Person:
Wang, Huihui
Author Name Variants
Fields of Specialization
HEALTH EQUITY,
HEALTH FINANCING,
HEALTH SERVICES DELIVERY,
HEALTH WORKER PERFORMANCE,
NUTRITION
Degrees
Departments
Health, Nutrition and Population Global Practice
Externally Hosted Work
Contact Information
Last updated
September 21, 2023
Biography
Dr. Wang, M.D., Ph.D., is a Senior Economist at the World Bank Group. She has 20 years of experiences working in low, middle- and high-income countries with a focus on supporting them to achieve Universal Health Coverage. Currently working with the global engagement unit, she is involved in several global initiatives related to transforming and improving primary health care, knowledge program on COVID-19 impact and response, as well as nutrition financing. She has also led the World Bank’s lending operations and technical support in health system reforms in East Asia, Europe and Central Asia and Africa regions. Huihui joined the Bank as a Young Professional in 2009. She holds a medical degree from Beijing Medical University, and M.A. in Economics and Ph.D. in Health Services and Policy Analysis from University of California, Berkeley.
Publication Search Results
1 - 10 of 23
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Publication
Universal Health Coverage for Inclusive and Sustainable Development: Country Summary Report for Ethiopia
(World Bank, Washington, DC, 2014-08)A low-income country, Ethiopia has made impressive progress in improving health outcomes. The Inter-agency Group for Child Mortality Estimation reported that Ethiopia has achieved Millennium Development Goal (MDG) 4, three years ahead of target, with under-5 mortality at 68 per 1,000 live births in 2012. Significant challenges remain, however, with the maternal mortality ratio at 420 out of 100,000 live births. The government has introduced a three-tier public health care delivery system to deliver essential health services and ensure referral linkages, with level three as specialized hospitals (one per 3.5 million 5 million population), level two as general hospitals (one per 1 million 1.5 million), level one as primary hospitals (one per 60,000 100,000) with satellite health centers (one per 15,000 25,000) and health posts (one per 3,000 5,000). One initiative contributing greatly toward universal health coverage (UHC) is the Health Extension Program (HEP) that provides free primary care services at health posts and communities. The country is at its early stage initiating insurance schemes to provide financial protection for its citizens: Social Health Insurance (SHI) for formal sector employees and Community-Based Health Insurance (CBHI) for rural residents and informal sector employees. Public facilities are expected to provide exempted services for free, and there is a fee-waiver system for the poor. -
Publication
Walking the Talk: Reimagining Primary Health Care After COVID-19
(World Bank, Washington, DC, 2021-06-28)Almost half a century ago, policy leaders issued the Declaration of Alma Ata and embraced the promise of health for all through primary health care (PHC). That vision has inspired generations. Countries throughout the world—rich and poor—have struggled to build health systems anchored in strong PHC where they were needed most. The world has waited long enough for high-performing PHC to become more than an aspiration; it is now time to deliver. The COVID-19 (Coronavirus) pandemic has facilitated the reckoning for that shared failure—but it has also created a once-in-a-generation opportunity for transformational health system changes. The pandemic has shown policy makers and ordinary citizens why health systems matter and what happens when they fail. Bold reforms now can prepare health systems for future crises and bring goals such as universal health coverage within reach. PHC holds the key to these transformations. To fulfill that promise, however, the walk has to finally match the talk. Walking the Talk: Reimagining Primary Health Care after COVID-19 outlines how to get there. It charts an agenda to reimagined, fit-for-purpose PHC. It asks three questions about health systems reform built around PHC: Why? What? How? The characteristics of high-performing PHC are precisely those that are most critical for managing the pressures coming to bear on health systems in the post-COVID world. The challenges include future outbreaks and other emergent threats, as well as long-term structural trends that are reshaping the environments in which systems operate in noncrisis times. Walking the Talk highlights three sets of megatrends that will increasingly affect health systems in the coming decades: • Demographic and epidemiological shifts • Changes in technology • Citizens’ evolving expectations for health care. Reimagined PHC systems will be equipped through optimized system design, financing, and delivery to ensure high-quality services, care to address patients’ needs, fairness and accountability, and resilient systems. -
Publication
Maternal and Child Health Inequalities in Ethiopia
(World Bank, Washington, DC, 2015-12)Recent surveys show considerable progress in maternal and child health in Ethiopia. The improvement has been in health outcomes and health services coverage. The study examines how different groups have fared in this progress. It tracked 11 health outcome indicators and health interventions related to Millennium Development Goals 1, 4, and 5. These are stunting, underweight, wasting, neonatal mortality, infant mortality, under-five mortality, measles vaccination, full immunization, modern contraceptive use by currently married women, antenatal care visits, and skilled birth attendance. The study explores trends in inequalities by household wealth status, mothers’ education, and place of residence. It is based on four Demographic and Health Surveys implemented in 2000, 2005, 2011, and 2014. Trends in rate differences and rate ratios are analyzed. The study also investigates the dynamics of inequalities, using concentration curves for different years. In addition, a decomposition analysis is conducted to identify the role of proximate determinants. The study finds substantial improvements in health outcomes and health services. Although there still exists a considerable gap between the rich and the poor, the study finds some reductions in inequalities of health services. However, some of the improvements in selected health outcomes appear to be pro-rich. -
