Article
Multidisciplinary Sciences
Moses Aikins, Philip Teg-Nefaah Tabong, Paola Salari, Fabrizio Tediosi, Francis M. Asenso-Boadi, Patricia Akweongo
Summary: Stakeholders acknowledged that the NHIS is currently unable to fulfill its financial obligations and suggested adopting capitation as a provider payment mechanism to reduce fraud and political interference. They also recommended rapid releases of specific statutory deductions and taxes for NHIS providers to address delays in claims' reimbursement, as well as aligning the NHIS with community-based health planning and including preventive and promotive health services to achieve Universal Health Coverage.
Article
Public, Environmental & Occupational Health
Viroj Tangcharoensathien, Walaiporn Patcharanarumol, Anond Kulthanmanusorn, Ariel Pablos-Mendez
Summary: The rapid economic growth in low and middle-income countries presents an opportunity for achieving universal health coverage, but challenges such as donor dependence, lack of fiscal space, and inefficient pre-payment systems need to be addressed. Political windows of opportunity, citizen accountability, and full subsidies for the poor and vulnerable are essential in moving towards universal health coverage.
JOURNAL OF GLOBAL HEALTH
(2021)
Article
Health Care Sciences & Services
Shabir Moosa
Summary: The primary health care system in Africa faces challenges in terms of insufficient human resources, inequitable distribution, and lack of training. However, there are opportunities in terms of global milestones and political will for investment in primary health care. The African Forum for PHC calls for the development of a regional plan to build robust primary health care systems, train and recruit sufficient workforce, and support primary health care with appropriate financing.
RISK MANAGEMENT AND HEALTHCARE POLICY
(2023)
Article
Health Policy & Services
Agnes Gatome-Munyua, Isidore Sieleunou, Orokia Sory, Cheryl Cashin
Summary: In order to achieve universal health coverage, countries need to increase public resources for healthcare and use existing resources more effectively. Strategic purchasing plays a critical role in advancing universal health coverage in sub-Saharan Africa and can help address the disparities in public health funding and progress towards UHC goals.
HEALTH SYSTEMS & REFORM
(2022)
Review
Medicine, General & Internal
Sjan-Mari van Niekerk, Sureshkumar Kamalakannan, Gakeemah Inglis-Jassiem, Maria Yvonne Charumbira, Silke Fernandes, Jayne Webster, Rene English, Quinette A. Louw, Tracey Smythe
Summary: This study explores the opportunities and challenges within the health system to achieve universal health coverage for people with stroke in South Africa. It highlights certain areas that show promising trends to improve service delivery, such as comprehensiveness, quality, and perceptions of care.
Review
Health Care Sciences & Services
Chukwudi A. Nnaji, Charles S. Wiysonge, Joseph C. Okeibunor, Thobile Malinga, Abdu A. Adamu, Prosper Tumusiime, Humphrey Karamagi
Summary: This scoping review shows that implementation research can be utilized to achieve UHC-related outcomes in Africa. It has identified key facilitators and barriers to the use of implementation research for promoting UHC in the region.
BMC HEALTH SERVICES RESEARCH
(2021)
Article
Public, Environmental & Occupational Health
Humphrey Cyprian Karamagi, Sokona Sy, Hillary Kipruto, Bertha Kembabazi, Solyana Ngusbrhan Kidane, Thandekile Ntombikayise Moyo, Regina Titi-Ofei, Dominic Atweam, Cornelius Debpuur, Anthony Ofosu, Francis Chisaka Kasolo
Summary: Ensuring effective functioning of sub national level in the health system is crucial for achieving health results in countries. However, the current health agenda lacks prioritization of how districts can use their existing resources efficiently to maximize equity and effectiveness. Ghana conducted a self-assessment to understand district functionality in delivering health results, highlighting the need for specific improvements in investments, access to services, and management architecture to achieve Universal Health Care. The study revealed a lack of correlation between functionality and performance as currently defined in Ghana, with higher functionality in oversight capacity compared to service provision or management capacities.
