Publication: Implementing Public Health Regulations in Developing Countries : Lessons from the OECD Countries
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Published
2010
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1073-1105
Date
2012-03-30
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Developing country efforts to enforce basic public health standards are often hindered by limited agency resources and poorly designed enforcement mechanisms, including excessive reliance on slow and erratic judicial systems. Traditional public health regulation can therefore be difficult to implement. This article examines innovative approaches to the implementation of public health regulations that have emerged in recent years within the OECD countries. These approaches aim to improve compliance with health standards among the different actors while reducing dependence on the legal system and the administrative resources of public health agencies in developing countries. Developing countries may find some useful lessons from these approaches that can be adapted for use in their own institutional settings.
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Publication Multisectoral Preventive Health Services in Sri Lanka : Lessons for Developing Countries in Providing Public Goods in Health(World Bank, Washington, DC, 2013-08)What can other developing countries learn from Sri Lanka on achieving good health at low cost? While its well-organized medical and maternal-child health services have been documented elsewhere, this paper fills a gap in documenting how it organizes services to reduce the population's exposure to disease -- a pure public good. The key factors underlying the effectiveness of these services are (1) strong focal points in the central Health Ministry for supporting preventive services; (2) pro-active outreach by the health line agency to collaborate with other sectors / agents whose work influences public health outcomes; and (3) community-level delivery institutions with well-trained multivalent Public Health Inspectors -- all underpinned by (4) assured tax-based financing. 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Developing country efforts to expand health coverage are characterized by a common enrollment and financing pattern, starting with formal-sector workers and following with government-subsidized enrollment of the poor. Thus, ISWs are typically left behind and have been referred to as "the missing middle." They find themselves financially unprotected against health shocks and with limited access to quality and timely health care. ISWs are generally reluctant to enroll in insurance schemes, including social health insurance (SHI), community insurance, and other arrangements. Further, initiatives to enroll them in self-financed contributory schemes have generally resulted in adverse selection, as those with high anticipated health needs are more willing to pay and enroll than others. Successful initiatives to cover this population group are the ones where government has abandoned its expectations to derive relatively substantial revenue from it. Offering this group a benefits package that is relatively smaller than that of formal workers and charging them a premium that is only a fraction of that charged to formal workers is a strategy used by some countries to limit the need for public subsidies. While there is evidence that greater insurance coverage has improved access to health services for ISWs and their dependents, in several countries it has not yet improved financial protection for this target group. A broad set of reforms will be required to strengthen the supply side to ensure that additional public financing translates into improved coverage for ISWs.Publication Implementing Public Expenditure Tracking Surveys for Results : Lessons from a Decade of Global Experience(World Bank, Washington, DC, 2009-11)Public Expenditure Tracking Surveys (PETS) can serve as a powerful tool to inform prevailing public financial management (PFM) practices and the extent to which government budgets link to execution and desired service delivery objectives and beneficiaries. Since the first PETS in Uganda in 1996, tracking exercises have now been conducted in over two dozen other countries, often as part of core analytical and advisory work related to PFM. This note synthesizes the findings and lessons from a number of recent PETS stocktaking exercises and indicates their potential benefits for enriching PFM and sectoral policy dialogues in a variety of country settings. 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