The Role of Digital Strategies in Financing Health Care for Universal Health Coverage in Low- and Middle-Income Countries

Meessen, Bruno

doi:10.9745/ghsp-d-18-00271

Cited by 39 publications

(41 citation statements)

References 27 publications

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“…From a UHC perspective, NHIF coverage may need to be extended to the informal sector by probably making it compulsory rather than voluntary. Voluntary health insurance may not be a route to achieve UHC . Compulsory means that it may have to not only cover the formally employed but all residents of a country.…”

Section: Discussionmentioning

confidence: 99%

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Mobile money use and social health insurance enrolment among rural dwellers outside the formal employment sector: Evidence from Kenya

Colbourn

Seal

2019

Health Planning & Management

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Background:The study set out to explore whether mobile money use (mobile phone-based financial services) increased the probability of rural dwellers outside the formal employment sector of being enrolled in Kenya's social health insurance, the National Hospital Insurance Fund (NHIF). Methods:We used data from the 2015 FinAccess Household Survey and analysed responses of 4282 rural individuals outside the formal employment sector. Probit and bivariate probit models were used and adjusted for mobile phone ownership, sex, age, age-squared, education, wealth quintile, bank account use, informal group membership, occupation, and health shocks. Results:We found that 16.26% (95% CI, 14.58% to 18.10%) of mobile money users had NHIF cover as compared with 2.44% (95% CI, 1.83% to 3.23%) of nonusers. Importantly, mobile money use increased the probability of being enrolled in NHIF by 4.6% (95% CI, 2.1% to 7.1%) after controlling for confounders. Access to mobile money was associated with reduced travel time and lower transport costs, which are likely to be key mechanisms for increasing NHIF enrolment.Conclusion: By lowering transport costs and saving travel time, mobile money provides an easy means to pay social health insurance premiums thus incentivising its uptake among rural people outside of formal employment.

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Section: Discussionmentioning

confidence: 99%

“…One of the main challenges with voluntary health insurance is high transaction costs for enrolling and paying premiums especially in sparsely populated rural areas . Approximately 74% of the Kenyan population reside in rural areas while 40.1% of rural dwellers live in poverty .…”

Section: Introductionmentioning

confidence: 99%

Mobile money use and social health insurance enrolment among rural dwellers outside the formal employment sector: Evidence from Kenya

Colbourn

Seal

2019

Health Planning & Management

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“…In order to be strategic, purchasers should focus on (i) identifying the best value, (ii) selecting the right providers, (iii) designing smart contracts, (iv) efficiently enforcing such contracts. Under this, the role of provider payment mechanisms and the best use of information (through data, digital solutions and learning - [8]) are deemed to be essential to support strategic purchasing. The potential for strategic purchasing to also reduce fragmentation is acknowledged i .…”

Section: (Continued From Previous Page)mentioning

confidence: 99%

Results-based financing as a strategic purchasing intervention: some progress but much further to go in Zimbabwe?

Witter

Chirwa

Chandiwana

et al. 2020

BMC Health Serv Res

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Background: Results-Based Financing (RBF) has proliferated in the health sectors of low and middle income countries, especially those which are fragile or conflict-affected, and has been presented by some as a way of reforming and strengthening strategic purchasing. However, few if any studies have empirically and systematically examined how RBF impacts on health care purchasing. This article examines this question in the context of Zimbabwe's national RBF programme. Methods: The article is based on a documentary review, including 60 documents from 2008 to 2018, and 40 key informant (KI) interviews conducted with international, national and district level stakeholders in early 2018 in Zimbabwe. Interviews and analysis of both datasets followed an existing framework for strategic purchasing, adapted to reflect changes over. Results: We find that some functions, such as assessing service infrastructure gaps, are unaffected by RBF, while others, such as mobilising resources, are partially affected, as RBF has focused on one package of care (maternal and child health services) within the wider essential health care, and has contributed important but marginal costs. Overall purchasing arrangements remain fragmented. Limited improvements have been made to community engagement. The clearest changes to purchasing arrangements relate to providers, at least in relation to the RBF services. Its achievements included enabling flexible resources to reach primary providers, funding supervision and emphasising the importance of reporting.(Continued on next page)

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“…The focus group advocated for removal of all forms of authorization while Onoka et al, (2016) findings concluded on strict adherence to the NHIS operational guideline and penalty for defaulting HMOs. In the course of finding solutions to the problem of moral abuse in the demand for services, Meesen (2018) showed that the management of the insurance scheme has been made more efficient through the use of digital technologies that support enrolment, referral, renewal, claims and feedback. The insurance management information system (IMIS) specifically addresses the insurance challenges in both the formal and informal sector and is flexible to meet different user needs and technical requirement.…”

Section: Discussionmentioning

confidence: 99%

Strategies to Improve Demand for Services in the Social Health Insurance Programme: Nigerian Enrollee Perspective

Ikechukwu

Okoronkwo²,

Nwonwu³

et al. 2020

IJSSR

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Globally, the World Health Organization has championed the introduction of various forms of health insurance as a means of improving the utilization of quality healthcare service which is targeted at achieving universal health coverage. Unfortunately, the operations of the Social Health Insurance Programme (SHIP) have witnessed inefficiencies in the demand for healthcare services as a result of moral hazard and this is evidenced by the non-achievement of set-out objective of the programme in Nigeria. Design/Methodology: The study adopted a qualitative approach which comprised of 3 focus group discussions (N=24). Key informants were purposely selected for the focus group discussion from three (3) purposively selected hospitals, one from each categorized type of facility. Content analysis was adopted and further analysis was achieved with the aid of Nvivo 11 software, which coded and categorized nodes into themes. Results: The focus group participants relayed their experiences in the programme which includes poor identification system, choice of only one provider except on emergency, benefit package not being comprehensive which has enabled moral hazard and suggested ways to improve it. Conclusions: Most of the enrollees do not show diligence in areas of demand for services and these were shown to emanate principally from economic issues around the enrollees desire to utilize the premium paid thereby leading to moral abuse. Therefore, certain measures need to be put in place so as to curtail observed market failures in the SHIP programme.

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The Role of Digital Strategies in Financing Health Care for Universal Health Coverage in Low- and Middle-Income Countries

Cited by 39 publications

References 27 publications

Mobile money use and social health insurance enrolment among rural dwellers outside the formal employment sector: Evidence from Kenya

Mobile money use and social health insurance enrolment among rural dwellers outside the formal employment sector: Evidence from Kenya

Results-based financing as a strategic purchasing intervention: some progress but much further to go in Zimbabwe?

Strategies to Improve Demand for Services in the Social Health Insurance Programme: Nigerian Enrollee Perspective

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