FRONTIERS IN PUBLIC HEALTH
(2023)
Article
Health Policy & Services
Elizabeth Ekirapa-Kiracho, Aloysius Ssennyonjo, Cheryl Cashin, Agnes Gatome-Munyua, Nkechi Olalere, Richard Ssempala, Chrispus Mayora, Freddie Ssengooba
Summary: There are multiple purchasing arrangements in Uganda, leading to conflicting incentives and inefficiencies in resource allocation and purchasing functions. Uganda needs to enhance resource pooling and harmonization of priorities to expand service coverage and provide high-quality services that meet local needs and aspirations for universal health coverage.
HEALTH SYSTEMS & REFORM
(2022)
Article
Public, Environmental & Occupational Health
Chris Atim, Indu Bhushan, Mark Blecher, Ramana Gandham, Vikram Rajan, Jonatan Daven, Olusoji Adeyi
Summary: This paper summarizes health financing themes from five middle-income countries with incomplete progress towards Universal Health Coverage, highlighting challenges such as inadequate financing, sub-optimal pooling, and unmet expectations in strategic purchasing. Despite variations, evidence of strong political commitment in some countries bodes well for further progress.
JOURNAL OF GLOBAL HEALTH
(2021)
Review
Public, Environmental & Occupational Health
Thomas Kuipers, Remco van de Pas, Anja Krumeich
Summary: Universal health coverage aims to provide affordable health interventions for all. The Netherlands has adopted a techno-economic approach to healthcare provision, ensuring most of the population is covered for most of the costs for most of the services.
GLOBALIZATION AND HEALTH
(2022)
Review
Public, Environmental & Occupational Health
Seun S. Anjorin, Abimbola A. Ayorinde, Mustapha S. Abba, Daniel Mensah, Elvis A. Okolie, Olalekan A. Uthman, Oyinlola O. Oyebode
Summary: This study evaluates the equity of health insurance schemes implemented in Africa and finds significant disparities in insurance coverage among rural residents, self-employed individuals, men, those with lower education levels, and the poor. Community-based health insurance schemes have shown some improvements in utilization for disadvantaged groups, but these groups still have limited access to essential health services.
JOURNAL OF PUBLIC HEALTH
(2022)
Article
Health Care Sciences & Services
Jacob Novignon, Charles Lanko, Eric Arthur
Summary: The study documents the political process and continued political interest in establishing the Ghana National Health Insurance Scheme (NHIS), highlighting the importance of political commitment and effective engagement with relevant stakeholders. The establishment of NHIS was seen as a solution to political promises and there have been commitments to improve the scheme in almost every election year.
HEALTH POLICY AND PLANNING
(2021)
Review
Medicine, General & Internal
Humphrey Cyprian Karamagi, Ali Ben Charif, Doris Osei Afriyie, S. Y. Sokona, Hillary Kipruto, Taiwo Oyelade, Benson Droti
Summary: This study aims to conduct a scoping review on inequalities in health service coverage in Africa. The study will collect and synthesize empirical research on inequalities in reproductive, maternal, newborn and child health services, infectious diseases, and non-communicable diseases in Africa. By analyzing the data and using descriptive statistics, strategies to address current challenges will be proposed.
Article
Social Issues
Sara Compion, Ram A. Cnaan, Jeffrey L. Brudney, Bok Gyo Jeong, Chao Zhang, Debbie Haski-Leventhal
Summary: The study found that novice episodic volunteers are primarily motivated by social reasons, while regular volunteers are motivated by altruistic reasons. Additionally, age and student status have an influence on distinguishing between novice and regular volunteers.
Review
Multidisciplinary Sciences
Maximillian Kolbe Domapielle
Summary: The importance of increasing fiscal space for health has been highlighted by the health-related Sustainable Development Goals (SDGs) and the Coronavirus Pandemic (COVID-19). Low and Middle-Income Countries (LMICs) are exploring various models of health insurance to provide financial access to health care, but there is a lack of research evidence on the most appropriate health financing model for Universal Health Coverage (UHC) in these settings. The journey towards UHC is a long-term policy engagement that requires adaptation to specific socio-cultural and political economy contexts, emphasizing the need for resilient and responsive health systems in LMICs for a gradual transition towards UHC.
