected after screenings and equity implications were concluded in three UHC dimensions based on equity index reported or equity improvement observed in time series studied. Result and discussion: All the three health insurance has different implication on equity between countries or within country. In terms of population coverage, SHI in Thailand showed an equitable coverage. Philippine also reported to have equitable population coverage in terms of geographical while in Vietnam, CBHI showed inequitable population coverage. The financial coverage has showed an inequity of CBHI in India, China, and Thailand. The inequity was also observed for SHI in Philippine, Vietnam and Philippines. More apparent is inequity in PHI for Malaysia and Philippines. The only equitable financial coverage reported was Thailand for its SHI. The final aspect is on service delivery coverage with equity has been observed in CBHI in China and SHI in Vietnam and Thailand. Conclusion: Social health insurance schemes can be further improved in addressing equity in all UHC aspects. CBHI of which showed some equitable measures for certain population subgroups, such as the poor, and formal workers can collectively be the way to go for SHI.
Background: Universal health coverage (UHC) indicators for monitoring the progress of effective service coverage for non-communicable diseases (NCDs) are still lacking. This paper aims to prove the possibility of adapting Quality Performance Indicators (QPIs) as indicators for effective service coverage of NCDs in the context of UHC. Materials and Methods: By reviewing major literatures on UHC framework and indicators between the years 2012 and 2015, service coverage indicators criteria and effective coverage indicator criteria were compiled. Two QPIs: one on breast cancer and one on acute myocardial infarction from renowned sources were selected as examples and their fulfilment of the indicator criteria was analysed. Result: The findings demonstrated that the selected QPIs were able to fulfil the criteria for indicators to measure effective service coverage component of Universal Health Coverage. Conclusion: It is proposed that suitable QPIs be considered to be adapted as indicators for UHC monitoring for non-communicable diseases.
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