Health financing issues and reforms in Africa

Bayarsaikhan, Dorjsuren; Musango, Laurent

doi:10.5430/ijh.v2n2p37

Cited by 11 publications

(10 citation statements)

References 6 publications

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“…These are potential qualitative research question for future studies. Finally, for countries like Malawi where donors provide a large share of healthcare budget[ 43 ], it is important to consider sustainability and cost-effectiveness of RBF in developing countries[ 44 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

Household costs and time to seek care for pregnancy related complications: The role of results-based financing

et al. 2017

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Results-based financing (RBF) schemes–including performance based financing (PBF) and conditional cash transfers (CCT)-are increasingly being used to encourage use and improve quality of institutional health care for pregnant women in order to reduce maternal and neonatal mortality in low-income countries. While there is emerging evidence that RBF can increase service use and quality, little is known on the impact of RBF on costs and time to seek care for obstetric complications, although the two represent important dimensions of access. We conducted this study to fill the existing gap in knowledge by investigating the impact of RBF (PBF+CCT) on household costs and time to seek care for obstetric complications in four districts in Malawi. The analysis included data on 2,219 women with obstetric complications from three waves of a population-based survey conducted at baseline in 2013 and repeated in 2014(midline) and 2015(endline). Using a before and after approach with controls, we applied generalized linear models to study the association between RBF and household costs and time to seek care. Results indicated that receipt of RBF was associated with a significant reduction in the expected mean time to seek care for women experiencing an obstetric complication. Relative to non-RBF, time to seek care in RBF areas decreased by 27.3% (95%CI: 28.4–25.9) at midline and 34.2% (95%CI: 37.8–30.4) at endline. No substantial change in household costs was observed. We conclude that the reduced time to seek care is a manifestation of RBF induced quality improvements, prompting faster decisions on care seeking at household level. Our results suggest RBF may contribute to timely emergency care seeking and thus ultimately reduce maternal and neonatal mortality in beneficiary populations.

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Section: Discussionmentioning

confidence: 99%

Household costs and time to seek care for pregnancy related complications: The role of results-based financing

et al. 2017

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“…For many countries, achieving UHC require reforms in their health financing systems so that people have financial protection while accessing quality health care [15]. Therefore, a number of countries in the African region have been attempting to reform the way health is financed to ensure sustainable progress towards UHC [15][16][17][18][19]. However, these attempts, largely spearheaded by Ministries of Health have been slow and intermittent as reflected in the slow and/or forward and backward movements in the reform processes [16,[20][21][22].…”

Section: Introductionmentioning

confidence: 99%

How has sustainable development goals declaration influenced health financing reforms for universal health coverage at the country level? A scoping review of literature

2021

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Background Achieving universal health coverage (UHC) requires health financing reforms (HFR) in many of the countries. HFR are inherently political. The sustainable development goals (SDG) declaration provides a global political commitment context that can influence HFR for UHC at national level. However, how the declaration has influenced HFR discourse at the national level and how ministries of health and other stakeholders are using the declaration to influence reforms towards UHC have not been explored. This review was conducted to provide information and lessons on how SDG declaration can influence health financing reforms for UHC based on countries experiences. Methods We conducted a rapid review of literature and followed the preferred reporting items for systematic review and meta-analysis (PRISMA) guideline. We conducted a comprehensive electronic search on Ovid Medline, PubMed, EBSCO, Scopus, Web of Science. In searching the electronic databases, we combined various conceptual terms for “sustainable development goals” and “health financing” using Boolean operators. In addition, we conducted manual searched using google scholar. Results Twelve articles satisfied our eligibility criteria. The included articles were analyzed thematically, and the results presented narratively. The SDG declaration has provided an enabling environment for putting in place necessary legislations, reforming health financing organization, and revisions of national health polices to align to the country’s commitment on UHC. However, there is limited information on the process; how health ministries and other stakeholders have used SDG declaration to advocate, lobby, and engage various constituencies to support HFR for UHC. Conclusion The SDG declaration can be a catalyst for health financing reform, providing reference for necessary legislations and policies for financing UHC. However, to facilitate better cross-country learning on how SDG declaration catalyzes HFR for UHC there, is need to examine the processes of how stakeholders have used the declaration as window of opportunity to accelerate reforms.

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“…For many countries achievement of UHC require reforms in health nancing system so that people have nancial protection while accessing quality health care (15). Therefore, a number of countries in the African region have been attempting to reform the way health is nanced to ensure sustainable progress towards UHC (15)(16)(17)(18)(19). However, these attempts, largely spearheaded by Ministries of Health have been slow and interruptive as re ected in the slow and/or forward and backward movements in the reform processes (16,(20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

Protocol: How Has Sustainable Development Goals Declaration Influenced Health Financing Reform Processes for Universal Health Coverage at the Country Level? A Systematic Review of Literature

Odoch¹,

Senkubuge²,

Hongoro³

2020

Preprint

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BackgroundAchieving universal health coverage (UHC) is necessitating reforms in the way countries finance health systems. However, health financing reforms (HFR) are inherently political and SDGs declaration is a political one. Therefore, the terrain where efforts for reforming health financing occurs is likely being influenced by the SDGs declaration. However, how the SDGs have influenced health financing reform processes at the national level, the outcomes of these processes and how stakeholders especially ministries of health are using SDGs to influence reforms towards UHC have not been explored. This review is proposed to provide information and lessons on how SDGs have influence health financing reforms for UHC at national level and identify methodological and empirical gaps in studies exploring the relationship between SDGs and health financing reforms for UHC. MethodsWe propose a systematic review of literature and shall adhere to preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. We shall search 5 databases (Ovid Medline, PubMed, EBSCO, Scopus and Web of Science) and grey literature. Boolean operators “OR” and “AND” will be used to combine the concepts of sustainable development goals and health financing. The literature to be reviewed will be those on health financing reforms (population), one of the factors influencing the reform is SDGs declaration (exposure/intervention), and there is change in a health financing function (outcome). Identification and selection of studies shall be done in duplicate using a predefined tool, the overall process shall be depicted in a PRISMA flow chart. Quality assessment will be conducted using Joanna Biggs Institute checklist. Data shall be managed in NVIVo, where a thematic synthesis of data will be conducted. The results will be presented narratively. DiscussionWe shall share our finding with relevant stakeholders through workshop and publications. The SDGs declaration is relatively new, how it is influencing health financing reforms towards UHC at national level needs to be documented and shared for cross-country learning by stakeholders involved in this area. In addition, the review is anticipated to provide information on the methodological and/or empirical gaps in studies exploring the linkage between SDGs declaration and health systems reforms.

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Health financing issues and reforms in Africa

Cited by 11 publications

References 6 publications

Household costs and time to seek care for pregnancy related complications: The role of results-based financing

Household costs and time to seek care for pregnancy related complications: The role of results-based financing

How has sustainable development goals declaration influenced health financing reforms for universal health coverage at the country level? A scoping review of literature

Protocol: How Has Sustainable Development Goals Declaration Influenced Health Financing Reform Processes for Universal Health Coverage at the Country Level? A Systematic Review of Literature

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