Publication: Maximizing the Impact of Community-Based Practitioners in the Quest for Universal Health Coverage
Loading...
Files in English
315 downloads
Published
2015-09
ISSN
Date
2015-12-04
Editor(s)
Abstract
The last decade has highlighted major gaps in the availability, accessibility, acceptability and quality of the health workforce in many countries. The quantity, skills and geographic distribution of the health workforce have long been recognized as factors that limit population health outcomes and progress towards the related Millennium Development Goals. Similarly, the even more ambitious health targets included in the Sustainable Development Goals – scheduled for adoption by the United Nations General Assembly later this month – may be undermined by the same factors.
Link to Data Set
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Integrating the Poor into Universal Health Coverage in Vietnam(World Bank, Washington DC, 2013-01)This case study is aimed at providing a descriptive assessment of the key features of Vietnam's Social Health Insurance (SHI), focusing on the impediments to integrating the poor into universal coverage. The trajectory of SHI in Vietnam is similar to that of many other countries in the East Asia and Pacific region. The poor were covered under a separate Health Care Fund for the Poor to begin with. The 2009 Law on Health Insurance merged all of the different programs into one. Health insurance premiums for the poor were fully subsidized by the government and enrolment became mandatory, resulting in almost complete enrollment of the poor by 2011. Vietnam has combined elements of contributory social health insurance with substantial levels of tax financing to provide coverage for the poor and informal sector. The case study is structured as follows. Section 2 describes the institutional structure and system characteristics of Vietnam's SHI. Section 3 addresses the main topic of the case study - the impediments to integrating the poor. Section 4 concludes by addressing the pending agenda.Publication Vietnam : Learning from Smart Reforms on the Road to Universal Health Coverage(World Bank Group, Washington, DC, 2014-08)Universal Health Coverage is a powerful framework for a nation aiming to protect their population against health risks. However, countries face multiple challenges in implementing, achieving and sustaining UHC strategies. Sharing and learning from diverse country experiences may enable to foster global and country progress toward that goal. The study seeks to contribute to the global effort of sharing potentially useful lessons to address policy concerns on the design and implementation of UHC strategies in LMICs. Vietnam is one of the LMICs that have taken relatively quick and effective actions to expand health coverage and improve financial protection in the last two decades. The country study, first, takes stock of UHC progress in Vietnam, examining both the breadth and the depth of health coverage and assessing financial protection and equity outputs (chapter one). Chapter two includes an in-depth analysis of some of the major success strategies and policy actions that the country took to expand health coverage and financial protection for all, including for the poor. Chapter three focuses on some of the UHC-related challenges that the country faces in pursuing expansion and sustaining UHC. Vietnam s experience suggests that, moving toward greater UHC outputs, the system must be constantly adjusted, and that UHC strategies must be adaptive, those used in the past to cover the formal sector and the poor may turn out inadequate to reach the uninsured in the informal sector.Publication Universal Health Coverage for Inclusive and Sustainable Development : Country Summary Report for Vietnam(World Bank Group, Washington, DC, 2014-09)Vietnam is regarded as a development success story. Political and economic reforms ( Doi Moi ) launched at the end of the 1980s have transformed the country from one of the poorest in the world to a lower middle-income country in a quarter century, with per capita income of $1,130 (World Bank, 2013). Over the past 10 years, Vietnam has seen average annual economic growth of nearly 8 percent. Poverty tumbled from 58 percent in 1993 to 12 percent in 2009. Economic development and innovative policy interventions led to steep gains in health outcomes and access to health care, although large disparities persist between the rich and poor, and between poorer and better-off regions (Vietnam General Statistics Office 2011b). Infant mortality declined from 30 to 16 per 100,000 live births, and under-five mortality rates from 42 to 25 per 100,000 live births, between 2001 and 2009 (Vietnam General Statistics Office 2011a, 2011c). Vietnam has shown strong political commitment toward universal health coverage (UHC), making it a national goal for 2014. A major challenge lies now in expanding coverage to the non-covered population (64 percent had coverage in 2012) while addressing the model s financial sustainability.Publication Universal Health Coverage for Inclusive and Sustainable Development : A Synthesis of 11 Country Case Studies(Washington, DC: World Bank, 2014-06-25)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 that have achieved UHC are showing how these programs 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.Publication Universal Health Coverage and the Challenge of Informal Employment : Lessons from Developing Countries(World Bank, Washington, DC, 2014-01)The aim of the report is to review existing approaches and available policy options to improve access to health care services and financial protection against health shocks for informal-sector workers (ISWs). Along with their families, ISWs represent the majority of the population in many developing countries. The report reviews the definition and measurement of the informal sector and the literature on efforts toward its health insurance coverage. It also examines several country cases based on published and unpublished reports and on structured interviews of expert informants. 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.
