Emerging challenges in implementing universal health coverage in Asia

Bredenkamp, Caryn; Evans, Timothy; Lagrada, Leizel P.; Langenbrunner, John C.; Nachuk, Stefan; Palu, Toomas

doi:10.1016/j.socscimed.2015.07.025

Cited by 56 publications

(61 citation statements)

References 19 publications

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“…In 2007, the Ministry of Public Health in Thailand established HITAP to generate evidence to inform decision making about which medicines and health technologies would be covered by the public health system. 192 ). • Using HTA as an input for budgetary impact consideration:…”

Section: Panel 5: the Health Intervention And Technology Assessment Pmentioning

confidence: 99%

Essential medicines for universal health coverage

et al. 2017

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Section: Panel 5: the Health Intervention And Technology Assessment Pmentioning

confidence: 99%

Essential medicines for universal health coverage

et al. 2017

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“…The rapid expansion of insurance coverage has created demand which cannot be met by the current health system (Bredenkamp et al 2015). Service quality is already extremely poor in many areas and citizens are increasingly expressing their discontent with services that they were until recently not even able to contemplate using.…”

Section: Discussionmentioning

confidence: 99%

Indonesia's road to universal health coverage: a political journey

Pisani

Kok

Nugroho

2016

Health Policy Plan.

138

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In 2013 Indonesia, the world's fourth most populous country, declared that it would provide affordable health care for all its citizens within seven years. This crystallised an ambition first enshrined in law over five decades earlier, but never previously realised. This paper explores Indonesia's journey towards universal health coverage (UHC) from independence to the launch of a comprehensive health insurance scheme in January 2014. We find that Indonesia's path has been determined largely by domestic political concerns – different groups obtained access to healthcare as their socio-political importance grew.A major inflection point occurred following the Asian financial crisis of 1997. To stave off social unrest, the government provided health coverage for the poor for the first time, creating a path dependency that influenced later policy choices. The end of this programme coincided with decentralisation, leading to experimentation with several different models of health provision at the local level. When direct elections for local leaders were introduced in 2005, popular health schemes led to success at the polls. UHC became an electoral asset, moving up the political agenda. It also became contested, with national policy-makers appropriating health insurance programmes that were first developed locally, and taking credit for them.The Indonesian experience underlines the value of policy experimentation, and of a close understanding of the contextual and political factors that drive successful UHC models at the local level. Specific drivers of success and failure should be taken into account when scaling UHC to the national level. In the Indonesian example, UHC became possible when the interests of politically and economically influential groups were either satisfied or neutralised. While technical considerations took a back seat to political priorities in developing the structures for health coverage nationally, they will have to be addressed going forward to achieve sustainable UHC in Indonesia.

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“…As recommended by various scholars (Bredenkamp et al, 2015;Mathauer & Behrendt, 2017), Chile, Uruguay, and Colombia have all implemented reforms oriented at equalizing the benefit packages between contributory and subsidized schemes. The analysis of these reforms shows, however, that the model of services provision is hindering the success of those measures in terms of guaranteeing access to quality services for those informal workers covered by the subsidized schemes, since disparities remain between public and private providers, and contributors are found generally to have more direct access to the latter.…”

Section: Access To Quality Services: Benefit Packages and Financialmentioning

confidence: 99%

“…Indeed, over the last two decades policy researchers have paid more attention to the provision of health coverage to informal workers, with a search of specialized literature showing 20 articles that explicitly address the subject. Half of these articles are completely focused on financing, others are distributed between issues such as enrolment, impacts on the formalization of the labor market, and occupational and maternal health, but only five of them (see Bredenkamp et al, 2015;Mathauer & Behrendt, 2017;Mathauer, Theisling, Mathivet, & Vilcu, 2016;Scheil-Adlung, 2013; develop a comprehensive analysis that includes coverage, benefits, and financial protection. Searches in publications by international agencies and grey literature yield similar results.…”

Section: Introductionmentioning

confidence: 99%

Advancing health coverage of informal workers in three Latin American countries

Bernales-Baksai

Solar-Hormazábal

2018

Soc Policy Adm

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Advancing universal health coverage (UHC) in Latin America (LA) requires that governments address the inclusion of informal workers, who represent a significant proportion of the working population. Based on case studies and a literature review, this article analyzes health policy reforms of three LA countries and examines their ability to promote the inclusion of informal workers. The analysis focuses on three dimensions: eligibility criteria, benefit packages, and financial protection. The countries analyzed are Chile, Uruguay, and Colombia, each having a different type of welfare regime. These three countries have applied relevant reforms for UHC. Chile has made strenuous efforts to provide a comprehensive benefit package for all, while Uruguay has promoted the extension of health coverage based on principles of citizen rights. Colombia, meanwhile, has significantly expanded the coverage of informal workers, although it still faces challenges in terms of providing them with a comprehensive benefit package. The analysis shows the linkages between eligibility criteria, benefit packages, and financial protection, in such a way that strategies to extend the coverage of informal workers need to be coupled with the harmonization of benefit packages, financial protection, and equal opportunity of access to providers.

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Emerging challenges in implementing universal health coverage in Asia

Cited by 56 publications

References 19 publications

Essential medicines for universal health coverage

Essential medicines for universal health coverage

Indonesia's road to universal health coverage: a political journey

Advancing health coverage of informal workers in three Latin American countries

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