Myriad of Health Care Financing Reforms in Zambia: Have the Poor Benefited?

Chitah, Bona; Chansa, Collins; Kaonga, Oliver; Workie, Netsanet Walelign

doi:10.1596/31144

Cited by 3 publications

(11 citation statements)

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“…Seven ESA countries spent half or less than the 15% committed to by heads of state (table 1). A case study from Zambia suggested that the demands of the COVID-19 pandemic on an underfunded health system led to rapid mobilisation of funds above the Abuja commitment of 15% for health sector pandemic control, raising recognition of the need for investment in improved public sector health systems, including for future pandemic preparedness 14…”

Section: Resultsmentioning

confidence: 99%

“…While this paper has focused on the overall levels of health financing, as is well noted in separate literature, the allocation of health resources, the level of spending on primary care and comprehensive primary healthcare services and on key social determinants of health are equally important for achieving better and more equitable health outcomes. At the same time, and as an area for separate inquiry, there is some indication that falling levels of overall public spending on health appears to weaken domestic spending on these key areas 14 21 25 29 37…”

Section: Discussionmentioning

confidence: 99%

“…Resource revenue data, fees and aid grants were not included, and their contribution to potential tax revenue merit further work. When we did the research (2021/2022) the most recent year in global databases preceded the pandemic period (2020–2022), when public spending on health systems increased significantly, although in particular areas of pandemic response, possibly leaving other areas with reduced funding 14. Within countries, national health accounts data could provide deeper evidence of sources of public health financing.…”

Section: Methodsmentioning

confidence: 99%

“…ESA countries are economically diverse, with their per capita GDP in 2020 ranging (in US dollars) from Mozambique (US$449) and the DRC (US$557); to 10 times higher levels in Botswana (US$6711) and South Africa (US$5091). At the same time, some ESA countries with high GDPs also have high inequality, with the region’s highest Gini coefficient of 63% in South Africa, and coefficients of less than 45% in many ESA countries at lower GDP levels 14. Given this diversity, we present the evidence for the different ESA countries, while also providing aggregated and per capita estimates for the ESA region as a whole.…”

Section: Introductionmentioning

confidence: 97%

“…At the same time, some ESA countries with high GDPs also have high inequality, with the region’s highest Gini coefficient of 63% in South Africa, and coefficients of less than 45% in many ESA countries at lower GDP levels. 14 Given this diversity, we present the evidence for the different ESA countries, while also providing aggregated and per capita estimates for the ESA region as a whole.…”

Section: Introductionmentioning

confidence: 99%

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Recovering lost tax to meet the health financing gap for universal public sector health systems in East and Southern Africa

Loewenson,

Mukumba

2023

BMJ Glob Health

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IntroductionUniversal healthcare services funded through taxation and free at point-of-access are the most equitable ways of funding healthcare rights. This paper examines key public sector health financing measures in 17 East and Southern African (ESA) countries, estimates the funding gap for basic and comprehensive services and relates this to sources of lost tax revenue.MethodsHealth financing and tax data for 2018 (the most recent year available) were extracted from international databases for each ESA country, and analysed collectively for the region, comparing against intergovernmental estimates of optimal funding and tax capacity. Despite limitations noted, the scale of the health financing gap and tax losses informed policy recommendations.ResultsThe annual average per capita financing gap ranged from $28 to $84 for basic to comprehensive services, respectively, applying estimates of funding needs. Many innovative financing measures being explored do not meet this scale of deficit. Annual ESA per capita tax losses were estimated as: US$34.20 from shortfalls in domestic tax capacity and US$13.80 from illicit financial flows largely due to commercial practices. A proposed 25% minimum effective tax rate on multinationals in a fairer global tax system would yield an additional annual collection US$26.20 in the region.ConclusionsAddressing a total annual tax loss of US$34 billion from these three sources alone would almost completely finance the region’s US$36 billion financing gap for a comprehensive public sector health system. The COVID-19 pandemic’s exposure of the need for investment in public sector services suggests an opportunity for an alliance between health and finance sectors to ensure progressive taxation as the core funding for an equitable, universal health system. This implies costing the health funding demands and gap in ESA countries; strengthening domestic tax capacity, expanding wealth taxes, curbing illicit outflows and providing health evidence to ongoing African diplomacy for a fairer global tax system.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Recovering lost tax to meet the health financing gap for universal public sector health systems in East and Southern Africa

