Universal Coverage (universal + coverage)

Distribution by Scientific Domains


Selected Abstracts


Social Health Insurance: Key Factors Affecting the Transition Towards Universal Coverage

INTERNATIONAL SOCIAL SECURITY REVIEW, Issue 1 2005
Guy Carrin
Several low- and middle-income countries are interested in extending their existing health insurance for specific groups to eventually cover their entire populations. For those countries interested in such an extension, it is important to understand the factors that affect the transition from incomplete to universal coverage. This paper analyses the experience of eight countries in the implementation of social health insurance. It highlights the importance of the socioeconomic and political context, particularly in relation to the level of income, structure of the economy, distribution of the population, ability to administer and level of solidarity within the country, but also stresses the important stewardship role government can play in facilitating the transition to universal coverage via social health insurance. [source]


Simple Transfers, Complex Outcomes: The Impacts of Pensions on Poor Households in Brazil

DEVELOPMENT AND CHANGE, Issue 5 2006
Peter Lloyd-Sherlock
ABSTRACT Drawing on quantitative survey data and in-depth interviews, this article seeks to map out the potential direct and indirect effects of simple cash transfers on households in impoverished rural and urban settings. Brazil is shown to have an extensive system of old age pensions, which affords almost universal coverage to households containing older people. These benefits have a significant impact on levels of poverty and vulnerability in recipient households. They also facilitate access to essential healthcare items, such as drugs, which are seldom freely available through the state health system. The in-depth interviews reveal that pensions can have important effects on intra-household relations, but these effects were not generalizable nor easily captured by quantitative survey tools. There was clear evidence that pensions reduced the propensity of older people to remain economically active, but this must be understood in a context of limited employment opportunities for all age groups and a high prevalence of disability. Overall, the article demonstrates the complex effects of a relatively simple cash transfer, which policy makers need to take into account. [source]


Progressive segmented health insurance: Colombian health reform and access to health services

HEALTH ECONOMICS, Issue 1 2007
Fernando Ruiz
Abstract Equal access for poor populations to health services is a comprehensive objective for any health reform. The Colombian health reform addressed this issue through a segmented progressive social health insurance approach. The strategy was to assure universal coverage expanding the population covered through payroll linked insurance, and implementing a subsidized insurance program for the poorest populations, those not affiliated through formal employment. A prospective study was performed to follow-up health service utilization and out-of-pocket expenses using a cohort design. It was representative of four Colombian cities (Cendex Health Services Use and Expenditure Study, 2001). A four part econometric model was applied. The model related medical service utilization and medication with different socioeconomic, geographic, and risk associated variables. Results showed that subsidized health insurance improves health service utilization and reduces the financial burden for the poorest, as compared to those non-insured. Other social health insurance schemes preserved high utilization with variable out-of-pocket expenditures. Family and age conditions have significant effect on medical service utilization. Geographic variables play a significant role in hospital inpatient service utilization. Both, geographic and income variables also have significant impact on out-of-pocket expenses. Projected utilization rates and a simulation favor a dual policy for two-stage income segmented insurance to progress towards the universal insurance goal. Copyright © 2006 John Wiley & Sons, Ltd. [source]


Price competition under universal service obligations

INTERNATIONAL JOURNAL OF ECONOMIC THEORY, Issue 3 2010
Axel Gautier
L13; L51 In industries like telecom, postal services or energy provision, universal service obligations (uniform price and universal coverage) are often imposed on one market participant. Universal service obligations are likely to alter firms' strategic behavior in such competitive markets. In the present paper, we show that, depending on the entrant's market coverage and the degree of product differentiation, the Nash equilibrium in prices involves either pure or mixed strategies. We show that the pure strategy market sharing equilibrium, as identified by Valletti, Hoernig, and Barros (2002), defines a lower bound on the level of equilibrium prices. [source]


Social Health Insurance: Key Factors Affecting the Transition Towards Universal Coverage

INTERNATIONAL SOCIAL SECURITY REVIEW, Issue 1 2005
Guy Carrin
Several low- and middle-income countries are interested in extending their existing health insurance for specific groups to eventually cover their entire populations. For those countries interested in such an extension, it is important to understand the factors that affect the transition from incomplete to universal coverage. This paper analyses the experience of eight countries in the implementation of social health insurance. It highlights the importance of the socioeconomic and political context, particularly in relation to the level of income, structure of the economy, distribution of the population, ability to administer and level of solidarity within the country, but also stresses the important stewardship role government can play in facilitating the transition to universal coverage via social health insurance. [source]


Social health insurance in developing countries: A continuing challenge

INTERNATIONAL SOCIAL SECURITY REVIEW, Issue 2 2002
Guy Carrin
This paper addresses the issue of the feasibility of "social" health insurance (SHI) in developing countries. SHI aims at protecting all population groups against financial risks due to illness. There are substantial difficulties in implementation, however, due to lack of debate and consensus about the extent of financial solidarity, problems with health service delivery, and insufficient managerial capacity. The transition to universal coverage is likely to take many years, but it can be speeded up. Adopting a "family" approach to financial protection, sustained financial support from governments and donors, and deconcentrating the development of SHI may slash several years from the time needed to achieve full universal protection against healthcare costs. [source]


