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Out-of-pocket payments (OOPs) are direct (at the point of service) financial contributions or co-payments by patients and their families associated with consumption of medical products (such as medicines) and/or services. They can be formal as well as informal payments. Together with taxation, social and private health insurance contributions, they constitute the main sources of financing for medical products and services in all countries of the world. This policy note looks at prevalence and trends of OOPs in Moldova during 2007-2013, evaluates their impact on the population's economic well-being (section two), identifies key drivers of the current OOPs (section three), and, based on the analysis, suggests several policy options for government's consideration (section four).
Access to Health Services --- Children --- Communicable Diseases --- Doctors --- Employment --- Equity --- Expenditures --- Health --- Health Economics & Finance --- Health Insurance --- Health Outcomes --- Health Policy --- Health System Performance --- Health Systems Development & Reform --- Health, Nutrition and Population --- Hospitals --- Human Development --- Insurance --- International Comparisons --- Internet --- Living Standards --- Migration --- Nurses --- Pharmacies --- Population --- Poverty --- Price Elasticity --- Private Health Insurance --- Private Sector --- Public Health --- Quality Control --- Social Health Insurance --- Social Insurance --- Unemployment --- Workers
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The Service Delivery Indicators (SDIs) provides a set of key indicators serving as a benchmark for service delivery performance in the health and education sectors in Sub-Saharan Africa. The overarching objective of the SDIs is to ascertain the quality of service delivery in primary education and basic health services. This would in turn enable governments and service providers alike to identify gaps and bottlenecks, as well as track progress over time, and across countries. The SDI survey interviewed 403 heath providers across Tanzania between May 2014 and July 2014. This technical report presents the findings from the implementation of the SDI in the health sector in Tanzania in 2014. Survey implementation activities took place following extensive consultations with the government and key stakeholders on survey design, sampling, and adaptation of survey instruments. A major challenge for Tanzania's health sector is the shortage of skilled human resources for health (HRH). This survey found that provider knowledge and abilities were not adequate to deliver quality services. Caseload per provider and absenteeism are relatively low, so the issue is not over burdened providers. There seems to be ample room for a significant increase in the caseload of Tanzanian providers, id est the level of productivity in health service delivery, without jeopardizing quality. In addition to increasing the volume of skilled HRH to address the shortage of providers, improvements in management, supervision and training is important to improving service delivery. Health for all in Tanzania will mean the simultaneous availability of widely accessible inputs and skilled providers.
Anemia --- Burden of Disease --- Children --- Dehydration --- Diabetes --- Diarrhea --- Disease Control & Prevention --- Doctors --- Financial Management --- Health --- Health Insurance --- Health Monitoring & Evaluation --- Health Professionals --- Health System Performance --- Health Systems Development & Reform --- Health, Nutrition and Population --- Hepatitis --- Hospitals --- Human Development --- Human Resources --- Incentives --- Insurance --- Internet --- Knowledge --- Latrines --- Malaria --- Measles --- Measurement --- Morbidity --- Mortality --- Nurses --- Pneumonia --- Polio --- Population --- Posters --- Poverty --- Public Health --- Sterilization --- Tetanus --- Treatment --- Tuberculosis --- Vaccines --- Waste --- Weight --- Workers
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This report analyses equity and financial protection in the health sector of Timor-Leste. In particular, it examines inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. Data are drawn from the 2009-2010 Demographic and Health Survey, the 2001-2002 and 2007-2008 Living Standards and Measurement Surveys as well as 2011-2012 Household Income Expenditure Survey, and the Ministry of Finance. All analyses are conducted using original data and performed using the health modules of the ADePT software.
