Improving equity in the distribution and financing of health services in Mauritius, a small island state with deeply rooted welfare state standards

Nundoochan, Ajoy

doi:10.1136/bmjgh-2021-006757

Cited by 8 publications

(6 citation statements)

References 25 publications

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“…Despite these challenges, the overall healthcare financing system in Mauritius is relatively proportional, with progressive direct taxes and voluntary insurance. The regressivity of OOP payments is attributed by the authors to patients' irrational preference for purchasing patented drugs instead of free generics [35,49].…”

Section: Discussionmentioning

confidence: 99%

“…According to a study conducted by Nundoochan in Mauritius, OOP expenditures remain relatively high and significant among the poorest segments of the population, particularly in the absence of social health insurance [35]. This situation is further exacerbated by a widespread perception of low service quality in the public sector.…”

Section: Europe America and Africamentioning

confidence: 99%

“…Attributes of the studies encompassed within the review[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35].…”

mentioning

confidence: 99%

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Inequalities in Out-of-Pocket Health Expenditure Measured Using Financing Incidence Analysis (FIA): A Systematic Review

Shaltynov,

Jamedinova,

Semenova

et al. 2024

Healthcare

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Government efforts and reforms in health financing systems in various countries are aimed at achieving universal health coverage. Household spending on healthcare plays a very important role in achieving this goal. The aim of this systematic review was to assess out-of-pocket health expenditure inequalities measured by the FIA across different territories, in the context of achieving UHC by 2030. A comprehensive systematic search was conducted in the PubMed, Scopus, and Web of Science databases to identify original quantitative and mixed-method studies published in the English language between 2016 and 2022. A total of 336 articles were initially identified, and after the screening process, 15 articles were included in the systematic review, following the removal of duplicates and articles not meeting the inclusion criteria. Despite the overall regressivity, insurance systems have generally improved population coverage and reduced inequality in out-of-pocket health expenditures among the employed population, but regional studies highlight the importance of examining the situation at a micro level. The results of the study provide further evidence supporting the notion that healthcare financing systems relying less on public funding and direct tax financing and more on private payments are associated with a higher prevalence of catastrophic health expenditures and demonstrate a more regressive pattern in terms of healthcare financing, highlighting the need for policy interventions to address these inequities. Governments face significant challenges in achieving universal health coverage due to inequalities experienced by financially vulnerable populations, including high out-of-pocket payments for pharmaceutical goods, informal charges, and regional disparities in healthcare financing administration.

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Section: Discussionmentioning

confidence: 99%

Section: Europe America and Africamentioning

confidence: 99%

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Inequalities in Out-of-Pocket Health Expenditure Measured Using Financing Incidence Analysis (FIA): A Systematic Review

Shaltynov,

Jamedinova,

Semenova

et al. 2024

Healthcare

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“…Arcaya et al systematically reviewed the methodological, theoretical, and philosophical aspects of health inequalities, which provides scientific guidance for the study of health ( 11 ). To better assess the equity of healthcare service, a series of indicators, such as the Kakwani index ( 12 , 13 ), the concentration index (CI) ( 14 , 15 ), and the horizontal inequity (HI) ( 16 , 17 ), are introduced to measure inequity in healthcare resource utilization and determine the contribution of different influences to the overall unfairness. Moreover, machine learning techniques are increasingly used to optimize health and social systems to ensure equality in healthcare delivery outcomes, performance, and resource allocation ( 18 , 19 ).…”

Section: Literature Reviewmentioning

confidence: 99%

Spatio-Temporal Disparity and Driving Forces of the Supply Level of Healthcare Service in the Yangtze River Delta