Global epidemiology of HIV,

JOURNAL OF MEDICAL VIROLOGY, Issue S1 2006
Francine E. McCutchan
Abstract HIV is among the most generically variable of human pathogens. A comprehensive and detailed description of HIV strains in the pandemic is an important foundation for diagnosis, treatment, and prevention. The current sequence database for HIV includes almost 800 complete genome sequences, documenting HIV-1 groups M, O, and N, and HIV-2. Among HIV-1 group M strains, responsible for the vast majority of HIV infections worldwide, 743 sequences represent 9 genetic subtypes, 16 circulating recombinant forms (CRF) that are spreading in populations, and a variety of unique recombinant forms (URF), identified so far only from a single individual. The global distribution of HIV is complex and dynamic with regional epidemics harboring only a subset of the global diversity. HIV strains differ enormously in terms of global prevalence. Six strains account for the majority of HIV infections: HIV-1 subtypes A, B, C, D, and two of the CRF, CRF01-AE and CRF02_AG, respectively. Many of the known subtypes and recombinant forms are currently rare in the epidemic, but could spread more widely if favorable conditions arise. HIV-2 is largely restricted to West Africa at relatively low prevalence there. Groups O and N of HIV-1 are very rare in the pandemic. The goal of universal coverage of HIV-1 strains by diagnostic tests can be met by minimizing false negative test rates for the six globally prevalent HIV-1 group M strains and HIV-2, and by evaluating systematically coverage of rare subtypes and recombinant forms. J. Med. Virol. 78:S7,S12, 2006. © 2006 Wiley-Liss, Inc. [source]


Strategies for Establishing Organ Transplant Programs in Developing Countries: The Latin America and Caribbean Experience

ARTIFICIAL ORGANS, Issue 7 2006
Josť Osmar Medina-Pestana
Abstract:, The Latin America and Caribbean region is composed of 39 countries. It is remarkable the progress of transplantation in the region in despite of the low economic resources when compared to other regions. The criteria for brain death are well established and culturally accepted. The consent for retrieval is based on required family consent in most countries. The regulations for living donors are also well established, with restrictions to unrelated donors and prohibition of any kind of commerce. The access to transplant is limited by the model of public financing by each country, and those with public universal coverage have no financial restrictions to cover the costs for any citizen; in countries with restricted coverage, the access is restricted to the employment status. There is a progressive increment in the annual number of solid organ transplants in Latin America, reaching near 10 000 in 2004, accomplished by adequate legislation that is also concerned with the prohibition of organ commerce. [source]


Ageing in "Poor Household" or Ageing into Poverty?

ASIAN SOCIAL WORK AND POLICY REVIEW, Issue 1 2010
Tackling the Policy Dilemma of Redistribution
The policy issue of how to target poor households rather than provide universal coverage takes the primary place in the question of redistribution where resources are limited. The Government of India's social protection programs, particularly the old age pension for the informal sector of the economy, has taken a targeting approach. In this article we show that there is a case for universal coverage since ageing households experience greater exclusion from market-based protection as well as from informal (household-based) protection. We make the argument for universal coverage on two grounds: first, a targeted approach has resulted in leakage, indicating that non-poor elderly individuals in the unorganized sector also require some sort of support. Though they are valid, we do not resort to traditional arguments against targeting, such as that it creates institutional lock-in mechanisms and stigmatizes the recipients. Second, the loss of income on age-related matters (e.g. hospitalization) or the ability of elderly individuals to gain credit is not particularly class-specific, although the targeting policy implies it is. The article is based on the secondary data source of the National Sample Survey, primary data sources, particularly those conducted by the authors in Kerala and Maharashtra and specifically designed for the ageing population, and ethnographic observations from fieldwork. [source]


Social Inequality: Utilisation of general practitioner services by socio-economic disadvantage and geographic remoteness

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2004
Gavin Turrell
Objective: To examine the association between socio-economic status (SES) and GP utilisation across Statistical Local Areas (SLAs) that differed in their geographic remoteness, and to assess whether Indigenous status and GP availability modified the association. Design: Retrospective analysis of Medicare data for all unreferred GP consultations (1996/97) for 952 SLAs comprising the six Australian States. Geographic remoteness was ascertained using the Area Remoteness Index of Australia (ARIA), and SES was measured by grouping SLAs into tertiles based on their Index of Relative Socioeconomic Disadvantage score. Main outcome measure: Age/sex standardised rates of GP utilisation for each SLA. Main results: In SLAs classified as ,highly accessible', rates of GP use were 10.8% higher (95% CI 5.7,16.0) in the most socio-economically disadvantaged tertile after adjustment for Indigenous status and GP availability. A very different pattern of GP utilsation was found in ,remote/very remote' SLAs. After adjustment, rates of GP use in the most socio-economically disadvantaged tertile were 25.3% lower (95% CI 5.9,40.7) than in the most advantaged tertile. Conclusions: People in socio-economically disadvantaged metropolitan SLAs have higher rates of GP utilisation, as would be expected due to their poorer health. This is not true for people living in disadvantaged remote/very remote SLAs: in these areas, those most in need of GP services are least likely to receive them. Australia may lay claim to having a primary health care system that provides universal coverage, but we are still some way from having a system that is economically and geographically accessible to all. [source]