Abstract:
BACKGROUND:Health-care financing should be equitable. In many developing countries such as Kenya, changes to health-care financing systems are being implemented as a means of providing equitable access to health care with the aim of attaining universal coverage. Vertical equity means that people of dissimilar ability to pay make dissimilar levels of contribution to the health-care financing system. Vertical equity can be analysed by measuring progressivity. OBJECTIVES:The aim of this study was to analyse progressivity by measuring deviations from proportionality in the relationship between sources of health-care financing and ability to pay using Kakwani indices applied to data from the Kenya Household Health Utilisation and Expenditure Survey 2007. METHODS:Concentration indices and Kakwani indices were obtained for the sources of health-care financing: direct and indirect taxes, out of pocket (OOP) payments, private insurance contributions and contributions to the National Hospital Insurance Fund. The bootstrap method was used to analyse the sensitivity of the Kakwani index to changes in the equivalence scale or the use of an alternative measure of ability to pay. RESULTS:The overall health-care financing system was regressive. Out of pocket payments were regressive with all other payments being proportional. Direct taxes, indirect taxes and private insurance premiums were sensitive to the use of income as an alternative measure of ability to pay. However, the overall finding of a regressive health-care system remained. CONCLUSION:Reforms to the Kenyan health-care financing system are required to reduce dependence on out of pocket payments. The bootstrap method can be used in determining the sensitivity of the Kakwani index to various assumptions made in the analysis. Further analyses are required to determine the equity of health-care utilization and the effect of proposed reforms on overall equity of the Kenyan health-care system.
journal_name
Health Policy Planjournal_title
Health policy and planningauthors
Munge K,Briggs AHdoi
10.1093/heapol/czt073subject
Has Abstractpub_date
2014-10-01 00:00:00pages
912-20issue
7eissn
0268-1080issn
1460-2237pii
czt073journal_volume
29pub_type
杂志文章abstract::The 'Community Action for Preventing HIV/AIDS Project' was implemented in four provinces in Cambodia (2001-04) to support a comprehensive set of HIV prevention efforts. Implementation was strictly monitored in terms of inputs, outputs and outcomes. We examine changes in these variables during the project period to ass...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czn014
更新日期:2008-07-01 00:00:00
abstract::Ensuring financial access to health services is a critical challenge for poor countries if they are to reach the health Millennium Development Goals (MDGs). This article examines the case of Rwanda, a country which has championed innovative health care financing policies. Between 2000 and 2007, Rwanda has improved fin...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czr070
更新日期:2011-11-01 00:00:00
abstract:Background:This study describes the post-diagnosis care-seeking costs incurred by people living with TB and/or HIV and their households, in order to identify the potential benefits of integrated care. Methods:We conducted a cross-sectional study with 454 participants with TB or HIV or both in public primary health car...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czw183
更新日期:2017-11-01 00:00:00
abstract::Global financing for the HIV response has reached unprecedented levels in recent years. Over US$10 billion were mobilized in 2007, an effort credited with saving the lives of millions of people living with HIV (PLHIV). A relatively unexamined aspect of the global HIV response is the role of the private sector in finan...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czr031
更新日期:2011-07-01 00:00:00
abstract:Background:The efficacy of low- and middle-income countries’ (LMIC) national drug policies in managing antiretroviral (ARV) pharmaceutical prices is not well understood. Though ARV drug prices have been declining in LMIC over the past decade, little research has been done on the role of their national drug policies. Th...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czw107
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:This study compares household heads' willingness-to-pay (WTP) for community-based health insurance (CBI) for themselves with their WTP for other household members, in order to provide information for policy makers on setting the premium and choosing the enrollment unit. METHOD:A random sample of 698 heads of...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czh014
更新日期:2004-03-01 00:00:00
abstract::Traditional medicine is commonly assumed to be a crucial health care option for poor households in developing countries. However, little research has been done in Asia to quantify the reliance on traditional medicine and its determinants. This research contributes to filling in this knowledge gap using household surve...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czv060
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:To estimate the cost-effectiveness of introducing hepatitis B vaccine into routine infant immunization services in Mozambique, which took place in the year 2001. METHODS:A decision analytic model was used to estimate the impact of hepatitis B vaccination. This model was developed for the WHO to estimate the ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czi006
更新日期:2005-01-01 00:00:00
abstract::In many developing countries people are expected to contribute to the cost of health care from their own pockets. As a result, people's ability to pay (ATP) for health care, or the affordability of health care, has become a critical policy issue in developing countries, and a particularly urgent issue where households...
journal_title:Health policy and planning
pub_type: 杂志文章,评审
doi:10.1093/heapol/11.3.219
更新日期:1996-09-01 00:00:00
abstract::The connection between HIV and sexual and reproductive health and rights (SRHR) is widely recognised along with the benefits of linking them at the legal/policy, health systems, and service delivery levels. However, despite increased rhetoric about the need for this three-tiered approach, integrated service delivery h...
