Moving towards universal health coverage: lessons from 11 country studies

Reich, Michael R.; Harris, Joseph; Ikegami, Naoki; Maeda, Akiko; Cashin, Cheryl; Araújo, Edson; Takemi, Keizo; Evans, Timothy

doi:10.1016/s0140-6736(15)60002-2

Cited by 290 publications

(260 citation statements)

References 5 publications

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“…First, the government of Ethiopia has made health a national priority in line with the MDG declaration and has invested massively in health infrastructure and training of health professionals over the last 20 years [13, 22]. Second, tailored community-based child survival interventions such as immunization and community-based management for major diseases such as malaria, pneumonia, and diarrheal diseases have been conducted through the flagship of HEP over the last 10 years [13, 14, 23]. The HEP involves trained and salaried female health extension workers who provide basic primary health care services at the community level.…”

Section: Discussionmentioning

confidence: 99%

Trends, causes, and risk factors of mortality among children under 5 in Ethiopia, 1990–2013: findings from the Global Burden of Disease Study 2013

Deribew

Tessema

Deribe

et al. 2016

Popul Health Metrics

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BackgroundEthiopia has made remarkable progress in reducing child mortality over the last two decades. However, the under-5 mortality rate in Ethiopia is still higher than the under-5 mortality rates of several low- and middle-income countries (LMIC). On the other hand, the patterns and causes of child mortality have not been well investigated in Ethiopia. The objective of this study was to investigate the mortality trend, causes of death, and risk factors among children under 5 in Ethiopia during 1990–2013.MethodsWe used Global Burden of Disease (GBD) 2013 data. Spatiotemporal Gaussian Process Regression (GPR) was applied to generate best estimates of child mortality with 95% uncertainty intervals (UI). Causes of death by age groups, sex, and year were measured using Cause of Death Ensemble modeling (CODEm). For estimation of HIV/AIDS mortality rate, the modified UNAIDS EPP-SPECTRUM suite model was used.ResultsBetween 1990 and 2013 the under-5 mortality rate declined from 203.9 deaths/1000 live births to 74.4 deaths/1000 live births with an annual rate of change of 4.6%, yielding a total reduction of 64%. Similarly, child (1–4 years), post-neonatal, and neonatal mortality rates declined by 75%, 64%, and 52%, respectively, between 1990 and 2013. Lower respiratory tract infection (LRI), diarrheal diseases, and neonatal syndromes (preterm birth complications, neonatal encephalopathy, neonatal sepsis, and other neonatal disorders) accounted for 54% of the total under-5 deaths in 2013. Under-5 mortality rates due to measles, diarrhea, malaria, protein-energy malnutrition, and iron-deficiency anemia declined by more than two-thirds between 1990 and 2013. Among the causes of under-5 deaths, neonatal syndromes such as sepsis, preterm birth complications, and birth asphyxia ranked third to fifth in 2013.Of all risk-attributable deaths in 1990, 25% of the total under-5 deaths (112,288/435,962) and 48% (112,288/232,199) of the deaths due to diarrhea, LRI, and other common infections were attributable to childhood wasting. Similarly, 19% (43,759/229,333) of the total under-5 deaths and 45% (43,759/97,963) of the deaths due to diarrhea and LRI were attributable to wasting in 2013. Of the total diarrheal disease- and LRI-related deaths (n = 97,963) in 2013, 59% (57,923/97,963) of them were attributable to unsafe water supply, unsafe sanitation, household air pollution, and no handwashing with soap.ConclusionsLRI, diarrheal diseases, and neonatal syndromes remain the major causes of under-5 deaths in Ethiopia. These findings call for better-integrated newborn and child survival interventions focusing on the main risk factors.

