Equity-Oriented Monitoring in the Context of Universal Health Coverage

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Koller, Theadora Swift; Prasad, Amit; Schlotheuber, Anne; Valentine, Nicole; Lynch, John; Vega, Jeanette

doi:10.1371/journal.pmed.1001727

Cited by 106 publications

(111 citation statements)

References 13 publications

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“…Another key success factor in the process in Indonesia was the concurrent development of specific software and technology for health inequality monitoring which enabled the use of local datasets. The existence of a technical handbook and easily accessible tools helped facilitate the application of the software to monitor health inequalities [7–9,11, 17]. At the heart of the collaborative process in Indonesia was the strong and ongoing support by the WHO country office, both at senior levels and by way of commitment and dedicated time of WHO staff, which helped maintain the momentum and relationships between stakeholders.…”

Section: Discussionmentioning

confidence: 99%

Capacity building for health inequality monitoring in Indonesia: enhancing the equity orientation of country health information systems

Hosseinpoor

Nambiar

Tawilah

et al. 2018

Global Health Action

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Background: Inequalities in health represent a major problem in many countries, including Indonesia. Addressing health inequality is a central component of the Sustainable Development Goals and a priority of the World Health Organization (WHO). WHO provides technical support for health inequality monitoring among its member states. Following a capacity-building workshop in the WHO South-East Asia Region in 2014, Indonesia expressed interest in incorporating health-inequality monitoring into its national health information system. Objectives: This article details the capacity-building process for national health inequality monitoring in Indonesia, discusses successes and challenges, and how this process may be adapted and implemented in other countries/settings. Methods: We outline key capacity-building activities undertaken between April 2016 and December 2017 in Indonesia and present the four key outcomes of this process. Results: The capacity-building process entailed a series of workshops, meetings, activities, and processes undertaken between April 2016 and December 2017. At each stage, a range of stakeholders with access to the relevant data and capacity for data analysis, interpretation and reporting was engaged with, under the stewardship of state agencies. Key steps to strengthening health inequality monitoring included capacity building in (1) identification of the health topics/areas of interest, (2) mapping data sources and identifying gaps, (3) conducting equity analyses using raw datasets, and (4) interpreting and reporting inequality results. As a result, Indonesia developed its first national report on the state of health inequality. A number of peer-reviewed manuscripts on various aspects of health inequality in Indonesia have also been developed. Conclusions: The capacity-building process undertaken in Indonesia is designed to be adaptable to other contexts. Capacity building for health inequality monitoring among countries is a critical step for strengthening equity-oriented national health information systems and eventually tackling health inequities.

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Section: Discussionmentioning

confidence: 99%

Capacity building for health inequality monitoring in Indonesia: enhancing the equity orientation of country health information systems

Hosseinpoor

Nambiar

Tawilah

et al. 2018

Global Health Action

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“…The health-related goal (SDG 3) calls upon countries to ‘ensure healthy lives and promote well-being for all at all ages’, with universal health coverage as the target that underpins all other health and health-related targets (SDG target 3.8) [5]. Health inequality monitoring is vital for tracking progress towards universal health coverage to ensure that disadvantaged populations achieve accelerated gains alongside overall improvement in the broader population, thus narrowing coverage gaps [6,7]. It is also important for countries to track progress towards national goals or global goals (if considered relevant in the national context).…”

Section: Introductionmentioning

confidence: 99%

National health inequality monitoring: current challenges and opportunities

Hosseinpoor

Bergen

Schlotheuber

et al. 2018

Global Health Action

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National health inequality monitoring needs considerably more investment to realize equity-oriented health improvements in countries, including advancement towards the Sustainable Development Goals. Following an overview of national health inequality monitoring and the associated resource requirements, we highlight challenges that countries may encounter when setting up, expanding or strengthening national health inequality monitoring systems, and discuss opportunities and key initiatives that aim to address these challenges. We provide specific proposals on what is needed to ensure that national health inequality monitoring systems are harnessed to guide the reduction of health inequalities.

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“…For this reason, measures to prevent catastrophic health expenditure and provision of quality care are of great concern to all countries, institutions, and the academia (1). High OOP payment was a major challenge to the people of Iran and many Iranians were unable to afford the cost in seeking for health care due to it (10). Previous studies in Iran have shown that the incidence of catastrophic health expenditures (CHE) ranges from 6% -17.7% at the national level (11,12), and 14.2% -22.2 % at the regional level (13,14), with an OOP payment of about 52.1% (15).…”

Section: Introductionmentioning

confidence: 99%

Measuring Financial Protection in Hospitalized Patients after the Health Sector Evolution Plan in Iran

et al. 2017

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Background: Protecting people from catastrophic health payments is widely recognized as an integral component of health systems and universal health coverage. Objectives: This study aimed to measure the financial protection against catastrophic health expenditure among hospitalized patients in Kermanshah, western Iran, after the implementation of the health sector evolution plan of Iran. Methods: This was a cross-sectional study. A total of 544 patients were selected using the proportional allocation to population size technique. A translated version of the world health survey questionnaire was used to collect data. Catastrophic health expenditure was calculated using WHO recommended methodology. Data were analyzed using STATA v.13. The statistical test performed included descriptive statistics and logistic regression. Results: About 4.8% of households with hospitalized patients were faced with catastrophic health expenditures. The total mean outof-pocket (OOP) medical expenditures of being hospitalized was 819,220 Rials per patient. Mean OOP in patients with catastrophic payment was 2,220,500 Rial. Major determinants of catastrophic payment were associated with surgical cost (OR: 8.09 P Value = 0.000), chronic disease (OR: 2.78 P Value = 0.025), household size (> 6) (OR: 6.70 P Value < 0.036), and economic status of households (Quintile 5; OR: 0.005 P Value = 0.000). Conclusions:The Health Sector Evolution Plan should target and extend aids especially for chronically ill patients, those who need surgery, and those at poorest quintile due to the fact that they are more vulnerable to catastrophic health expenditure. These groups should be the priorities in the health sector evolution plan revision to achieve a more desired outcome.

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Equity-Oriented Monitoring in the Context of Universal Health Coverage

Abstract: As part of the Universal Health Coverage Collection, Ahmad Reza Hosseinpoor and colleagues discuss methodological considerations for equity-oriented monitoring of universal health coverage, and propose recommendations for monitoring and target setting.

Cited by 106 publications

References 13 publications

Capacity building for health inequality monitoring in Indonesia: enhancing the equity orientation of country health information systems

Capacity building for health inequality monitoring in Indonesia: enhancing the equity orientation of country health information systems

National health inequality monitoring: current challenges and opportunities

Measuring Financial Protection in Hospitalized Patients after the Health Sector Evolution Plan in Iran

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