Publication
Maternal and Child Health Inequalities in Ethiopia
(Washington, DC, 2015-12)Recent surveys show considerable progress in maternal and child health in Ethiopia. The improvement has been in health outcomes and health services coverage. The study examines how different groups have fared in this progress. It tracked 11 health outcome indicators and health interventions related to millennium development goals one, four, and five. These are stunting, underweight, wasting, neonatal mortality, infant mortality, under -five mortality, measles vaccination, and full immunization, modern contraceptive use by currently married women, antenatal care visits, and skilled birth attendance. Trends in rate differences and rate ratios are analyzed. The study also investigates the dynamics of inequalities, using concentration curves for different years. In addition, a decomposition analysis is conducted to identify the role of proximate determinants. The study finds substantial improvements in health outcomes and health services. Although there still exists a considerable gap between the rich and the poor, the study finds some reductions in inequalities of health services. However, some of the improvements in selected health outcomes appear to be pro-rich. -
Publication
Ethiopia Health Extension Program: An Institutionalized Community Approach for Universal Health Coverage
(Washington, DC: World Bank, 2016-04-25)As a low-income country, Ethiopia has made impressive progress in improving health outcomes. This report examines how Ethiopia’s Health Extension Program (HEP) has contributed to the country’s move toward Univeral Health Coverage (UHC), and to shed light on how other countries may learn from Ethiopia’s experiences of HEP when designing their own path to UHC. HEP is one of the government’s UHC strategies introduced in a context of limited resources and low coverage of essential health services. The key aspects of the program include the capacity building and mobilization of more than 30, 000 Health Extension Workers (HEWs) targeting more than 12 million model families, and the mobilization of “health development army” to support the community-based health system. Using the HEP-UHC conceptual model and data from Demographic and Health Surveys, the study examines how the HEP has contributed to the country’s move toward UHC. During the period that the HEP has been implemented, the country has experienced significant improvements in many dimensions: in terms of socioeconomic, psychological, behavioral, and biological dimensions of the beneficiaries; and in terms of the coverage of health care services. The study finds an accelerated rate of improvements among the rural, less-educated, and the poor population, which is leading to an overall reduction in equity gaps and improvements in the equity indicators – including the concentration indices - that suggest a more equitable distribution of resources and health outcomes. The HEP in Ethiopia has demonstrated that an institutionalized community approach is effective in helping a country make progress toward UHC. The elements of success in the HEP include the emphasis on community mobilization which identifies community priorities, engages and empowers community members, and supports their ability to solve local problems. The other aspect of HEP is the emphasis on institutionalization of the activities, which addresses the sustainability of community programs through high level of political commitment, and effective coordination of national policies and leveraging of support from partners. These findings may offer useful lessons for other low income countries facing similar challenges in developing and implementing a sustainable UHC strategy. -
Publication
Positioning Nutrition with Universal Health Coverage: Optimizing Health Financing Levers
(World Bank, Washington, DC, 2022-01)Achieving universal health coverage (UHC) is a top global priority, and nutrition actions are a critical part of meeting that goal. When delivered within key windows of opportunity to improve health throughout the life-course, essential nutrition actions play an important role in reducing the burden of disease and preventing permanent physical and cognitive impairments, ultimately staving off future health care costs for both individuals and health systems. Coverage and quality of nutrition service delivery remains low, despite robust evidence of cost-effective interventions. The health system, and most especially primary health care (PHC), is essential for delivering high-impact, cost-effective, nutrition-specific interventions at scale. There are gaps in knowledge on how to deploy resources more effectively to improve the delivery of nutrition services as part of preventive and promotive health care. A shift in focus is needed from the “what” and “why” of scaling-up nutrition to the “how” of improving nutrition services coverage and quality of nutrition services delivered through the health system, and especially PHC. Parts 1, 2, and 3 of this paper introduce the thesis that health financing arrangements can be optimized to ensure that distribution and utilization of health system resources are aligned with nutrition objectives. Parts 4, 5, and 6 of the paper explore the financing challenges and options to address key financing and service delivery challenges. -
Publication
