1 / 18

OUTLINE

Financing, Universal Coverage and Social Health Protection by David B Evans, Director Department of Health Systems Financing. OUTLINE. A social protection floor Social health protection – the need The response. UN Response to the Financial Crisis http://www.unsystemceb.org/.

deon
Download Presentation

OUTLINE

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Financing, Universal Coverage and Social Health Protection byDavid B Evans, DirectorDepartment of Health Systems Financing

  2. OUTLINE • A social protection floor • Social health protection – the need • The response

  3. UN Response to the Financial Crisishttp://www.unsystemceb.org/ April 2009, UN Chief Executives Board (CEB) agreed on nine joint initiatives to confront the crisis, accelerate recovery and pave the way for a fairer and more sustainable globalization: 1. Additional financing for the most vulnerable2. Food Security3. Trade4. A Green Economy Initiative5. A Global Jobs Pact6. A Social Protection Floor7. Humanitarian, Security and Social Stability8. Technology and Innovation9. Monitoring and Analysis

  4. Social Protection Floor • ILO and WHO lead agencies + 16 UN, WB, Regional Development Banks, international NGOs http://www.socialsecurityextension.org/gimi/gess/ShowTheme.do?tid=1321 2. Two core components: • Ensuring the availability, continuity, and geographical and financial access to essential services, including health • Realizing access by ensuring a basic set of essential social transfers, in cash and in kind, to provide a minimum income and livelihood security for poor and vulnerable populations and to facilitate access to essential services.

  5. Financial and Economic Crisis – Is it Over? • Recovery remains fragile Continuing employment; volatile asset prices; declines in ODA; early days for innovative financing • Systems for monitoring vulnerability are badly needed Much speculation, but few hard facts; limited high frequency data; population groups – particularly the working poor; countries – low income, fragile and aid dependent states • Health systems have been affected Cuts in budgets, increased cost sharing, reductions in salaries, rising costs of inputs, deferred capital investment • Policy responses Crisis and opportunity: Pro-health, pro-poor public spending – innovative taxation on "bads"; widen social protection; evidence-based interventions; protect prevention and primary care; deliver results, promote equity

  6. OUTLINE • A social protection floor • Social health protection – the need • The response

  7. Insufficient accessVariations in coverage with skilled birth attendants

  8. Global Progress on MDG 4

  9. Patterns of exclusion: massive deprivation in some countries, marginalization of the poor in others. Births attended by skilled health personnel (percentage), by income quintile Source: World Health Report 2008

  10. Problem 1: Still Insufficient Resources for Health (2006 US$) High Level Task Force on Innovative Financing for Health Systems: Countries need $44 per capita in 2009, rising to over $60 in 2015

  11. Problem 2: Impact of Direct Out-of-Pocket Payments: Lack of access & incidence of financial catastrophe and impoverishment

  12. Catastrophic expenditure related to out-of-pocket payment at the point of service Source: Xu et al. Health Affairs 2007

  13. Problem 3: InefficiencyCountries grouped by total health expenditure in 2005 (international $)

  14. Countries grouped according to their total health expenditure in 2005 (international $) Source: World Health Report 2008

  15. OUTLINE • A social protection floor • Social health protection – the need • The response

  16. The Vision: Universal Coverage World Health Assembly 2005: All Member States adopted resolution urging countries to develop health financing systems to: • Ensure all people have access to needed services • Without the risk of financial catastrophe World Health Report 2010 will be on Financing for Universal Coverage Important component of a Social Protection Floor

  17. FinancingSolutions • Raise additional funds where health needs are high and revenues insufficient – external and domestic • Reduce reliance on out of pocket payments where they are high, by moving towards pre-payment • Enhance social protection by ensuring the poor and other vulnerable groups have access to needed services, personal and non personal • Improve efficiency: appropriate mix of activities to fund, appropriate inputs in production of health services, provider payment methods and other incentives for efficient service provision and use, and financial, contractual and other relationships with the non-government sector • Promote transparency and accountability in health financing systems

  18. CONCLUDING REMARKS • Impact of crisis can still be substantial • Still a long way from universal coverage and social health protection • Clear what needs to be done – crisis can be a good time to implement major reforms – social protection and social protection in health vitally important

More Related