the health
ncbi.nlm.nih.gov
Priority-setting for achieving universal health coverage
Kalipso Chalkidou, Amanda Glassman, Robert Marten, Jeanette Vega, Yot Teerawattananon, Nattha Tritasavit, Martha Gyansa-Lutterodt, Andreas Seiter, Marie Paule Kieny, Karen Hofman, Anthony J Culyer
Bulletin of the World Health Organization 94 (6), 462, 2016
Governments in low-and middle-income countries are legitimizing the implementation of universal health coverage (UHC), following a United Nation’s resolution on UHC in 2012 and its reinforcement in the sustainable development goals set in 2015. UHC will differ in each country depending on country contexts and needs, as well as demand and supply in health care. Therefore, fundamental issues such as objectives, users and cost–effectiveness of UHC have been raised by policy-makers and stakeholders. While priority-setting is done on a daily basis by health authorities–implicitly or explicitly–it has not been made clear how priority-setting for UHC should be conducted. We provide justification for explicit health priority-setting and guidance to countries on how to set priorities for UHC. a NICE International, London, England. b Center for Global Development, Washington, United States of America (USA). c Rockefeller Foundation, New York, USA. d FONASA, Santiago, Chile. e HITAP, 6th Floor 6th Building, Department of Health; Ministry of Public Health, Nonthaburi 11000, Thailand. f Ministry of Health, Accra, Ghana. g World Bank, Washington, USA. h World Health Organization, Geneva, Switzerland. i School of Public Health, University of Witwatersrand, Johannesburg, South Africa. j University of York, York, England.
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scielosp.org
Health financing for universal coverage and health system performance: concepts and implications for policy
Joseph Kutzin
Bulletin of the World Health Organization 91, 602-611, 2013
Unless the concept is clearly understood, “universal coverage” (or universal health coverage, UHC) can be used to justify practically any health financing reform or scheme. This paper unpacks the definition of health financing for universal coverage as used in the World Health Organization’s World health report 2010 to show how UHC embodies specific health system goals and intermediate objectives and, broadly, how health financing reforms can influence these. All countries seek to improve equity in the use of health services, service quality and financial protection for their populations. Hence, the pursuit of UHC is relevant to every country. Health financing policy is an integral part of efforts to move towards UHC, but for health financing policy to be aligned with the pursuit of UHC, health system reforms need to be aimed explicitly at improving coverage and the intermediate objectives linked to it, namely, efficiency, equity in health resource distribution and transparency and accountability. The unit of analysis for goals and objectives must be the population and health system as a whole. What matters is not how a particular financing scheme affects its individual members, but rather, how it influences progress towards UHC at the population level. Concern only with specific schemes is incompatible with a universal coverage approach and may even undermine UHC, particularly in terms of equity. Conversely, if a scheme is fully oriented towards system-level goals and objectives, it can further progress towards UHC. Policy and policy analysis need to shift from the scheme to the system level.
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