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Social health protection: global and regional good practice
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Transcript of Social health protection: global and regional good practice
64thSession of
the Regional Committee
for the Eastern Mediterranean
Islamabad, Pakistan9–12 October 2017
SIDE MEETING
SOCIAL HEALTH PROTECTION:
GLOBAL AND REGIONAL GOOD PRACTICES
Dr Zafar MirzaDirector of Health System Development
Tuesday, 10 October 2017 1600 to 1700 hours
2
Social Health Protection
a series of public or publicly organized and mandated private measures against
social distress and economic loss caused by the reduction of productivity, stoppage or reduction of earnings or the cost of necessary treatment
that can result from ill health.
SHP Coverage is defined as effective access to affordable
quality health care and financial protection in case of
sickness.
ILO
Universal Health Coverage
UHC means that all
people and communities
can use the promotive,
preventive, curative,
rehabilitative and
palliative health services
they need, of sufficient
quality to be effective,
while also ensuring that
the use of these services
does not expose the user to financial hardship.
WHO
Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all
3
All people must enjoy a basic standard of living, including through social protection systems. 2030 Agenda for Sustainable Development
“leave no one behind”
Population Coverage
Fin
anci
al C
ove
rage
Country
Group
Government
revenue
Social health
insurance
schemes
Private health
insurance
schemes
Other
prepayment
arrangements
Population
covered
Group 1 All nationals are
covered
Under
consideration
Expatriate
population but
variable
–
100% for
nationals
Non-nationals[?]
Group 2All citizens eligible,
mainly public
sector employees
actually covered
Formal sector
employees,
parastatal
organizations,
vulnerable
population
Formal private
sector employees
but variable
–
40%–90%
population [lacks
depth of
coverage]
Group 3All citizens eligible,
mainly public
sector employees
actually covered
No national
programs, for
certain
geographic areas
or labour sector
Formal private
sector employees
but limited in
scope
Limited
community health
insurance
schemes
Around 25%
[lacks depth of
coverage]
7
Population coverage
Group 3
US$ 12–82
Group 2
US$ 20–320
Group 1
US$ 519–1,714Group 3
US$ 37–137
Group 2
US$ 43–631
Group 1
US$ 678–2,043
Per capita Total and “General Government” Expenditure on Health by Country Group, 2013
In EMR, it is estimated that up to
16.5 million people face financial
catastrophe and 7.5 million
become poor due to
out-of-pocket payments annually
10
Service coverage
In several LMICs access to health services is hampered due to emergencies
Most countries have Essential Health Service Package - with inconsistent implementation
In most countries, a large share of out-patient services is provided by the Private Sector
Quality of services is far from being optimal –1/10 inpatients have adverse events
11
Utilization of Private and Public Sectors Outpatient Clinics in Selected Countries
Assessment of private health sector in 12 countries. Cairo: WHO Regional Office for the Eastern. Mediterranean; 2013 (unpublished).
0%10%20%30%40%50%60%70%80%90%
100%
private sectorPublic sector
EssentialHealth
Services Package
13
Progressive trends for SHP/UHC in the region - I
New vision for Social Health Protection and UHC: Oman formulated a ‘Health Vision 2050’ Morocco generalized a state-funded insurance programme Pakistan is piloting a Prime Minister’s National Health
Programme
Health system transformation: The I.R. of Iran funded a Health Transformation Plan to achieve
UHC by 2025 Saudi Arabia, Bahrain and Kuwait devised overhauling
strategies to enhance their health systems performance, Jordan is embarking upon a major health system reform
14
Progressive trends for SHP/UHC in the region – II
Policy and societal dialogues on UHC: Sudan and Tunisia
Ten countries have developed roadmaps for health system strengthening &UHC:
Most countries are developing health financing arrangements to promote financial protection
Family Practice is being adopted as a basis for reforming PHC
15
Global best practices and lessons for the Region
1. Separating health fund from the general government treasury
2. Voluntary prepayment arrangements does not work for UHC: Compulsion and Subsidization
3. Fragmenting funds is an obstacle
4. Strategic purchasing is critical
5. Involving both private and public providers