This article argues that the suspension of funding to Uganda from the Global Fund could have been avoided. The article outlines how the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund) suspended five grants to Uganda following an audit report that exposed gross mismanagement in the Project Management Unit. The authors argue that this could have been avoided if a legitimate and fair decision-making process was used and that this lesson should be applied to other countries.
Resource allocation and health financing
Accountability for reasonableness framework could improve transparency and effectiveness of Global Fund projects
Kapiriri L, Martin D: Bulletin of the World Health Organization (WHO): the International Journal of Public Health, 2006
Have pro-poor health policies improved the targeting of spending and the effective delivery of health care in South Africa?
Burget R, Swanepoel C: United Nations Economic Commission for Africa, October 2006
South Africa’s apartheid health system was grossly ineffective. Private and public health spending combined was among the highest in the world at 8.4% of GDP, yet inequalities in provision, poor efficiency of spending and other factors impacting on health status meant that the country was not among the top 60 in terms of health status indicators (Goudge, 1999). In an attempt to remove obstacles to access to health services, the government introduced free primary health care in 1996. The paper attempts to gauge the impact of these changes. The focus falls on changes in the incidence of South African public health spending.
South Africa: New social grants plan cautiously welcomed
IRIN Plus News, 23 November 2006
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.
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.