Going Universal in Africa

Cotlear, Daniel; Rosemberg, Nicolas

doi:10.1596/29177

Cited by 16 publications

(9 citation statements)

References 7 publications

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“…This movement led an increasing number of countries to launch policies aimed at reducing and/or removing user fees . However, beyond the concerns related to implementation challenges, in most settings, user fee reduction and/or removal policies tend to specifically target certain groups of the population and/or exclusively concern a specific set of services.…”

Section: Introductionmentioning

confidence: 99%

Determinants of individual healthcare expenditure: A cross‐sectional analysis in rural Burkina Faso

Nakovics

Brenner

Robyn

et al. 2019

Health Planning & Management

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Summary Introduction Overwhelming evidence suggests that out‐of‐pocket expenditures (OOPEs) hamper access to care and impose a heavy economic burden across sub‐Saharan Africa (SSA). Still, current user fee reduction and removal policies often target specific groups and services, leaving large sections of the population exposed to OOPE. Methods To estimate the magnitude and the determinants of OOPE for curative services in Burkina Faso, we used data from a household survey conducted in 24 districts between October 2013 and March 2014 (n = 7844). Given a context of medical pluralism, we purposely focused on total OOPE irrespective of type of care sought. We used a two‐part regression model to estimate determinants of OOPE. Results Nearly 60% of those who reported an illness episode incurred a positive expenditure, with an average amount of 9362.52 FRS CFA per episode (1 USD = 577.94 FRS CFA). The first model revealed that the probability of incurring a positive OOPE was positively associated with perceived illness severity (P < .001), hospitalization (P < .001), and negatively associated with age (P = .026), distance (P = .060), and poorest wealth quintile (P = .054). The second model revealed that the magnitude of OOPE was positively associated with age (P = .087), education (P = .025), being household head (P = .015), having a chronic comorbidity (P = .025), perceived illness severity (P = .029), and hospitalization (P < .001) and negatively associated with symptoms unlikely to lead to adverse outcomes if not attended to in time (P = .056). Conclusion Our findings indicate that OOPEs remain a problem in Burkina Faso and that broader spectrum policy reforms are urgently needed to ensure adequate financial protection.

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Section: Introductionmentioning

confidence: 99%

Determinants of individual healthcare expenditure: A cross‐sectional analysis in rural Burkina Faso

Nakovics

Brenner

Robyn

et al. 2019

Health Planning & Management

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“…Both the World Health Organization and the World Bank have recently called on the global community to universalize access to affordable health care within a generation (WHO and World Bank, 2017;Bloom et al, 2018). This movement has also reached the policy world, with several developing countries in Africa, Asia, and Latin America trying to expand access to health care among populations of lower socioeconomic status (Boerma et al, 2014;Atun et al, 2015;Reich et al, 2016), and with Obamacare becoming one of the key domestic policy debates in the US over the last decade (Cotlear et al, 2015;Reinhardt, 2017). While there is buy-in from the international community, national governments are faced with the challenge of implementation, which involves issues of design related to both equity and financial sustainability.…”

Section: Introductionmentioning

confidence: 99%

Does Universalization of Healthwork? Evidence from Health Systems Restructuring and Expansion in Brazil

2019

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“…We assume that within 5-year intervals, the duration of primary school, age-specific trends in coverage would have increased gradually. Gradual rollout is typical of at-scale programs in developing countries with numerous implementation, financing, and bureaucratic challenges 56 . However, in sensitivity analyses, we subject the assumption of a linear scale-up to an additional robustness check where we smooth MDM coverage using a log-linear process.…”

Section: Methodsmentioning

confidence: 99%

Intergenerational nutrition benefits of India’s national school feeding program

et al. 2021

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India has the world’s highest number of undernourished children and the largest school feeding program, the Mid-Day Meal (MDM) scheme. As school feeding programs target children outside the highest-return “first 1000-days” window, they have not been included in the global agenda to address stunting. School meals benefit education and nutrition in participants, but no studies have examined whether benefits carry over to their children. Using nationally representative data on mothers and their children spanning 1993 to 2016, we assess whether MDM supports intergenerational improvements in child linear growth. Here we report that height-for-age z-score (HAZ) among children born to mothers with full MDM exposure was greater (+0.40 SD) than that in children born to non-exposed mothers. Associations were stronger in low socioeconomic strata and likely work through women’s education, fertility, and health service utilization. MDM was associated with 13–32% of the HAZ improvement in India from 2006 to 2016.

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Going Universal in Africa

Cited by 16 publications

References 7 publications

Determinants of individual healthcare expenditure: A cross‐sectional analysis in rural Burkina Faso

Determinants of individual healthcare expenditure: A cross‐sectional analysis in rural Burkina Faso

Does Universalization of Healthwork? Evidence from Health Systems Restructuring and Expansion in Brazil

Intergenerational nutrition benefits of India’s national school feeding program

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