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The goals of universal health coverage (UHC) are to ensure that all
people can access quality health services, to safeguard all people
from public health risks, and to protect all people from
impoverishment due to illness, whether from out-of-pocket payments
for health care or loss of income when a household member falls
sick. Countries as diverse as Brazil, France, Japan, Thailand, and
Turkey have shown how UHC can serve as vital mechanisms for
improving the health and welfare of their citizens, and lay the
foundation for economic growth and competitiveness grounded in the
principles of equity and sustainability. Ensuring universal access
to affordable, quality health services will be an important
contribution to ending extreme poverty by 2030 and boosting shared
prosperity in low-income and middle-income countries (LMICs), where
most of the world's poor live. The book synthesizes the experiences
from 11 countries - Bangladesh, Brazil, France, Ethiopia, Ghana,
Indonesia, Japan, Peru, Thailand, Turkey and Vietnam - in
implementing policies and strategies to achieve and sustain UHC.
These countries represent diverse geographic and economic
conditions, but all have committed to UHC as a key national
aspiration and are approaching it in different ways. The study
examined the UHC policies for each country around three common
themes: (i) the political economy and policy process for adopting,
achieving, and sustaining UHC; (ii) health financing policies to
enhance health coverage; and (iii) human resources for health
policies for achieving UHC. The findings from these country studies
are intended to provide lessons that can be used by countries
aspiring to adopt, achieve, and sustain UHC. Although the path to
UHC is specific to each country, countries can benefit from the
experiences of others in learning about different approaches and
avoiding potential risks.
Any analysis of health financing issues has to begin with sound
estimates of the level and flow of resources in a health system,
including total levels of spending, the sources of health
expenditures, the uses of funds in terms of services purchased, and
in terms of who purchases them. The analysis should also aim at
understanding how these resource flows are correlated with health
system outcomes, including those of improving health, reducing
health inequalities, and reducing the incidence of catastrophic
health expenditure. National Health Accounts (NHA) provide a
framework to collect, compile, and analyze such data on all types
of health spending in a country and so create a robust evidence
base for policy making. Although NHA data delineate the key
financial metrics of a health system, the collection of these data
have not been institutionalized in most developing countries. The
root problems are often the same: insufficient resources to
collect, collate, analyze and produce information on spending; poor
development of health and other information systems; low levels of
local capacity to interpret information to meet policy needs; and
inadequate demand for data within countries. Furthermore, in many
low- and middle-income countries, NHA activities have been
conducted as ad hoc, donor-driven initiatives. Since 2008, the
World Bank has been coordinating a global initiative to identify
bottlenecks to the institutionalization of NHA, and to learn
lessons in countries at different stages on the journey towards
this institutionalization. The focus has been less on the
production of NHA and more on its relevance as a tool to enable
policy makers develop and implement evidence-based decisions, and
better measure the impact of health reforms, especially those
related to health financing. This report has been developed through
a consultative process, involving experts and policy makers from
more than fifty low-, middle- and high-income countries, large and
small, in all corners of the world, development partners and World
Bank staff globally. The report represents a synthesis of lessons
learned from country experiences and is intended to serve as a
strategic guide to countries and their development partners as they
design and implement their strategy to develop nationally relevant
and internationally comparable data, collected in a routine and
cost-effective manner."
Los fines de la cobertura universal de salud son asegurar que toda
la poblacion pueda acceder a servicios de salud de calidad. Parses
que han logrado la cobertura universal de salud estan demostrando
c6mo estos programas pueden servir como mecanismos esenciales de
mejora de la salud.
La couverture sanitaire universelle pour un developpement durable
inclusif synthetise les experiences de 11 pays ? Bangladesh,
Bresil, Ethiopie, France, Ghana, Indonesie, Japon, Perou,
Thailande, Turquie et Vietnam - dans la mise en ?uvre de politiques
et de strategies d'atteinte et de maintien de la CSU.
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