journal_title:Health policy and planning
pub_type: 杂志文章,评审
doi:10.1093/heapol/czw119
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Between 25 and 44% of mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) occurs through breastfeeding. As a result, feeding guidelines for infants of HIV-infected mothers are being formulated in many resource-poor countries. The impact of introducing these guidelines on mothers' ac...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czg020
更新日期:2003-06-01 00:00:00
abstract::Despite efforts taken by the Government of India, mothers and newborns are excluded from the maternal and child health services, especially those in poorer and weaker sections of the society. Hence, we have utilized the most recent National Family Health Survey (NFHS-4) data to assess the socio-economic inequities in ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czaa020
更新日期:2020-06-01 00:00:00
abstract::Development assistance for health (DAH) has increased substantially in recent years and is seen as important to the improvement of health and health systems in developing countries. As a result, there has been increasing interest in tracking and understanding these resource flows from the global health community. A nu...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czr076
更新日期:2012-09-01 00:00:00
abstract::This paper investigates the key factors associated with the demand for Urban Resident Basic Medical Insurance (URBMI), which was established in 2007 and aims to cover all Chinese urban residents. Two waves of longitudinal household survey data are used, and a three-level random-intercept logit model is used for the an...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czs014
更新日期:2012-12-01 00:00:00
abstract::In 1998 Bangladesh began a sector wide approach (SWAp) to the extension of health care to vulnerable groups in the country. The central feature of this approach is the funding of an essential service package (ESP) emphasizing maternal care, certain communicable diseases and child health. This study examines the way in...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/17.3.247
更新日期:2002-09-01 00:00:00
abstract::Little is understood about the feasibility and acceptability of primary care-based models of task-sharing care for people with severe mental disorders (SMDs) in low- and middle-income countries (LMICs). A participatory planning approach was adopted in preparation for the transition from hospital-delivered psychiatric ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czv072
更新日期:2016-04-01 00:00:00
abstract::Similar to many other countries, Chile is facing the challenges of rapid ageing and the increase in long-term care (LTC) needs for this population. Implementation of LTC systems has been the response to these challenges in other countries, however, Chile still lacks a strategy for addressing LTC needs. This article ad...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czy083
更新日期:2018-11-01 00:00:00
abstract::This paper examines healthcare utilization behaviour in Sri Lanka with special emphasis on the choice between costly private and free public healthcare services. We use a data set that combines nationwide household survey data and district level healthcare supply data. Our findings suggest that even with universal pub...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czx085
更新日期:2017-11-01 00:00:00
abstract::The burden of diarrhoeal disease remains high in the developing world. Community-based safe drinking water programmes are being promoted as cost-effective interventions that will help reduce this illness burden. However, the effectiveness of these programmes remains under-investigated. The primary argument of this pap...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czn017
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVES:The Global Alliance for Vaccines and Immunization (GAVI) anticipated that growing demand for new vaccines could sufficiently impact the vaccines market to allow low-income countries (LICs) to self-finance new vaccines. But the time required to lower vaccine prices was underestimated and the amount that price...
journal_title:Health policy and planning
pub_type: 杂志文章,评审
doi:10.1093/heapol/czs123
更新日期:2013-12-01 00:00:00
abstract::A decade after the first International Conference on Safe Motherhood, maternal mortality remains very high in most West African countries, even in capital cities. The detection of high risk pregnancies, known as the risk approach, during antenatal consultations has been the basis of most maternal and child health prog...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/15.1.11
更新日期:2000-03-01 00:00:00
abstract:INTRODUCTION:There is an immense need for scaling-up neuropsychiatric care in low-income countries. Contextualized cost-effectiveness analyses (CEAs) provide relevant information for local policies. The aim of this study is to perform a contextualized CEA of neuropsychiatric interventions in Ethiopia and to illustrate ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czv093
更新日期:2016-05-01 00:00:00
abstract::This article presents research findings into the effectiveness of an innovative equity fund approach to improving access to public sector health services for the poor in Kirivong Operational Health District in Cambodia. The operational health district is the lowest organizational level in the Cambodian health system, ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czj001
更新日期:2006-01-01 00:00:00
abstract::Given the demonstrated efficacy of vitamin A supplements in reducing childhood mortality, health officials now have to decide whether it would be efficient to target the supplements to high risk children. Decisions about targeting are complex because they depend on a number of factors; the degree of clustering of prev...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/12.1.29
更新日期:1997-03-01 00:00:00
abstract::Community-based health insurance (CBHI) has gained popularity in many low- and middle-income countries, partly as a policy response to calls for low-cost, pro-poor health financing solutions. In Africa, Rwanda has successfully implemented two types of CBHI systems since 2005, one of which with a flat rate premium (200...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czaa135
更新日期:2020-12-02 00:00:00
abstract::Adequate supervision is critical to maintain the performance of health workers who provide essential maternal and child health services in low-resource areas. Supportive supervision emphasizing problem-solving, skill development and mentorship has been shown to improve the motivation and effectiveness of health worker...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czaa167
更新日期:2020-12-22 00:00:00
abstract::OBJECTIVES We describe modern and alternative health services use in terminal illness of adults, and assess whether utilization patterns of TB/AIDS patients are distinct from those of patients suffering from other illnesses. METHODS Data are from post-mortem interviews with close relatives or caretakers of the decease...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czp015
更新日期:2009-07-01 00:00:00
abstract::Two assumptions underpin much of the literature that has examined the links between HIV/AIDS and security: (1) that HIV/AIDS is now firmly established as an international security issue; and (2) that Resolution 1308, adopted by the UN Security Council in July 2000, was the decisive moment in the securitization process...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czq051
更新日期:2010-11-01 00:00:00
abstract:Background:Previous literature suggests that increasing numbers of development aid donors can reduce aid effectiveness but this has not been tested in the health sector, which has experienced substantial recent growth in aid volume and number of donors. Methods:Based on annual data for 1995-2010 on 139 low- and middle...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czw164
更新日期:2017-05-01 00:00:00
abstract::In Mauritania, obstetrical risk insurance (ORI) has been progressively implemented at the health district level since 2002 and was available in 25% of public healthcare facilities in 2015. The ORI scheme is based on pre-payment scheme principles and focuses on increasing the quality of and access to both maternal and ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czz150
更新日期:2020-05-01 00:00:00