South Africa's Department of Health confirmed on Thursday that a new social grant system was on the cards for chronically ill people, including those living with HIV/AIDS. At present, government policy stipulates that HIV positive grant recipients be deregistered once antiretroviral (ARV) treatment restores them to good health and they are able to start seeking work. However, local AIDS activists charged that with national unemployment estimated at around 35 percent, most beneficiaries were usually jobless and too ill to work before they started receiving the monthly stipend. The article describes these issues raised.
Resource allocation and health financing
South Africa: New social grants plan cautiously welcomed
IRIN Plus News, 23 November 2006
The impact of social health protection on access to health care, health expenditure and impoverishment: A comparative analysis of three African countries
Jutting J, Scheil-Adlung X: World Institute for Development Research (WIDER), 2006
Recently, there has been an increasing focus on social health protection through health insurance as a potentially promising way to better deal with health risks in developing countries. However, the empirical basis for a profound analysis of the effects of health insurance is still very weak. This paper summarises the results of three individual research projects measuring the impact of membership in a health insurance scheme in three African countries: Kenya, Senegal and South Africa.
The political economy of health care finance
Moreno-Ternero JD, Roemer JE: World Institute for Development Research (WIDER), 2006
The authors present a model of political competition, in a multi-dimensional policy space and with policy-oriented candidates, to analyse the problem of health care finance. In this model, health care is either financed publicly (by means of general taxation) or privately (by means of a co-payment). The extent of these two components (as well as the overall tax schedule in the country) is the outcome of the process of political competition. The model shows that, in equilibrium, parties propose policies that implement the latest (and most expensive) medical techniques available.
Cost-effectiveness analysis of HIV chemoprophylaxis
Grant R, Lama J, Goicochea P, et al: The Sixteenth International AIDS Conference, August 2006
Ethical guidelines require that research on effectiveness of HIV chemoprophylaxis be performed in populations where the intervention would be feasible if the trials demonstrate efficacy with acceptable safety. Population effects and cost effectiveness were simulated using a mathematical model that considers heterosexual and homosexual transmission, higher infectiousness in early and late infection, age and sex effects on susceptibility, risk behavior variation, condom replacement, known age-sex partner preferences, and primary and secondary drug resistance. The article describes the findings and relevant conclusions drawn.
Financing mental health services in low- and middle-income countries
Dixon A, McDaid D, Knapp M, Curran C: Health Policy and Planning 21 (3), March 2006
Mental disorders account for a significant and growing proportion of the global burden of disease and yet remain a low priority for public financing in health systems globally. In many low-income countries, formal mental health services are paid for directly by patients out-of-pocket and in middle-income countries undergoing transition there has been a decline in coverage. The paper explores the impact of health care financing arrangements on the efficient and equitable utilization of mental health services. Through a review of the literature and a number of country case studies, the paper examines the impact of financing mental health services from out-of-pocket payments, private health insurance, social health insurance and taxation. The implications for the development of financing systems in low- and middle-income countries are discussed.
Health budget should meet Abuja Declaration
The Daily Mirror Reporter (Zimbabwe), 20 September 2006
In a presentation before the parliamentary portfolio committee on health and child welfare yesterday, the health ministry said its budgetary allocation for next year should conform to the declaration. This article presents its argument that in Zimbabwe, the Ministry of Health and Child Welfare budget should at least meet the Abuja Declaration target of a minimum of 15% of the government budget going to Ministry of Health.
Further details: /newsletter/id/31771
Health budgets in Africa
Wemos
In 2005, Wemos together with several Southern organizations conducted case studies in Ghana, Zambia, Kenya and Uganda on the role of the International Monetary Fund (IMF) in determining budgets for health, particularly for health workers' salaries. Achieving the health related Millennium Development Goals (MDGs) requires a substantial financial injection in the health sectors of low-income countries. Public expenditure, however, is restricted by IMF macroeconomic policies and conditions, through ceilings on the public sector wage bill. The report describes the findings and conclusions of the four case studies.
Health insurance: Is it globally relevant
Berset P: Geneva Health Forum, 31 August 2006
Financing of health systems is well known for raising controversial ideas and provoking stormy debate. Should a prepayment system be applied to deficient health systems in under-developed countries? Different judgements on the global relevance of insurance are presented.
Oxfam urges massive investment in health systems
Oxfam press release, 14 August 2006
Oxfam International today urged donor nations and developing country governments to scale up their investment in health systems to address the critical shortage of health workers and crumbling infrastructure. "For the first time in human history, we have the resources to stop HIV/AIDS from killing millions of people. What we do not know is whether our leaders will muster the generosity to save these lives," said Dr, Mohga Kamal Yanni, senior health and HIV policy advisor for Oxfam International.
Priority setting of health interventions: The need for multi-criteria decision analysis
Baltussen R, Niessen L: Cost Effectiveness and Resource Allocation 4:14, 21 August 2006
Priority setting of health interventions is often ad-hoc and resources are not used to an optimal extent. Underlying problem is that multiple criteria play a role and decisions are complex. Interventions may be chosen to maximize general population health, to reduce health inequalities of disadvantaged or vulnerable groups, ad/or to respond to life-threatening situations, all with respect to practical and budgetary constraints. This is the type of problem that policy makers are typically bad at solving rationally, unaided. Therefore, the development of a multi-criteria approach to priority setting is necessary, and this has indeed recently been identified as one of the most important issues in health system research.