Human Resources

More than 95% of medical aid scheme members have access to HIV/AIDS cover exceeding the state's proposed package of minimum benefits, but less than 1% of them are coming forward to take advantage of the available care. This is one of the key findings of a study released by the Centre for Actuarial Research at the University of Cape Town in association with the Treatment Action Campaign (TAC).

Phyllida Travis, Dominique Egger, Philip Davies, Abdelhay Mechbal. Evidence and Information for Policy, World Health Organization, 2002.
The paper proposes that stewards should have access to reliable, up-to-date information on: Current and future trends in health and health system performance? For example, on levels, trends and inequalities in key areas such as national health expenditures; human resources; health system outcomes; health risk factors; vulnerable groups; coverage; provider performance; organisational / institutional challenges in provision, financing, resource generation, stewardship Important contextual factors and actors the political, economic and institutional context; the roles and motivation of different actors; user / consumer preferences; opportunities and constraints for change. Events / reforms in other sectors with implications for the health sector Possible policy options, based on national and international evidence and experience? For example, intelligence on different policy tools and instruments for similar problems; on their effects in different settings, and on managing change. It includes information on relatively specific things such as cost-effective interventions; and on possible institutional arrangements for different functions.

In an earlier article, the authors outline some reasons for the disappointingly small effects of primary health care programs and identified two weak links standing between spending and increased health care. The first was the inability to translate public expenditure on health care into real services due to inherent difficulties of monitoring and controlling the behavior of public employees. The second was the "crowding out" of private markets for health care, markets that exist predominantly at the primary health care level. This article presents an approach to public policy in health that comes directly from the literature on public economics. It identifies two characteristic market failures in health. The first is the existence of large externalities in the control of many infectious diseases that are mostly addressed by standard public health interventions. The second is the widespread breakdown of insurance markets that leave people exposed to catastrophic financial losses. Other essential considerations in setting priorities in health are the degree to which policies address poverty and inequality and the practicality of implementing policies given limited administrative capacities. Priorities based on these criteria tend to differ substantially from those commonly prescribed by the international community.

The emerging crisis of health manpower in Africa could defeat the efforts of governments, private health care providers, NGOs, and donors in controlling the HIV/AIDS epidemic. This was one of the principal findings of a consultative meeting on improving collaboration amongst health professionals, government and other stakeholders on health workers issues, recently held by WHO and the World Bank in Addis Ababa, Ethiopia.