Child Health --- Children --- Disease Control & Prevention --- Doctors --- Equity --- Expenditures --- Financial Management --- Gender --- Health --- Health Economics & Finance --- Health Finance --- Health Insurance --- Health Monitoring & Evaluation --- Health Outcomes --- Health Professionals --- Health System Performance --- Health Systems Development & Reform --- Health, Nutrition and Population --- Hospitals --- Household Income --- Human Development --- Human Resources --- Infant Mortality --- Insurance --- Living Standards --- Measurement --- Mortality --- Nurses --- Nutrition --- Obesity --- Pharmacies --- Polio --- Population --- Poverty --- Private Sector --- Public Health --- Public Hospitals --- Public Spending --- Rehabilitation --- Risk --- Sexually Transmitted Diseases --- Social Insurance --- Weight --- Workers
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The Philippines health sector is at a critical stage in its transformation. While the country has undertaken several significant health sector reforms in the past decades, a large unfinished policy agenda remains. The achievement of the health Millennium Development Goals (MDGs), especially among poor households, is at risk and there is a newly emerging challenge of addressing non-communicable diseases MDG. The overall health spending ratio is one of the lowest in the region with out-of-pocket (OOP) spending, a measure of financial protection, at over half of all health spending, well above the average for global comparators. It is within this context, that the Philippine health sector review takes stock of health reforms implemented to date, and evaluates the impact of these reforms on health systems performance. Based on this evaluation, the review identifies the challenges and future policy directions for accelerating the transformation of the Philippines health sector for improved health outcomes, financial protection of the population and consumer satisfaction.
Agricultural Knowledge & Information Systems --- Agriculture --- Communicable Diseases --- Decentralization --- Economics --- Employment --- Employment Opportunities --- Expenditures --- Family Planning --- Food Production --- Health Economics & Finance --- Health Education --- Health Insurance --- Health Monitoring & Evaluation --- Health System Performance --- Health Systems Development & Reform --- Health, Nutrition and Population --- Hospitals --- Housing --- Human Development --- Infant Mortality --- Inservice Training --- Insurance --- Life Expectancy --- Living Standards --- Malaria --- Malnutrition --- Medical Education --- Medicare --- Morbidity --- Mortality --- Nutrition --- Nutrition Programs --- Physicians --- Public Health --- Public Sector --- Regional Rural Development --- Rural Development --- Social Development --- Sterilization
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The Kamagayan Comprehensive Care Center (KC3) clients report being very satisfied with the comprehensive package of health services offered under the BCP and they feel welcome and accepted at the KC3. Community members in Kamagayan, including family members of the KC3 clients, also praise the service as an excellent intervention. Virtually all key stakeholders interviewed noted that the KC3 team had performed especially well in building trust between clients and their health service providers, families, and community. In that sense, community-based advocacy efforts were successful at generating an enabling environment for service delivery. The KC3 clients, family members, and community representatives also appreciated efforts from the KC3 team to promote demand reduction through counseling, Narcotics Anonymous (NA) sessions, and privileged access to the Argao Treatment and Rehabilitation Center (TRC). There is great demand and genuine interest among the KC3 clients and patients' clients to become peer educators and provide support to PWID. The professionalization of PWID through peer educator roles has also reportedly reduced stigma and discrimination and increased acceptance of PWID in the community. Should services for PWID be scaled up in Cebu and beyond, recruiting a workforce of peer educators should not be a critical challenge, an important lesson learned for future harm reduction projects in the Philippines.
Adolescent Health --- Aids --- Alcoholism --- Amphetamines --- Capacity Building --- Children --- Civil Society Organizations --- Communication Channels --- Crime --- Discrimination --- Drugs --- Epidemiology --- Good Governance --- Health --- Health Monitoring & Evaluation --- Health System Performance --- Health, Nutrition and Population --- Hiv/Aids --- Human Development --- Human Rights --- Hygiene --- Informed Consent --- Injecting Drug Users --- Malaria --- Marketing --- Needs Assessment --- Peer Groups --- Pharmacies --- Posters --- Prevention --- Prostitution --- Public Health --- Respect --- Sex Workers --- Sterilization --- Substance Abuse --- Technical Assistance --- Tuberculosis --- Women --- Workers --- World Health Organization
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Bleak short-term economic outlook raises the risk that social and environmental achievements may not be sustained. The changed economic circumstances have exposed shortcomings in Brazil's development model, epitomized by the struggle to achieve a sustainable fiscal policy. Against this background, some Brazilians are now asking whether the gains of the past decade might have been an illusion, created by the commodity boom, but unsustainable in today's less forgiving international environment. Brazil thus finds itself at an important juncture and, to a certain extent, the policy course set today will determine whether the country can sustain the gains of the past and return to a path of solid, inclusive and environmentally sustainable growth. This Systematic Country Diagnostic offers a contribution to the debate about Brazil's future development.
