Health financing and family planning in the context of Universal Health Care: Connecting the discourse

Appleford, Gabrielle; RamaRao, Saumya

doi:10.31899/rh6.1021

Cited by 5 publications

(5 citation statements)

References 17 publications

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“…Service exemption schemes for MCH, such as those in Sahelian countries, may also fail to include family planning as part of a continuum of care. 10 , 18 Even when family planning is included in a benefits package or service exemption scheme, this may not translate to provision. A seven-country study of health insurance schemes 19 concluded that despite the formal inclusion of family planning services in the national benefits packages examined, actual integration of these services faced challenges, with implications for the availability of family planning services in practice.…”

Section: Resultsmentioning

confidence: 99%

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The inclusion of sexual and reproductive health services within universal health care through intentional design

Appleford¹,

RamaRao

Bellows

2020

Sexual and Reproductive Health Matters

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In this paper, we argue that how sexual and reproductive health (SRH) services are included in UHC and health financing matters, and that this has implications for universality and equity. This is a matter of rights, given the differential health risks that women face, including unwanted pregnancy. How traditional vertical SRH services are compensated under UHC also matters and should balance incentives for efficiency with incentives for appropriate provision using the rights-based approach to user-centred care so that risks of sub-optimal outcomes are mitigated. This suggests that as UHC benefits packages are designed, there is need for the SRH community to advocate for more than simple "SRH inclusion". This paper describes a practical approach to integrate quality of SRH care within the UHC agenda using a framework called the "5Ps". The framework emphasises a "systems" and "design" lens as important steps to quality. The framework can be applied at different scales, from the health system to the individual user level. It also pays attention to how financing and resource policies intended to promote UHC may support or undermine the respect, protection and fulfilment of SRH and rights. The framework was originally developed with a specific emphasis on quality provision of family planning. In this paper, we have extended it to cover other SRH services.

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Section: Resultsmentioning

confidence: 99%

“…Polity: why purchase The framework was originally developed with a specific emphasis on the quality provision of family planning. 9,10 In this paper, we have extended it to cover other SRH services. Following the framework (Table 1), we describe how the different elements of purchasing may influence quality of SRH care.…”

Section: Findings 5ps Frameworkmentioning

confidence: 99%

The inclusion of sexual and reproductive health services within universal health care through intentional design

Appleford¹,

RamaRao

Bellows

2020

Sexual and Reproductive Health Matters

Self Cite

View full text Add to dashboard Cite

show abstract

“…The WHO report has shown that accelerating UHC cannot be achieved without increasing financial protection and without inclusion of essential health services, which is also applicable to universal SRHR services ( 37 ). In many low-income countries, including Ethiopia, however, financing the SRHR services and others is still a major challenge for achieving universal SRHR services within the scheme of UHC, partly attributed to financial constraint.…”

Section: Srhr Services Included In the Current Ethiopian Financing An...mentioning

confidence: 99%

Universal Health Coverage Policy and Progress towards the Attainment of Universal Sexual and Reproductive Health and Rights Services in Ethiopia

Berhan

Ali²,

Tassew³

et al. 2022

Ethiop J Health Sci

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Critical interpretive analysis of literature review was applied to shed light on the status of universal access to Sexual and Reproductive Health and Rights (SRHR) and the progress towards Universal Health Coverage (UHC) in Ethiopia. Special emphasis was given to the determinations of the Ethiopian health policy frameworks to include comprehensive SRHR services in the UHC benefit package. Clinical services for pregnant women and newborn, abortion care, family planning, Female Genital Mutilation (FGM) complication treatment, Comprehensive Sexuality Education (CSE), and sexual health services are included in the national cost exempted services, but the latter three are not yet included in the health programs with defined objective and work plan. Capital intensive Sexual and Reproductive Health (SRH) services (such as infertility and reproductive cancers diagnosis and treatment) are not included in the UHC benefit package. Over the last two decades, a substantive progress is made in family planning service and maternal and child health, probably because they were taken as Millennium Development Goals (MDGs) indicators and have got better financial protection and political commitment. In order to include other SRHR services in the benefit package in due course and attain universal SRHR services without financial hardship in the Primary Health Care (PHC) setting, the domestic financing should be endorsed as a driving force. To make the multi-sectoral efforts towards achieving UHC and sustainable development goals (SDGs) complete, building resilient health systems through the humanitarian-development nexus for health systems strengthening in fragile setting should be equally prioritized, thereby leaving no one behind underserved.

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“…On family planning, Marshall 33 postulates that in some countries, religion plays a factor in government's choices of implementing certain family planning policies and reforms above others. Family planning may also be more frequently excluded given the high levels of donor dependency (especially for financing commodities) 34 and low cofinancing requirements. 35 36 Finally, information required to prioritising a wide range of interventions may not have been as widely available for older HBPs.…”

Section: 6mentioning

confidence: 99%

The journey to UHC: how well are vertical programmes integrated in the health benefits package? A scoping review

Regan¹,

Wilson

Chalkidou

et al. 2021

BMJ Glob Health

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BackgroundCountries are recommended to progressively work towards universal health coverage (UHC), and to make explicit choices regarding the expansion of priority services. However, there is little guidance on how to manage the inclusion of vertical programmes, funded by external partners, in health benefits packages (HBP) in low and middle-income countries (LMICs).ObjectiveWe conducted a scoping review to map the inclusion of six vertical programmes (HIV, tuberculosis, malaria, maternal and child health, contraceptives, immunisation) in 26 LMICs.MethodsWe identified 26 LMICs with an HBP that was not aspirational (eg, with evidence of implementation or funding). For each HBP, we collected information on the corresponding UHC scheme, health financing at the time of establishment, revisions since inception and entitlements. For each vertical programme, we developed a list of tracer interventions based on the Disease Control Priorities 3 and the 100 Core Health Indicators List. We then used this list of tracer interventions to map the coverage of the six vertical programmes.ResultsThe review shows that there is no common starting point for countries embarking into UHC. Some HBPs were almost three decades old. Whole package revisions are rare. The inclusion of vertical programme does not follow a given pattern based on health financing indicators or country’s income group. Maternal child health services are the most often included and family planning the least. Six countries in our sample covered all vertical programmes, while one covered only one of six.ConclusionsThis review has shown that there has been a long history of countries facing this question and we have provided the first mapping of inclusion of vertical programmes in UHC. The results of the mapping can inform decisions in countries embarking in UHC.

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Health financing and family planning in the context of Universal Health Care: Connecting the discourse

Cited by 5 publications

References 17 publications

The inclusion of sexual and reproductive health services within universal health care through intentional design

The inclusion of sexual and reproductive health services within universal health care through intentional design

Universal Health Coverage Policy and Progress towards the Attainment of Universal Sexual and Reproductive Health and Rights Services in Ethiopia

The journey to UHC: how well are vertical programmes integrated in the health benefits package? A scoping review

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