Users also downloaded
Showing related downloaded files
Publication Moving Out of Poverty : Volume 1. Cross-Disciplinary Perspectives on Mobility(Washington, DC: World Bank and Palgrave Macmillan, 2007)This volume brings together multidisciplinary perspectives on poor people's mobility, a dynamic approach that hopefully will add to the reader's understanding of how and why people move into and out of poverty. The chapters draw on the latest longitudinal micro data to present a moving picture of poverty that is rather different from what one can see in single snapshots, the staple of traditional poverty analysis. The book is also important because the contributors' distinct disciplinary perspectives demonstrate clearly why it is critical to draw on diverse information to improve the reader's understanding about how to reduce poverty. The economic findings reinforce what has been known for some time: fast economic growth underpins poverty reduction, but the speed of declines in poverty is greatly affected by social and political factors. The economic panels also show that the people mired in chronic poverty around the world are actually fewer in number than the people moving in and out of poverty. Static studies do not capture this dynamic quality of poverty and vulnerability. Of particular interest are the chapters clarifying interactions between the local social, political, and economic factors that underlie persistent poverty, vulnerability, and inequality. They point to the need to draw from different disciplines as we turn to the task of reaching the bottom poor trapped in poverty and those churning in and out of poverty.Publication Global Economic Prospects, January 2025(Washington, DC: World Bank, 2025-01-16)Global growth is expected to hold steady at 2.7 percent in 2025-26. However, the global economy appears to be settling at a low growth rate that will be insufficient to foster sustained economic development—with the possibility of further headwinds from heightened policy uncertainty and adverse trade policy shifts, geopolitical tensions, persistent inflation, and climate-related natural disasters. Against this backdrop, emerging market and developing economies are set to enter the second quarter of the twenty-first century with per capita incomes on a trajectory that implies substantially slower catch-up toward advanced-economy living standards than they previously experienced. Without course corrections, most low-income countries are unlikely to graduate to middle-income status by the middle of the century. Policy action at both global and national levels is needed to foster a more favorable external environment, enhance macroeconomic stability, reduce structural constraints, address the effects of climate change, and thus accelerate long-term growth and development.Publication Digital Progress and Trends Report 2023(Washington, DC: World Bank, 2024-03-05)Digitalization is the transformational opportunity of our time. The digital sector has become a powerhouse of innovation, economic growth, and job creation. Value added in the IT services sector grew at 8 percent annually during 2000–22, nearly twice as fast as the global economy. Employment growth in IT services reached 7 percent annually, six times higher than total employment growth. The diffusion and adoption of digital technologies are just as critical as their invention. Digital uptake has accelerated since the COVID-19 pandemic, with 1.5 billion new internet users added from 2018 to 2022. The share of firms investing in digital solutions around the world has more than doubled from 2020 to 2022. Low-income countries, vulnerable populations, and small firms, however, have been falling behind, while transformative digital innovations such as artificial intelligence (AI) have been accelerating in higher-income countries. Although more than 90 percent of the population in high-income countries was online in 2022, only one in four people in low-income countries used the internet, and the speed of their connection was typically only a small fraction of that in wealthier countries. As businesses in technologically advanced countries integrate generative AI into their products and services, less than half of the businesses in many low- and middle-income countries have an internet connection. The growing digital divide is exacerbating the poverty and productivity gaps between richer and poorer economies. The Digital Progress and Trends Report series will track global digitalization progress and highlight policy trends, debates, and implications for low- and middle-income countries. The series adds to the global efforts to study the progress and trends of digitalization in two main ways: · By compiling, curating, and analyzing data from diverse sources to present a comprehensive picture of digitalization in low- and middle-income countries, including in-depth analyses on understudied topics. · By developing insights on policy opportunities, challenges, and debates and reflecting the perspectives of various stakeholders and the World Bank’s operational experiences. This report, the first in the series, aims to inform evidence-based policy making and motivate action among internal and external audiences and stakeholders. The report will bring global attention to high-performing countries that have valuable experience to share as well as to areas where efforts will need to be redoubled.Publication Empowerment in Practice : From Analysis to Implementation(Washington, DC: World Bank, 2006)This book represents an effort to present an easily accessible framework to readers, especially those for whom empowerment remains a puzzling development concern, conceptually and in application. The book is divided into two parts. Part 1 explains how the empowerment framework can be used for understanding, measuring, monitoring, and operationalizing empowerment policy and practice. Part 2 presents summaries of each of the five country studies, using them to discuss how the empowerment framework can be applied in very different country and sector contexts and what lessons can be learned from these test cases. While this book can offer only a limited empirical basis for the positive association between empowerment and development outcomes, it does add to the body of work supporting the existence of such a relationship. Perhaps more importantly, it also provides a framework for future research to test the association and to prioritize practical interventions seeking to empower individuals and groups.Publication Making Teacher Policy Work(Washington, DC: World Bank, 2023-11-08)This report zooms into what lies behind the success or failure of teacher policies: how teachers experience these policies, and how systems scale and sustain these policies. The report argues that for policies to be successful, they need to be designed and implemented with careful consideration of the barriers that could hinder teachers’ take-up of the policy (individual-level barriers), and the barriers that could hinder the implementation and sustainability of policies at scale (system-level barriers). Teacher polices too often fail to yield meaningful changes in teaching and learning because both their design and implementation overlook how teachers perceive, understand, and act in response to the policy and because they miss what is needed at a system level to achieve and sustain change. To avoid this, policymakers need to go beyond what works in teacher policy to how to support teachers in different contexts to adopt what works, while making sure it is implementable at scale and can be sustained over time. This requires unpacking teacher policies to consider the barriers that might hinder success at both the individual and system levels, and then putting in place strategies to overcome these barriers. The report proposes a practical framework to uncover the black box of effective teacher policy and discusses the factors that enable their scalability and sustainability. The framework distills insights from behavioral science to identify the barriers that stand in the way of the changes targeted by the policy and to develop strategies to overcome them. The framework is used to examine questions such as: What changes are required at an individual level to achieve the specific goals of a given teacher policy What barriers constrain the adoption of these changes How can the policy be better designed and implemented to tackle these barriers Moreover, the report draws on evidence from quantitative and qualitative studies on successful and failed teacher policies to examine the factors that make teacher policy operationally and politically feasible such that it can work at scale and be sustained over time.