Access of Poor to Social Services --- Access to Information --- Agricultural Subsidies --- Air Pollution --- Air Quality --- Audits --- Cancer --- Capital Markets --- Carbon Emissions --- Cartels --- Climate Change --- Commercial Banks --- Competition --- Credit --- Debt --- Decision Making --- Deforestation --- Demographics --- Developed Countries --- Drinking Water --- Economic Development --- Economics --- Economies of Scale --- Education For All --- Emission Reductions --- Emissions --- Environment --- Environment and Natural Resource Management --- Environmental Economics & Policies --- Environmental Policy --- Equity --- Expenditures --- Financial Subsidies --- Food Production --- Health System Performance --- Human Development --- Incentives --- Labor Costs --- Land --- Logging --- Macroeconomics and Economic Growth --- Natural Resources --- Patents --- Political Economy --- Population Growth --- Poverty Reduction --- Property Rights --- Public Sector Development --- Public Sector Governance --- Purchasing Power --- Risk Management --- Securities --- Tariffs --- Tax Reform --- Taxes --- Trade --- Transaction Costs --- Unemployment --- Wages --- Waste Management --- Water Pollution --- Water Resource Management
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This review of public expenditures on Social Protection (SP) in Nicaragua is based on the analytical framework of Social Risk Management (SRM) developed by the World Bank. The concept of managing social risk comes from the notion that certain groups in society are vulnerable to unexpected shocks which threaten their livelihood and/or survival. Social protection focuses on the poor since they are more vulnerable to the risks and normally do not have the instruments to handle these risks. This prevents the poor from taking more risky activities that usually yield higher returns and that could help them overcome gradually their poverty situation. Social risk management involves policies and programs aimed at reducing key risks, breaking inter-generational cycle of poverty and vulnerability. Risk management consists in the choice of appropriate risk prevention, mitigation and coping strategies to minimize the adverse impact of social risks. Social protection under SRM is defined as public interventions to assist individuals, households and communities to better manage risk and provide support to the critically poor. Thus Social protection should provide: a safety net, particularly for the poor that are likely to fall in the cracks of established programs; and a springboard for the poor to bounce out of poverty.
Access to Health Services --- Access to Justice --- Adolescents --- Adult Education --- Breastfeeding --- Child Development --- Child Labor --- Commercial Banks --- Cost-Effectiveness --- Crime --- Crop Insurance --- Disasters --- Domestic Violence --- Early Childhood --- Education For All --- Educational Attainment --- Farm Size --- Fertility --- Food Consumption --- Health Insurance --- Health Monitoring & Evaluation --- Health System Performance --- Health, Nutrition and Population --- Hospitals --- Housing --- Human Capital --- Human Development --- Human Development Index --- Human Rights --- Injuries --- International Cooperation --- Irrigation --- Labor Market --- Land Tenure --- Macroeconomics and Economic Growth --- Maternal Mortality --- Mortality --- Mortality Rate --- Natural Disasters --- Natural Resources --- Natural Resources Management --- Nutrition --- Poverty Reduction --- Pregnancy --- Primary Education --- Public Health --- Public Spending --- Reproductive Health --- Respect --- Risk Management --- Rule of Law --- Rural Development --- Rural Population --- Rural Poverty Reduction --- Sanitation --- Savings --- School Attendance --- Secondary Education --- Social Protection and Risk Management --- Social Protections & Assistance --- Social Protections and Labor --- Social Safety Nets --- Technical Assistance --- Tetanus --- Unemployment --- Urban Areas --- Violence --- Violence Against Women --- Vulnerable Groups --- Workers
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Over the past few decades, modern information technology has made a significant impact on people’s daily lives worldwide. In the field of health care and prevention, there has been a progressing penetration of assistive health services such as personal health records, supporting apps for chronic diseases, or preventive cardiological monitoring. In 2020, the range of personal health services appeared to be almost unmanageable, accompanied by a multitude of different data formats and technical interfaces. The exchange of health-related data between different healthcare providers or platforms may therefore be difficult or even impossible. In addition, health professionals are increasingly confronted with medical data that were not acquired by themselves, but by an algorithmic “black box”. Even further, externally recorded data tend to be incompatible with the data models of classical healthcare information systems.From the individual’s perspective, digital services allow for the monitoring of their own health status. However, such services can also overwhelm their users, especially elderly people, with too many features or barely comprehensible information. It therefore seems highly relevant to examine whether such “always at hand” services exceed the digital literacy levels of average citizens.In this context, this reprint presents innovative, health-related applications or services emphasizing the role of user-centered information technology, with a special focus on one of the aforementioned aspects.
