Financial Risks From Ill Health in Myanmar

Htet, Soe; Fan, Victoria Y.; Alam, Khurshid; Mahal, Ajay

doi:10.1177/1010539514558332

Cited by 15 publications

(20 citation statements)

References 18 publications

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“…On financial protection, for instance, our review suggests that for chronically ill, older adults and individuals with disabilities, formal insurance schemes do not guarantee protection from CHE, despite greater needs for health services [50, 81]. Our findings extend those of others, confirming that households with older adults, young children or chronically ill borrow money or sell assets to finance illness, underlining the bilateral link between health and poverty [43, 103]. Looking at a wider spectrum of health financing arrangements, a Nigerian study found that households with older adults participating in informal health financing arrangements (other than health insurance schemes) were less likely to incur CHE than those with formal schemes [104].…”

Section: Discussionsupporting

confidence: 56%

Leaving no one behind? Social inclusion of health insurance in low- and middle-income countries: a systematic review

Hees

O’Fallon

Hofker³

et al. 2019

Int J Equity Health

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Background One way to achieve universal health coverage (UHC) in low- and middle-income countries (LMIC) is the implementation of health insurance schemes. A robust and up to date overview of empirical evidence assessing and substantiating health equity impact of health insurance schemes among specific vulnerable populations in LMICs beyond the more common parameters, such as income level, is lacking. We fill this gap by conducting a systematic review of how social inclusion affects access to equitable health financing arrangements in LMIC. Methods We searched 11 databases to identify peer-reviewed studies published in English between January 1995 and January 2018 that addressed the enrolment and impact of health insurance in LMIC for the following vulnerable groups: female-headed households, children with special needs, older adults, youth, ethnic minorities, migrants, and those with a disability or chronic illness. We assessed health insurance enrolment patterns of these population groups and its impact on health care utilization, financial protection, health outcomes and quality of care. Results The comprehensive database search resulted in 44 studies, in which chronically ill were mostly reported (67%), followed by older adults (33%). Scarce and inconsistent evidence is available for individuals with disabilities, female-headed households, ethnic minorities and displaced populations, and no studies were yielded reporting on youth or children with special needs. Enrolment rates seemed higher among chronically ill and mixed or insufficient results are observed for the other groups. Most studies reporting on health care utilization found an increase in health care utilization for insured individuals with a disability or chronic illness and older adults. In general, health insurance schemes seemed to prevent catastrophic health expenditures to a certain extent. However, reimbursements rates were very low and vulnerable individuals had increased out of pocket payments. Conclusion Despite a sizeable literature published on health insurance, there is a dearth of good quality evidence, especially on equity and the inclusion of specific vulnerable groups in LMIC. Evidence should be strengthened within health care reform to achieve UHC, by redefining and assessing vulnerability as a multidimensional process and the investigation of mechanisms that are more context specific. Electronic supplementary material The online version of this article (10.1186/s12939-019-1040-0) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 56%

Leaving no one behind? Social inclusion of health insurance in low- and middle-income countries: a systematic review

Hees

O’Fallon

Hofker³

et al. 2019

Int J Equity Health

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“…The presence of an elderly person in the household was found to be significant as a risk factor for CHE in all 19 papers that evaluated this variable in their analyses (15–17, 19, 21, 22, 25–28, 32–34, 36, 39, 41–44).…”

Section: Resultsmentioning

confidence: 99%

Determinants of Household Catastrophic Health Expenditure: A Systematic Review

Azzani

Roslani

2019

MJMS

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The World Health Organization estimates that annually 150 million people experience severe (catastrophic) financial difficulties as a result of healthcare payments. Therefore, a systematic review was carried out to identify the determinants of household catastrophic health expenditure (CHE) in low-to high-income countries around the world. Both electronic and manual searches were conducted. The main outcome of interest was the determinants of CHE due to healthcare payments. Thirty eight studies met the inclusion criteria for review. The analysis revealed that household economic status, incidence of hospitalisation, presence of an elderly or disabled household member in the family, and presence of a family member with a chronic illness were the common significant factors associated with household CHE. The crucial finding of the current study is that socioeconomic inequality plays an important role in the incidence of CHE all over the world, where low-income households are at high risk of financial hardship from healthcare payments. This suggests that healthcare financing policies should be revised in order to narrow the gap in socioeconomic inequality and social safety nets should be implemented and strengthened for people who have a high need for health care.

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“…9 Malaysia and Sri Lanka have traditionally relied on public sector financing and delivery, whereas India and Myanmar rely substantially on the private sector. [10][11][12] And in contrast to the high-income countries in the region, the middle-and low-income countries rely primarily on households for long-term care and often have inadequate social protection systems. 13 Overall NCD prevalence and mortality continue to increase in the region.…”

Section: Introductionmentioning

confidence: 99%