Towards Universal Health Care In Emerging Economies

This book explores how political, social, economic and institutional factors in eight emerging economies have combined to generate diverse outcomes in their move towards universal health care. Structured in three parts, the book begins by framing social policy as an integral system in its own right. The following two parts go on to discuss the opportunities and challenges of achieving universal health care in Thailand, Brazil and China, and survey the obstacles facing India, Indonesia, Russia, South Africa and Venezuela in the reform of their health care systems. The evolution of social policy systems and the cases in this volume together demonstrate that universalism in health care is continuously redefined by the interactions between diverse political forces and through specific policy processes. At a time when international and national-level discourse around health systems has once again brought universalism to the fore, this edited collection offers a timely contribution to the field in its thorough analysis of health care reform in emerging economies.

Srinath Reddy, Yasmine Rouai, Jeffrey L. Sturchio, Cicely Thomas, Tana Wuliji, Snow Yang, Pascal Zurn

This book is about 24 developing countries that have embarked on the journey towards universal health coverage (UHC) following a bottom-up approach, with a special focus on the poor and vulnerable, through a systematic data collection that provides practical insights to policymakers and practitioners. Each of the UHC programs analyzed in this book is seeking to overcome the legacy of inequality by tackling both a “financing gap†? and a “provision gap†?: the financing gap (or lower per capita spending on the poor) by spending additional resources in a pro-poor way; the provision gap (or underperformance of service delivery for the poor) by expanding supply and changing incentives in a variety of ways. The prevailing view seems to indicate that UHC require not just more money, but also a focus on changing the rules of the game for spending health system resources. The book does not attempt to identify best practices, but rather aims to help policy makers understand the options they face, and help develop a new operational research agenda. The main chapters are focused on providing a granular understanding of policy design, while the appendixes offer a systematic review of the literature attempting to evaluate UHC program impact on access to services, on financial protection, and on health outcomes.

Using cross-country analysis and case studies, this book provides new insights and potential policy responses for the key fiscal policy challenges that both advanced and emerging economies will be facing.

This report describes the current situation with regard to universal health coverage and global quality of care, and outlines the steps governments, health services and their workers, together with citizens and patients need to urgently take.

Universal health coverage (UHC) has been recognized by the World Health Organization as a key element in reducing social inequality and a critical component of sustainable development and poverty reduction. In most of the world UHC is sought through a combination of public and private-sector health care systems. In most low- and middle-income countries health systems are evolving to increasingly rely on the private sector because the public sector lacks the infrastructure and staff to meet all health care needs. With growing individual assets available for private-sector expenditure, patients often seek better access to technology, staff, and medicines. However, in low-income countries nearly 50 percent of health care financing is out-of-pocket. With the expected increase in the overall fraction of care provided through the private sector, these expenditures can be financially catastrophic for individuals in the informal workforce. In the global workforce of approximately 3 billion people, only 10 to 15 percent are estimated to have some type of access to occupational health services. The informal workforce is growing worldwide, and the degree to which its occupational health needs are satisfied depends on the capabilities of the general health care system. In July 2014, the Institute of Medicine held a workshop on approaches to universal health coverage and occupational health and safety for informal sector workers in developing countries. This report summarizes the presentations and discussions from this workshop. Approaches to Universal Health Coverage and Occupational Health and Safety for the Informal Workforce in Developing Countries identifies best practices and lessons learned for the informal workforce in developing countries in the financing of health care with respect to health care delivery models that are especially suitable to meeting a population's needs for a variety of occupational health issues, including the prevention of or mitigation of hazardous risks and the costs of providing medical and rehabilitation services and other benefits to various types of workers within this population. These experiences and lessons learned may be useful for stakeholders in moving the discussions, policies, and mechanisms forward to increase equitable access to quality health services without financial hardship for the informal workforce.

For the last two decades, major Asian economies have successfully kept their economic growth momentum going. Now, as these economies are entering a new phase of economic growth, more attention is being paid to their respective states of social development, especially the provision and the expansion of social security and, in particular, health care. Academic study of the development of health care in developing countries has been for the most part neglected by the literature, and in-depth country case studies that are directly comparable on a one-to-one basis have not yet been conducted in a systematic manner. This book volume also proposes a new stance on health policy and the health care policy paradigm, one that focuses on "saving lives" from premature death, as well as illness, accidents, misery and poverty, based on the normative theory of developmental social policy (DSP). This groundbreaking book will therefore serve as a valuable reference volume for health policy, social policy and public policy experts, social development experts, health and development economists, health sociologists, social workers, government administrators as well as other medical and health professionals and academics.

The goals of universal health coverage (UHC) are to ensure that all people can access quality health services, to safeguard all people from public health risks, and to protect all people from impoverishment due to illness, whether from out-of-pocket payments for health care or loss of income when a household member falls sick. Countries as diverse as Brazil, France, Japan, Thailand, and Turkey have shown how UHC can serve as vital mechanisms for improving the health and welfare of their citizens, and lay the foundation for economic growth and competitiveness grounded in the principles of equity and sustainability. Ensuring universal access to affordable, quality health services will be an important contribution to ending extreme poverty by 2030 and boosting shared prosperity in low-income and middle-income countries (LMICs), where most of the world's poor live. The book synthesizes the experiences from 11 countries – Bangladesh, Brazil, France, Ethiopia, Ghana, Indonesia, Japan, Peru, Thailand, Turkey and Vietnam – in implementing policies and strategies to achieve and sustain UHC. These countries represent diverse geographic and economic conditions, but all have committed to UHC as a key national aspiration and are approaching it in different ways. The study examined the UHC policies for each country around three common themes: (i) the political economy and policy process for adopting, achieving, and sustaining UHC; (ii) health financing policies to enhance health coverage; and (iii) human resources for health policies for achieving UHC. The findings from these country studies are intended to provide lessons that can be used by countries aspiring to adopt, achieve, and sustain UHC. Although the path to UHC is specific to each country, countries can benefit from the experiences of others in learning about different approaches and avoiding potential risks.