fever --- FeverApp --- ecological momentary assessment --- user behavior --- sociodemographic characteristics --- registry --- guidelines --- feasibility --- usability --- routine health information system --- health management information system --- health system performance --- machine learning --- digital health --- registry analysis --- ClinicalTrials.gov --- device regulation --- new information technology --- Technology Acceptance Model (TAM) --- institution --- institutionalism --- digital informatics --- human–computer interaction --- personal health informatics --- consumer health data --- consumer health information --- self-tracking --- quantified self --- mHealth apps --- telemonitoring --- telemedicine --- telecardiology --- cardiology --- wearable --- sensors --- consumer health devices --- cardiovascular disease --- heart failure --- atrial fibrillation --- mental health --- psychiatry --- psychiatric record --- psychiatric notes --- patient accessible electronic health record --- PAEHR --- open notes --- policies --- COVID-19 --- technology acceptance --- user survey --- wearable health monitor --- ECG patch --- personal electronic health records --- technology adoption --- endogenous motivations --- health information privacy concern --- mixed-methods --- ePA --- online review helpfulness --- signaling theory --- sentiment analysis --- physician rating websites --- consumer decision-making --- health information technology --- information exchange --- hospital --- market
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This is a policy note following from the book Health Financing in the Republic of Gabon. The book is a comprehensive assessment of health financing in the Republic of Gabon. The book reviews the health financing situation in light of the government's introduction of a national health insurance program and its commitment to achieving universal health insurance coverage in the medium term. The book provides a diagnostic of the situation in light of recent data from the demographic and health survey, updated national health accounts, and a review of public expenditures in the health sector. Additionally, it performs a benchmarking exercise to assess how Gabon performs in its health spending and health outcomes compared to countries of similar income and compared to countries in the region. A forthcoming household survey is expected to provide better information on financial protection against illness costs. This book attempts to diagnose Gabon's current situation in regards to achieving universal health coverage. Gabon should be commended for its commitment to improving health indicators of the poor and the underserved. The book shows that while the government has set an ambitious goal for itself, several challenges exist in meeting these objectives in the medium term as follows (i) resource mobilization efforts are a priority to sustain its programs financially; (ii) to prioritize resources for areas considered, value for money, to improve equity in access and delivery of health services, with particular focus on primary care, public health program, and quality of care; (iii) to increase the population's coverage under the national health insurance program, with focus on the poor and the informal sector workers; and (v) to consider areas that would improve efficiency and reduce costs. The book is timely, given that the government has recently produced, the Plan Social. It provides a diagnostic of the health sector and provides key recommendations and options for the government to consider in the short to medium term.