Loewenson,

Mukumba

2023

BMJ Glob Health

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Governance Challenges in International Health Financing and Implications for the New Pandemic Fund

Brown,

Rhodes,

Tacheva

et al. 2023

Preprint

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Background: The failures of the international COVID-19 response highlighted key gaps in pandemic preparedness and response (PPR). The G20 and WHO have called for additional funding of $10.5 billion per year to adequately strengthen the global PPR architecture. In response to these calls, in 2022 the World Bank announced the launch of a new Financial Intermediary Fund (The Pandemic Fund) to catalyse this additional funding. However, there is considerable unclarity regarding the governance makeup and financial modalities of the Pandemic Fund, and divergence of opinion about whether the Fund has been successfully designed to respond to key challenges in global health financing. Methods/ results: To better situate the Pandemic Fund within discussions about existing challenges in global health financing, this article presents the results of a scoping review identifying key challenges associated with international health financing instruments. A total of 73 documents were collected from which 51 were reviewed for analysis. Thematic analysis identified eight thematic groupings that emerged from the literature which were then used as policy criteria to assess the current governance and financing design of the Pandemic Fund using available information on the Fund. The eight themes in hierarchical order of frequency were: misaligned aid allocation; accountability; multistakeholder representation and participation; country ownership; donor coherency and fragmentation; transparency; power dynamics, and; anti-corruption. Assessment of the Pandemic Fund against these criteria found that although some mechanisms have been adopted to recognise and address challenges, overall, the Pandemic Fund has unclear policies in response to most of the challenges while leaving many unaddressed. Conclusion: It remains unclear how the Pandemic Fund is explicitly addressing the eight challenges identified. Moreover, there is evidence that the Pandemic Fund might be exacerbating these global financing challenges, thus raising questions about its potential efficacy, suitability, and chances of success. In response, this article offers three sets of policy recommendations for how the Pandemic Fund and PPR financing architecture might respond more effectively to the identified challenges.

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Economic Debate On Financing Model of The National Health System

Anwar,

Bachtiar,

Fahmy

2023

devotion

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The topic of health-care financing is becoming increasingly important, particularly in light of the Covid-19 pandemic. In this study, we examine the pattern of funding for the national health system from the standpoint of economic thought, as well as the role of government in the context of macroeconomic analysis of social welfare. Conceptual Analysis is the method employed. The data used is based on related theory. This study discovered that health issues are social welfare issues as one of the macroeconomic goals. The macroeconomic debate employs an interdisciplinary framework in which the determinants include external shocks and policy levers, while the pure or theoretical ones are descriptive and applied, resulting in outputs such as prices, growth, output, and international balances. In theory, government involvement in the economy can be divided into two extremes: the classical view and the Keynesian view. The problem of wage and price flexibility, self-adjustment, and government intervention is the result of these two views, though there is a middle view; Schumpeter. The health system can be funded in three ways: entirely by the government, partially by the government, and entirely by the private sector or the public. Furthermore, the cost of health insurance is influenced by the economy, competition, rules, company goals, market structure, government intervention, and a variety of other factors. In the future, studies must be conducted using big data

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Myriad of Health Care Financing Reforms in Zambia: Have the Poor Benefited?

Cited by 3 publications

References 0 publications

Recovering lost tax to meet the health financing gap for universal public sector health systems in East and Southern Africa

Recovering lost tax to meet the health financing gap for universal public sector health systems in East and Southern Africa

Governance Challenges in International Health Financing and Implications for the New Pandemic Fund

Economic Debate On Financing Model of The National Health System

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