Article
Surgery
P. Naidu, J. E. Ataguba, M. Shrime, B. C. Alkire, K. M. Chu
Summary: This study investigated the occurrence of catastrophic health expenditure and impoverishment among surgical patients in a hospital in South Africa. The majority of patients did not experience catastrophic health expenditure, but 17% of patients became impoverished after paying small amounts of fees.
WORLD JOURNAL OF SURGERY
(2022)
Article
Public, Environmental & Occupational Health
Mweete Debra Nglazi, John Ele-Ojo Ataguba
Summary: This study assessed the changing patterns in prevalence and determinants of overweight and obesity among non-pregnant women in South Africa aged 15 to 49 years between 1998 and 2017. The results showed that the prevalence of overweight and obesity among women of childbearing age increased over the past two decades, with a decrease in urban-rural disparities.
Article
Economics
John E. Ataguba
Summary: The concentration index and its normalization are widely used in assessing socioeconomic inequalities in health and health care. However, researchers may overlook the underlying behaviors when interpreting the corrected or normalized concentration indices. Additionally, the use of Wagstaff's and Erreygers' corrected concentration indices with binary health variables may pose challenges.
Article
Public, Environmental & Occupational Health
Frederik Federspiel, Josephine Borghi, Melisa Martinez-Alvarez
Summary: Debt burdens in LMICs are steadily increasing, and the COVID-19 economic recession is exacerbating the situation, posing a threat to essential health spending. While development loans can have positive effects on population health, the subsequent debt servicing requirements may adversely affect government health spending. However, the existing evidence is insufficient to understand how debt may constrain government health spending.
GLOBAL HEALTH ACTION
(2022)
Article
Medicine, General & Internal
Nasser Fardousi, Everton Nunes da Silva, Roxanne Kovacs, Josephine Borghi, Jorge O. M. Barreto, Soren Rud Kristensen, Juliana Sampaio, Helena Eri Shimizu, Luciano B. Gomes, Leticia Xander Russo, Garibaldi D. Gurgel, Timothy Powell-Jackson
Summary: Using the variation in the design of Brazil's PMAQ program, this study finds that providing performance bonuses to family health team workers improves the quality of care compared to traditional input-based budgets, with larger bonuses associated with greater improvements.
Article
Economics
Peter Binyaruka, Josephine Borghi
Summary: The study examines the time and transport costs of accessing healthcare in poor settings. It found that the poorest and rural patients face substantial time burden to access healthcare, but incur less transport and medical costs compared to their counterparts. The consultation time is similar across patients, while waiting time is similar across facility types. Patients spend more time travelling to public facilities and dispensaries but incur less transport cost.
HEALTH ECONOMICS REVIEW
(2022)
Review
Health Care Sciences & Services
Sharif A. Ismail, Sze Tung Lam, Sadie Bell, Fouad M. Fouad, Karl Blanchet, Josephine Borghi
Summary: This systematic review evaluates interventions to improve vaccination coverage in protracted crises and identifies several adaptable approaches as well as key unifying mechanisms. However, evidence for these interventions remains limited. Adapting these approaches for local system resilience-building remains a challenge.
BMC HEALTH SERVICES RESEARCH
(2022)
Article
Health Care Sciences & Services
Jessica King, Pallavi Prabhakar, Neha Singh, Munshi Sulaiman, Giulia Greco, Sandra Mounier-Jack, Josephine Borghi
Summary: This study examines equity in terms of health needs, service utilization, and health care payments among South Sudanese refugees and host communities in Uganda. The study found that wealthier groups have higher health needs for acute and chronic conditions, while poorer groups have greater need for maternal care. Although service coverage for acute, chronic, and antenatal care is similar among hosts and refugee communities, access to delivery care is lower for hosts. The costs of acute and chronic care can be substantial and regressive, leading to catastrophic expenditures that primarily benefit wealthier groups. Efforts are needed to improve access to acute and chronic care among the poorest and reduce out-of-pocket payments and their impoverishing effects.
