Health Financing for Poor People: Resource Mobilization and Risk Sharing

by Preker, Alexander S.

• ISBN13: 9780821355251
• ISBN10: 0821355252
• Edition: 1st
• Format: Paperback
• Copyright: 2004-04-01
• Publisher: World Bank

Summary

One of the most urgent development challenges facing many low and middle income countries is the need for adequate financing systems to pay for health care provision to the estimated 1.3 billion impoverished people living in rural areas or working in the informal sector in urban areas. This publication considers ways of improving the financing of health care at low income levels, as part of a global strategy for increased investment in health and poverty reduction. Topics discussed include: global and regional trends in healthcare financing; strengths and weaknesses of community-based health financing, and experiences in Asia and Africa; country case studies using household survey analysis from Senegal, Rwanda, India and Thailand; deficit financing; and the impact of risk sharing on achieving health system goals.

Table of Contents

Foreword	xv
Dean T. Jamison
Preface	xvii
Acknowledgments	xxiii
PART 1 GLOBAL AND REGIONAL TRENDS	1	(198)
1. Rich-Poor Differences in Health Care Financing	3	(50)
Alexander S. Preker, Guy Carrin, David Dror, Melitta Jakab, William C. Hsiao, and Dyna Arhin-Tenkerang
Overview and Context	4	(5)
Conceptual Underpinnings for Community-Based Action
In Health Care Financing	9	(5)
Methodology for Assessing Impact, Strengths, and Weaknesses	14	(10)
Discussion of Main Findings from Background Reviews	24	(17)
Conclusions and Recommendations	41	(3)
Appendix 1A Statistical Data (Summary Tables)	44	(9)
2. Review of the Strengths and Weaknesses of Community Financing	53	(66)
Melitta Jakab and Chitra Krishnan
Methods	54	(5)
What Is Community-Based Health Financing?	59	(9)
Performance of Community-Based Health Financing	68	(16)
Determinants of Successful Resource Mobilization,
Social Inclusion, and Financial Protection	84	(8)
Concluding Remarks	92	(1)
Appendix 2A Performance Variables Reported in the Reviewed Studies	93	(7)
Appendix 2B Core Characteristics of Community Financing Schemes from the Review of the Literature	100	(19)
3. Experience of Community Health Financing in the Asian Region	119	(38)
William C. Hsiao
What Is Community Financing?	122	(11)
A Summary of the Value Added by Types of Community-Financing Schemes	133	(2)
A Review of Selected Asian Community-Financing Schemes	135	(22)
4. Experience of Community Health Financing in the African Region	157	(44)
Dyna Arhin-Tenkorang
Conceptual Framework	161	(10)
Evidence	171	(14)
Discussion	185	(7)
Conclusion	192	(7)
PART 2 COUNTRY CASE STUDIES USING HOUSEHOLD SURVEY ANALYSIS	199	(160)
5. Analysis of Community Financing Using Household Surveys	201	(30)
Melitta Jakab, Alexander S. Preker, Chitra Krishnan, Pia Schneider, Francois Diop, Johannes Paul Jutting, Anil Gumber, M. Kent Ranson, and Siripen Supakankunti
Background	203	(6)
Methods	209	(7)
Results	216	(6)
Discussion	222	(3)
Concluding Remarks	225	(1)
Appendix 5A List of Reviewed Survey Instruments	226	(5)
6. Financial Protection and Access to Health Care in Rural Areas of Senegal	231	(20)
Johannes Paul Jutting
Health Insurance in Rural Sub-Saharan Africa	232	(3)
Research Design and Methodology	235	(3)
Results	238	(9)
Conclusions	247	(4)
7. Community-Based Health Insurance in Rwanda	251	(24)
Pia Schneider and Francois Diop
Background	253	(1)
Data Sources and Methodology	254	(4)
Results	258	(14)
Discussion and Conclusion	272	(3)
8. The SEWA Medical Insurance Fund in India	275	(18)
M. Kent Ranson
Methods	277	(3)
Results	280	(5)
Discussion	285	(8)
9. The Potential Role of Community Financing in India	293	(22)
Anil Gumber
Community Financing in India and the SEWA Program	295	(6)
Research Design and Methodology	301	(1)
Results	302	(13)
10. Impact of the Thailand Health Card	315	(44)
Siripen Supakankunti
Methods	326	(9)
Discussion	335	(17)
Conclusions and Recommendations	352	(7)
PART 3 EXPENDITURE GAPS AND DEVELOPMENT TRAPS	359	(58)
11. Deficit Financing of Health Care for the Poor	361	(36)
Alexander S. Preker, John C. Langenbrunner, and Erni Suzuki
Progress toward Achieving the MDGs	361	(5)
Key Drivers of Accelerated Progress toward Achieving the MDGs	366	(7)
Estimating the Cost of Achieving the MDGs	373	(11)
Financing the Expenditure Gap	384	(5)
Conclusions	389	(8)
12. Impact of Risk Sharing on the Attainment of Health System Goals	397	(20)
Guy Corrin, Riadh Zeramdini, Philip Musgrove, Jean-Pierre Poullier, Nicole Valentine, and Ke Xu
Health System Goals and Functions in a Nutshell	398	(1)
The Organizational Form of Health Financing and Its Link to the Attainment of Health System Goals	399	(1)
Organization of Health Financing in the World	400	(1)
Modeling the Impact of the Organizational Form of Health Financing on Health System Attainment Indicators	401	(9)
Community Risk-Sharing Arrangements: Further Need to Measure Their Impact	410	(1)
Concluding Remarks	411	(1)
Appendix 12A Statistical Data	412	(5)
About the Coeditors and Contributors	417	(10)
The Coeditors	417	(1)
Other Contributing Authors	418	(9)
Index	427