This paper proposes a comprehensive framework for projecting public heath and long-term care expenditures. Notably, it considers the impact of demographic and non-demographic effects for both health and long-term care. Compared with other studies, the paper extends the demographic drivers by incorporating death-related costs and the health status of the population.
Resource allocation and health financing
Projecting OECD health and long-term care expenditures: What are the main drivers?
Organisation for Economic Co-operation and Development
What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts?
D McIntyre, M Thiede, G Dahlgren, M Whitehead Social Science & Medicine, 62, 4 February 2006, 858-865
This paper presents the findings of a critical review of studies carried out in low- and middle-income countries (LMICs) focusing on the economic consequences for households of illness and health care use. These include household level impacts of direct costs (medical treatment and related financial costs), indirect costs (productive time losses resulting from illness) and subsequent household responses. It highlights that health care financing strategies that place considerable emphasis on out-of-pocket payments can impoverish households.
Cost effectiveness analysis of strategies to combat malaria in developing countries
BMJ 2005;331:1299 (3 December)
A much larger infusion of resources than those currently available is needed to make headway in the fight to roll back malaria. On cost effectiveness grounds, in most areas in sub-Saharan Africa greater coverage with highly effective combination treatments should be the cornerstone of malaria control. However, treatment alone can achieve less than half the total benefit obtainable through a combination of interventions - scaling up the use of impregnated mosquito nets or indoor spraying with insecticides is also critical. Intermittent presumptive treatment of pregnant women can bring a small but important additional health gain at relatively low cost.
User fees for health
An Eldis issues guide
User fees for health care, also referred to as cost sharing, cost recovery or co-payment, are widespread around the developing world, despite mounting opposition to them. Many studies have found them to be among the barriers to the use of health services, and have shown that they affect poor people more than others. Such concerns have led many researchers, advisers, and policy makers to question whether user fees should be applied, especially among poor and vulnerable groups. In particular, there is concern that user fees will hinder access to essential social services and so prevent the Millennium Development Goals from being met.
Cost effectiveness analysis of strategies for tuberculosis control in developing countries
Rob Baltussen, health economist, Katherine Floyd, health economist, Christopher Dye, coordinator
The objectives of this study are to assess the costs and health effects of tuberculosis control interventions in Africa and South East Asia in the context of the millennium development goals. The conclusions are that DOTS treatment of new smear-positive cases is the first priority in tuberculosis control, including in countries with high HIV prevalence. DOTS treatment of smear-negative and extra-pulmonary cases and DOTS-Plus treatment of multidrug resistant cases are also highly cost effective. To achieve the millennium development goal for tuberculosis control, substantial extra investment is needed to increase case finding and implement interventions on a wider scale.
Deprivation and the equitable allocation of health care resources to decentralised districts in Tanzania
Equinet discussion paper
There is a marked variation in deprivation between various districts in Tanzania. Tanzania recently adopted a needs-based formula, which includes a poverty measure, to allocate resources to districts. This paper presents an analysis of the allocation of health care resources in Tanzania. This paper analyses equity in current resource allocation in Tanzania, and compares these allocations to equity target allocations, using an index of deprivation. The results revealed that districts currently receiving relatively high allocations according the current poverty-based formula would receive slightly lower budgets if the deprivation index was used in the resource allocation formula. Those with very low allocations would receive slightly more if the deprivation index was used to guide resource allocation. However, the resource allocation differences between the poverty-based and deprivation-based formulae were small. This suggests that Tanzania has already made good progress in addressing equity in resource allocation between districts.
Political support is crucial for health policy reform in South Africa
University of Cape Town, the London School of Hygiene and Tropical Medicine
Debates about the best way to fund South Africa's health system have run for over a decade. Plans for social health insurance have not received enough support to become law. In contrast reform of private health insurance regulations have been passed. Why has the pace of reform between the private and public sectors differed? The University of Cape Town, together with the London School of Hygiene and Tropical Medicine, compared reforms to private and social health insurance to see why their success has varied.
Good economics: implementing cost-effective strategies against malaria
Many governments in affected countries have failed to introduce cost-effective approaches to tackle malaria. Researchers from the London School of Hygiene and Tropical Medicine reviewed the literature on malaria control and used economic analysis to assess demand for and supply of malaria control methods. The authors make recommendations for improving both the prevention and treatment of this major public health problem. Governments need to play a role in ensuring access to cost-effective interventions for malaria treatment and prevention. Often such preventions are beyond the means of individuals, and the high costs of treating severe malaria can drive households into poverty.
Promoting equitable health care financing in the African context: Current challenges and future prospects
Equinet discussion paper
The issue of appropriate mechanisms for mobilising health care financing resources is once again high on the policy agenda of African governments. The objectives of this paper are to critically evaluate how health services are currently funded, explore recent trends in health care financing and identify lessons from the health care financing experience of African countries. It also considers the implications of this review for policy, advocacy and future research needs.
A Call to Action: PHR Asks African Health Ministers to Link Long-term Health Plans to the Millennium Development Goals
Physicians for Human Rights statement
Many African health ministries face insufficient and unpredictable funding from development partners and others, and have limited resources to devote to even important tasks such as long-term planning in developing their health work forces. PHR is calling on African Union ministers of health, who meet in Botswana in mid-October, to commit to developing targets, plans, and budgets for health workforces and systems to meet the Millennium Development Goals by 2015, as well as other health aims. The challenges to developing these plans are real, but the potential benefits to them are immense.