Access to Health Services --- Burden of Disease --- Child Health --- Childbirth --- Children --- Communicable Diseases --- Debt --- Decision Making --- Equity --- Expenditures --- Fiscal Policy --- Health --- Health Care Costs --- Health Economics & Finance --- Health Finance --- Health Insurance --- Health Law --- Health Monitoring & Evaluation --- Health Outcomes --- Health Policy --- Health System Performance --- Health Systems Development & Reform --- Health, Nutrition and Population --- Hiv/Aids --- Hospitals --- Human Development --- Human Resources --- Hygiene --- Incentives --- Infant Mortality --- Insurance --- Internet --- Knowledge --- Law and Development --- Life Expectancy --- Managed Care --- Morbidity --- Mortality --- Nutrition --- Oral Rehydration therapy --- Population --- Postnatal Care --- Poverty --- Prevention --- Public Expenditure, Financial Management and Procurement --- Public Health --- Public Sector Governance --- Quality Control --- Quality of Health Care --- Quality of Life --- Rehabilitation --- Social Protection and Risk Management --- Social Safety Nets/Social Assistance --- Tuberculosis --- Waste --- Weight --- Workers
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Over the past few decades, modern information technology has made a significant impact on people’s daily lives worldwide. In the field of health care and prevention, there has been a progressing penetration of assistive health services such as personal health records, supporting apps for chronic diseases, or preventive cardiological monitoring. In 2020, the range of personal health services appeared to be almost unmanageable, accompanied by a multitude of different data formats and technical interfaces. The exchange of health-related data between different healthcare providers or platforms may therefore be difficult or even impossible. In addition, health professionals are increasingly confronted with medical data that were not acquired by themselves, but by an algorithmic “black box”. Even further, externally recorded data tend to be incompatible with the data models of classical healthcare information systems.From the individual’s perspective, digital services allow for the monitoring of their own health status. However, such services can also overwhelm their users, especially elderly people, with too many features or barely comprehensible information. It therefore seems highly relevant to examine whether such “always at hand” services exceed the digital literacy levels of average citizens.In this context, this reprint presents innovative, health-related applications or services emphasizing the role of user-centered information technology, with a special focus on one of the aforementioned aspects.
Medicine --- fever --- FeverApp --- ecological momentary assessment --- user behavior --- sociodemographic characteristics --- registry --- guidelines --- feasibility --- usability --- routine health information system --- health management information system --- health system performance --- machine learning --- digital health --- registry analysis --- ClinicalTrials.gov --- device regulation --- new information technology --- Technology Acceptance Model (TAM) --- institution --- institutionalism --- digital informatics --- human–computer interaction --- personal health informatics --- consumer health data --- consumer health information --- self-tracking --- quantified self --- mHealth apps --- telemonitoring --- telemedicine --- telecardiology --- cardiology --- wearable --- sensors --- consumer health devices --- cardiovascular disease --- heart failure --- atrial fibrillation --- mental health --- psychiatry --- psychiatric record --- psychiatric notes --- patient accessible electronic health record --- PAEHR --- open notes --- policies --- COVID-19 --- technology acceptance --- user survey --- wearable health monitor --- ECG patch --- personal electronic health records --- technology adoption --- endogenous motivations --- health information privacy concern --- mixed-methods --- ePA --- online review helpfulness --- signaling theory --- sentiment analysis --- physician rating websites --- consumer decision-making --- health information technology --- information exchange --- hospital --- market --- fever --- FeverApp --- ecological momentary assessment --- user behavior --- sociodemographic characteristics --- registry --- guidelines --- feasibility --- usability --- routine health information system --- health management information system --- health system performance --- machine learning --- digital health --- registry analysis --- ClinicalTrials.gov --- device regulation --- new information technology --- Technology Acceptance Model (TAM) --- institution --- institutionalism --- digital informatics --- human–computer interaction --- personal health informatics --- consumer health data --- consumer health information --- self-tracking --- quantified self --- mHealth apps --- telemonitoring --- telemedicine --- telecardiology --- cardiology --- wearable --- sensors --- consumer health devices --- cardiovascular disease --- heart failure --- atrial fibrillation --- mental health --- psychiatry --- psychiatric record --- psychiatric notes --- patient accessible electronic health record --- PAEHR --- open notes --- policies --- COVID-19 --- technology acceptance --- user survey --- wearable health monitor --- ECG patch --- personal electronic health records --- technology adoption --- endogenous motivations --- health information privacy concern --- mixed-methods --- ePA --- online review helpfulness --- signaling theory --- sentiment analysis --- physician rating websites --- consumer decision-making --- health information technology --- information exchange --- hospital --- market