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Section: Discussionmentioning

confidence: 99%

Trends, causes, and risk factors of mortality among children under 5 in Ethiopia, 1990–2013: findings from the Global Burden of Disease Study 2013

Deribew

Tessema

Deribe

et al. 2016

Popul Health Metrics

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show abstract

“…Such commitment requires that everyone receives needed health care services without experiencing financial difficulty [1, 2]. Despite recent efforts to search for alternative health financing mechanisms [3, 4], out-of-pocket payments are the primary mechanism to finance health services in low and middle income countries [2, 5]. Large and unpredictable out-of-pocket expenses for health care services may push families to spend considerable proportions of their disposable income (also known as catastrophic health expenditure or CHE) and, at the most extreme, push households into poverty (also known as impoverishment) [6–8].…”

Section: Introductionmentioning

confidence: 99%

The impact of out-of-pocket payments for dental care on household finances in low and middle income countries

2017

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BackgroundDental care is extremely costly and beyond most people means in developing countries. The primary aim of this study was to determine the impact of out-of-pocket payments for dental care on household finances in 40 low and middle income countries. A second aim was to compare the burden of payments for dental care with that for other health services.MethodsWe used data from 174,257 adults, aged 18 years and above, who reported their total and itemized household expenditure in the past four weeks as part of the World Health Surveys. The financial burden on households was measured using the catastrophic health expenditure (CHE) and impoverishment approaches. A household was classified as facing CHE if it spent 40% or more of its capacity to pay, and as facing impoverishment if it fell below the country-specific poverty line after spending on health care was subtracted from household expenditure. The odds of experiencing CHE and impoverishment due to expenditure on dental care were estimated from two-level logistic regression models, controlling for various individual- and country-level covariates.ResultsHouseholds that paid for dental care had 1.88 (95% Confidence Interval: 1.78-1.99) greater odds of incurring CHE and 1.65 (95% CI: 1.52–1.80) greater odds of facing impoverishment, after adjustment for covariates. Furthermore, the impact of paying for dental care was lower than that for medications or drugs, inpatient care, outpatient care and laboratory tests but similar to that of health care products, traditional medicine and other health services.ConclusionHouseholds with recent dental care spending were more likely to use a large portion of their disposable income and fall below the poverty line. Policy makers ought to consider including dental care as part of universal health care and advocate for the inclusion of dental care coverage in health insurance packages.

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“…For example by holding seminars about JKN BPJS program to increase the number of BPJS members. If the number of BPJS members increased, it is expected the number of patient visits also increased (Reich et al, 2016;Harris, 2015, Listiyana & Rustiana, 2017.…”

Section: Ksf Strategy Discussionmentioning

confidence: 99%

SWOT Analysis on JKN Implementation in Ngaliyan Health Center Semarang in 2016

Melani¹,

Santjaka²,

Latif³

2018

UJPH

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The position of Health Center (Puskesmas) as a first level health facility becomes the spearhead in good implementation of JKN (Jaminan Kesehatan Nasional or National Health Insurance). By using SWOT Analysis in 6M dimension (Men, Money, Method, Material, Machine, Market), it is expected to be an alternative for Ngaliyan Health Center to improve the work performance and become a reliable health facility for Ngaliyan citizens. And it can support the realization of totally covered insurance in 2019. This study aims to explore the strengths, weaknesses, opportunities, and threats to the Ngaliyan Health Center in organizing JKN service in 6M dimension (Men, Money, Method, Material, Market, Machine), to find the critical point and make KSF (Key Success Factor). The research is qualitative descriptive with structured in-depth interview approach. Using 15 informants selected by purposive sampling. The results of this study obtained a critical point that is on the dimension of money. There was a deficit between capitation and expenditure funds of the Health Center in the implementation of JKN. (Men, Money, Method, Material, Machine, Market) Abstrak Kedudukan puskesmas sebagai fasilitas kesehatan tingkat pertama menjadi ujung tombak pelaksanaan JKN yang baik. Dengan menggunakan Analisa SWOT dalam dimensi 6M

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Moving towards universal health coverage: lessons from 11 country studies

Cited by 290 publications

References 5 publications

Trends, causes, and risk factors of mortality among children under 5 in Ethiopia, 1990–2013: findings from the Global Burden of Disease Study 2013

Trends, causes, and risk factors of mortality among children under 5 in Ethiopia, 1990–2013: findings from the Global Burden of Disease Study 2013

The impact of out-of-pocket payments for dental care on household finances in low and middle income countries

SWOT Analysis on JKN Implementation in Ngaliyan Health Center Semarang in 2016

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