2022

Front. Public Health

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The equalization of healthcare supply is not only related to the people's need for a better life, but can also provide a strong guarantee for the high-quality and sustainable development of the Yangtze River Delta integration. By using exploratory spatial analysis techniques, this study analyzed the spatio-temporal evolution characteristics and heterogeneous influence effects of the supply level of healthcare service in the Yangtze River Delta from 2007 to 2019. It was found that the supply level of healthcare service in the Yangtze River Delta had improved significantly. The differences in the supply level of healthcare service between cities had tended to narrow without polarization, and the supply level of healthcare service generally showed a high spatial pattern in the south delta and low spatial pattern in the north delta. The higher the supply level of healthcare service was, the weaker the interannual variability was. The supply level of healthcare service in the Yangtze River Delta region presented obvious spatial association and differentiated tendency of local high and low spatial clusters. The relative length and curvature of the supply level of healthcare service in the Yangtze River Delta generally presented a spatial pattern with low values in the northeast and high values in the southwest. Population density and urban-rural income gap generally exhibited negative spatio-temporal impact on the supply level of healthcare service across most cities. On the other hand, urbanization level and per capita disposable income generally had positive spatio-temporal impact on the supply level of healthcare service across most cities. Per capita gross domestic product (GDP) showed an increasingly positive spatio-temporal impact on the supply level of healthcare service across most cities. While per capita fiscal expenditure exhibited significantly negative impact on the supply level of healthcare service across most cities in space.

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“…There are 13 clinics with inpatient and outpatient services operating in the private sector. In addition, there are six dialysis clinics, including those in private clinics [27].…”

Section: Introductionmentioning

confidence: 99%

An assessment of the performance of the national health research system in Mauritius

Musango

Nundoochan²,

Ramful

et al. 2023

BMC Health Serv Res

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Background The goal of universal health coverage (UHC) is that every individual has access to high-quality health services without running the consequences of financial hardship. The World health report 2013 "Research for universal health coverage" states a performant National Health Research Systems (NHRS) can contribute by providing solutions to challenges encountered in advancing towards UHC by 2030. Pang et al. define a NHRS as the people, institutions, and activities whose primary aim is to generate and promote utilization of high-quality knowledge that can be used to promote, restore, and/or maintain the health status of populations. The WHO Regional Committee for Africa (RC) adopted a resolution in 2015 urging member states to strengthen their NHRS to facilitate production and utilization of evidence in policy development, planning, product development, innovation, and decision-making. This study aimed to calculate NHRS barometer scores for Mauritius in 2020, identify the gaps in NHRS performance, and recommend interventions for boosting the Mauritius NHRS in the pursuit of UHC. Methods The study used a cross-sectional survey design. A semi-structured NHRS questionnaire was administered and complemented with a review of documents archived in pertinent Mauritius Government Ministries, universities, research-oriented departments, and non-governmental organizations websites. The African NHRS barometer developed in 2016 for countries to monitor the RC resolution implementation was applied. The barometer consists of four NHRS functions (leadership and governance, developing and sustaining resources, producing and utilizing research, financing research for health [R4H]), and 17 sub-functions, e.g., existence of a national policy on research for health (R4H), presence of a Mauritius Research and Innovation Council (MRIC), existence of knowledge translation platform. Results In 2020, Mauritius had an overall average NHRS barometer score of 60.84%. The four NHRS functions average indices were 50.0% for leadership and governance, 77.0% for developing and sustaining resources, 52.0% for producing and utilizing R4H, and 58.2% for financing R4H. Conclusion The performance of NHRS could be improved through the development of a national R4H policy, strategic plan, prioritized agenda, and national multi-stakeholder health research management forum. Furthermore, increased funding for the NHRS may nurture the human resources for health research capacities, hence the number of pertinent publications and health innovations.

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Improving equity in the distribution and financing of health services in Mauritius, a small island state with deeply rooted welfare state standards

Cited by 8 publications

References 25 publications

Inequalities in Out-of-Pocket Health Expenditure Measured Using Financing Incidence Analysis (FIA): A Systematic Review

Inequalities in Out-of-Pocket Health Expenditure Measured Using Financing Incidence Analysis (FIA): A Systematic Review

Spatio-Temporal Disparity and Driving Forces of the Supply Level of Healthcare Service in the Yangtze River Delta

An assessment of the performance of the national health research system in Mauritius

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