A Guiding Framework for Nutrition Public Expenditure Reviews
(Washington, DC: World Bank, 2022-05-04)Nutrition investments affect human capital formation, which in turn affects economic growth. Malnutrition is intrinsically connected to human capital—undernutrition contributes to nearly half of child mortality, and stunting reduces productivity and earnings in adulthood. Improving nutrition requires a multisectoral effort, but it is difficult to identify and quantify the basic financing parameters as used in traditional sectors. What is being spent and by whom and on what? To address these questions, nutrition public expenditure reviews (NPERs) determine the level of a country’s overall nutrition public spending and assess whether its expenditure profile will enable the country to realize its nutrition goals and objectives. When done well, NPERs go beyond simply quantifying how much is spent on nutrition; they measure how well money is being spent to achieve nutrition outcomes and identify specific recommendations for improvement. A Guiding Framework for Nutrition Public Expenditure Reviews presents the key elements of an NPER and offers guidance, practical steps, and examples for carrying out an NPER. The book draws upon good practices from past NPERs as well as common practices and expertise from public expenditure reviews in other sectors. This handbook is intended for practitioners who are tasked with carrying out NPERs. Other target audiences include country nutrition policy makers, development partner officials, government technical staff, and nutrition advocates. The book presents data and analytical challenges faced by previous NPER teams and lays out the kinds of analyses that past NPERs have been able to carry out and those that they were unable to perform because of data or capacity constraints. It concludes with further work needed at the global and country levels to create the conditions necessary to conduct more comprehensive NPERs. -
Publication
Universal Health Coverage in Low-Income Countries: Tanzania’s Efforts to Overcome Barriers to Equitable Health Service Access
(World Bank, Washington, DC, 2018-01)During the past decade, Tanzania has experienced steady economic growth, with average annual growth rates of between 6 and 7 percent. Despite this positive trend in the economy, poverty rates have not decreased accordingly; more than one-fourth of Tanzania’s 53 million inhabitants live below the poverty line and almost 10 percent live in extreme poverty. The health sector has been identified as a policy priority area in Tanzania. The main purpose of this case study is to describe Tanzania’s efforts to promote universal health coverage (UHC) inclusive of the poor, and to identify challenges and opportunities for the health system to advance on this path in a coherent and integrated fashion. Given the large number of interventions implemented in the health sector, efforts were selected based on their potential to address the challenges to the equitable access to health services, namely the poor quality of health services and the limited financial protection. The paper is organized as follows: section one gives introduction. Section two describes supply-side efforts and features the devolution of health services, the primary health care (PHC) strengthening program, and results-based financing. Section three analyzes Tanzania’s social protection program and synthesizes the country’s experience with user fees, as well as their impact on financial protection. Section four features the community health funds, Tanzania’s most explicit effort to increase financial protection in health. Section five assesses the implementation of these initiatives. Section six highlights some opportunities to include the poor and address the challenges to pro-poor UHC in Tanzania. -
Publication
Benchmarking Health Systems in Middle East and North Africa Countries
(Taylor and Francis, 2017-01-31)Health systems are not easy to benchmark, in part because the health sector produces more than one outcome. This article offers two ways of benchmarking the health systems of countries in the Middle East and North Africa (MENA) focusing on two different outcomes, health status and financial protection. The first approach is by measuring the gap between predicted health outcomes based on country socioeconomic status and actual health outcomes. The second approach is by simply comparing the levels of out-of-pocket (OOP) spending in MENA countries. The article offers some interesting findings about the large heterogeneity in both health system outcome achievements despite considerable cultural and linguistic similarities in the region. Moreover, three discrete clusters of countries are found on the health status measure. The findings also give specific health system target outcomes for MENA countries to focus their reform efforts. -
Publication
Progressive Pathway to Universal Health Coverage in Tanzania: A Call for Preferential Resource Allocation Targeting the Poor
(Taylor and Francis, 2018-10-31)Universal health coverage (UHC) can be a vehicle for improving equity, health outcomes, and financial well-being. After publication of the World Health Organization’s report in 2010, many countries declared their goal of achieving UHC. A key lesson from research evidence and country experience in implementation of pro-poor UHC is that public budget plays a crucial role in financing the poor. It has long been recognized that if a country wants to reduce the gap between the poor and non-poor, deprived groups should receive preferential allocation of health care resources to achieve more rapid improvements in their health. Based on a technical analysis of public funds allocation mechanisms in Tanzania, we argue that these mechanisms should prioritize the poor more explicitly and give them preferential treatment to close the gap with the non-poor in service utilization and health outcomes.