BMC HEALTH SERVICES RESEARCH
(2022)
Article
Health Care Sciences & Services
Garibaldi Dantas Gurgel Junior, Soren Rud Kristensen, Everton Nunes da Silva, Luciano Bezerra Gomes, Jorge Otavio Maia Barreto, Roxanne J. Kovacs, Juliana Sampaio, Adriana Falangola Benjamin Bezerra, Keila Silene de Brito e Silva, Helena Eri Shimizu, Allan Nuno Alves de Sousa, Nasser Fardousi, Josephine Borghi, Timothy Powell-Jackson
Summary: Brazil introduced one of the largest P4P schemes in the world in 2011, but the design of the scheme could have been better structured to direct health providers towards improvements in quality of care. Compared with England's P4P scheme, the Brazilian scheme focused more on structural quality, had more indicators, and was less regular.
Article
Public, Environmental & Occupational Health
Munzer Alkhalil, Maher Alaref, Abdulkarim Ekzayez, Hala Mkhallalati, Nassim El Achi, Zedoun Alzoubi, Fouad Fouad, Muhammed Mansur Alatras, Abdulhakim Ramadan, Sumit Mazumdar, Josephine Borghi, Preeti Patel
Summary: Health aid displacement is not an effective tool used by donors in Syria to improve aid-effectiveness. Some leading donors, such as the EU, Germany, Norway and Canada, show evidence of health aid displacement. Donors prefer to fund humanitarian activities, with humanitarian aid being 50 times more than development health aid, due to easier implementation and dynamic borders.
Article
Public, Environmental & Occupational Health
S. Pongutta, E. Ferguson, C. Davey, V. Tangcharoensathien, S. Limwattananon, J. Borghi, C. K. H. Wong, L. Lin
Summary: This study assessed the impacts of the Dekthai Kamsai programme on overweight/obesity, underweight and stunting among male and female primary school students. The results showed that the intervention program was effective in reducing overweight/obesity and poor height gain, but had no significant effect on wasting. These findings highlight the benefits of a multifaceted school nutrition intervention and the need for tailor-made interventions for wasting to comprehensively address the double burden of malnutrition.
Article
Public, Environmental & Occupational Health
John Ele-Ojo Ataguba, Charles Birungi, Santiago Cunial, Matthew Kavanagh
Summary: This study examines the relationship between income inequality and HIV incidence, AIDS mortality, and COVID-19 mortality. The findings show a significant positive correlation between income inequality and all three outcomes. Countries with higher income inequality have higher rates of HIV incidence, AIDS mortality, and COVID-19 excess deaths. Income inequality weakens pandemic response.
Article
Public, Environmental & Occupational Health
Sharif A. Ismail, Andrada Tomoaia-Cotisel, Aya Noubani, Fouad M. Fouad, Sadie Bell, Josephine Borghi, Karl Blanchet
Summary: This study used qualitative system dynamics to conduct an in-depth case study on the response of routine childhood vaccination delivery system in Lebanon to multiple shocks. The findings revealed various system responses, including demand promotion measures and supply side strategies. Some systemic changes were introduced, but certain resilience-promoting measures paradoxically increased vulnerability to later shocks.
Article
Public, Environmental & Occupational Health
John E. Ataguba, Chijioke O. Nwosu, Amarech G. Obse
Summary: Maternal health statistics have improved in many countries in sub-Saharan Africa (SSA), but progress remains slow in meeting the Sustainable Development Goals (SDG) targets. Accelerating antenatal care (ANC) coverage is critical to improving maternal health outcomes. Countries should target reducing health disparities between-/within-socioeconomic groups to achieve progress.
SSM-POPULATION HEALTH
(2023)
Article
Economics
Peter Binyaruka, Anna Foss, Abdullah Alibrahim, Nicholaus Mziray, Rachel Cassidy, Josephine Borghi
Summary: This study examines the demand- and supply-side factors influencing access to facility-based delivery care in Tanzania. The findings suggest that factors such as education, religion, economic status, parity, and antenatal care visits significantly influence the demand for facility-based delivery care. Additionally, facilities offering outreach services, longer consultation times, and higher interpersonal quality are associated with higher rates of facility-based delivery.
HEALTH ECONOMICS REVIEW
(2023)